CDN/US Covid-related political discussion

[KevinB]

No.

Easier actually.

Unlike equalization, health care is a provincial responsibility, funded by the federal government. Beyond needing to provide funding to have not provinces to ensure equal levels of care across the nation, there is nothing preventing the feds from playing hardball and withholding federal funding to provinces for healthcare if they do not agree with reform.

The problem is the Fed Gov...

 

[Altair]

The problem is the Fed Gov...

Yes, all federal parties have committed to tossing more good money at the problem without fixing what was wrong with it in the first place.

 

[Brad Sallows]

(Except the USA which spends a lot more as a percentage of GDP on healthcare, largely because of the profit factor baked into their system)

Health care costs in the US are primarily payroll costs. Unless personal income is deemed "profit" (a definition I'd be happy to adopt so that the moral posturing nonsense over "non-profit" can be shelved forever), "profit factor" isn't "largely" responsible. What makes the US an outlier is that most countries put into place some kinds of public health care scheme before the high inflation period of the 1970s, and the US did not. They were able to contain cost growth, while the US was not. To effectively contain costs, the US would need to cut compensation across nearly all health care professions and occupations. That is very low on any list of politically feasible options.

 

[Brad Sallows]

there is nothing preventing the feds from playing hardball and withholding federal funding to provinces for healthcare if they do not agree with reform.

Sure, except the hardball is also being played with voters.

 

[Brad Sallows]

Maybe this thread should be split into a Public vs. Private Healthcare discussion.

Yes and no. Among the people who are paying a price for others' COVID safety are those who have not been getting timely life-saving diagnoses and treatments (and I mean because of general draw-downs in activity, not because of temporary surges of unvaxed patients). I'm waiting to see whether the moral crusade will extend to extraordinary effort and funding to make up for the deficit of health care. Or do they just get kicked to the curb as collateral damage while all the "Think of X/It'll save a life!" posturing goes back into storage.

 

[Altair]

Maybe this thread should be split into a Public vs. Private Healthcare discussion.

Except its not.

Firstly, its not private versus public, its how private can help public.

Secondly, in regards to covid, we are being hammered with lockdowns and restrictions simply due to how poorly structured our healthcare system is, especially in regards to ICU capacity.

The rationing of care in Alberta has less to do with covid itself and more to do with a healthcare system, the best this country has to offer, being less able to deal with a surge in cases than the poorest of US states, Alabama, Louisiana, ect

 

[PMedMoe]

Oh well. Just means there's another thread I can ignore.

 

[Weinie]

This argument about the Canadian health care system ability to deal with a pandemic is ridiculous.

Provinces rely on historical data to construct their health care approach. ICU beds were modeled on data that they have compiled over decades: CFO's, who hold the reins, have analyzed and provided those numbers and provincial bureaucrats have dutifully endorsed them. It is, and always was, a numbers game. To now state that it is anything else is disingenuous or navel-gazing. The calculus is that people and economies are suffering and dying.

Perhaps it will have similar ramifications as the OPEC crisis in 1973. It was a world wide shock. As a consequence, global economies adapted.

 

[Altair]

This argument about the Canadian health care system ability to deal with a pandemic is ridiculous.

Provinces rely on historical data to construct their health care approach. ICU beds were modeled on data that they have compiled over decades: CFO's, who hold the reins, have analyzed and provided those numbers and provincial bureaucrats have dutifully endorsed them. It is, and always was, a numbers game. To now state that it is anything else is disingenuous or navel-gazing. The calculus is that people and economies are suffering and dying.

Perhaps it will have similar ramifications as the OPEC crisis in 1973. It was a world wide shock. As a consequence, global economies adapted.

Does it not seem a tad bit more ridiculous that most other western nations can handle a surge in ICU admissions but in Canada the second that we start approaching 4-5 per 100,000 the system begins to collapse?

Meanwhile most other western nations are spending around the same as Canada in terms of money going to healthcare.

 

[Weinie]

Does it not seem a tad bit more ridiculous that most other western nations can handle a surge in ICU admissions but in Canada the second that we start approaching 4-5 per 100,000 the system begins to collapse?

Meanwhile most other western nations are spending around the same as Canada in terms of money going to healthcare.

I don't get treated in (insert Western nation) health care system.

You get (unions recalcitrant demands, an aging population, angst among all political parties to discuss the inclusion of private options) what you pay for.

 

[Altair]

I don't get treated in (insert Western nation) health care system.

No reason to not examine and recognize best practices.

You get (unions recalcitrant demands, an aging population, angst among all political parties to discuss the inclusion of private options) what you pay for.

Except the Germans, the French the Italians are paying the same as Canada while receiving vastly superior results. This should be considered nothing less than a national disgrace that covid 19 has brought to light.

 

[Brad Sallows]

Please quantify "vastly superior results". Exclude all effects which might be due to healthier lifestyle (eg. less obesity, more activity).

 

[Colin Parkinson]

This argument about the Canadian health care system ability to deal with a pandemic is ridiculous.

Provinces rely on historical data to construct their health care approach. ICU beds were modeled on data that they have compiled over decades: CFO's, who hold the reins, have analyzed and provided those numbers and provincial bureaucrats have dutifully endorsed them. It is, and always was, a numbers game. To now state that it is anything else is disingenuous or navel-gazing. The calculus is that people and economies are suffering and dying.

Perhaps it will have similar ramifications as the OPEC crisis in 1973. It was a world wide shock. As a consequence, global economies adapted.

Case in point was the woefully inadequate PPE supply, the system is run on a barebones rationing system and not configured for such events. I have no doubt they were warned and ignored by CFO's and bureaucrats. Having a public/private system like Malaysia gives the people flexibility in treatment options and a certain amount flexibility in the amount of care that can be given.

 

[lenaitch]

Case in point was the woefully inadequate PPE supply, the system is run on a barebones rationing system and not configured for such events. I have no doubt they were warned and ignored by CFO's and bureaucrats. Having a public/private system like Malaysia gives the people flexibility in treatment options and a certain amount flexibility in the amount of care that can be given.

Ontario actually had an emergency stockpile of PPE (I think as a result of SARS but I'm not sure) but a lot of it was found to be unusable. I don't know whether certain items actually had expiry dates, but a lot of it was simply found to be rotten (elastics, rubber, etc.). It's takes more than simply buying a bunch of stuff and shoving boxes in a warehouse for several years.

 

[Colin Parkinson]

Ontario actually had an emergency stockpile of PPE (I think as a result of SARS but I'm not sure) but a lot of it was found to be unusable. I don't know whether certain items actually had expiry dates, but a lot of it was simply found to be rotten (elastics, rubber, etc.). It's takes more than simply buying a bunch of stuff and shoving boxes in a warehouse for several years.

Very true, it requires management and there are ways and means to do that.

 

[Altair]

Please quantify "vastly superior results". Exclude all effects which might be due to healthier lifestyle (eg. less obesity, more activity).

Certainly.

Lower ER wait times, quicker access to specialists, lower wait times for elective surgery, more physicians per 100,000, more hospital beds per 100,000, more ICU beds per 100,000, less hospital mortality rates.

According to the WHO https://www.who.int/healthinfo/paper30.pdf

France is ranked first.

Italy second.

UK is 18th

Canada is 30th.

Out of 11 major economies, the Canadian system came in 10th.

Canada's health system ranked second last among 11 countries: report

A new report has ranked Canada's health system second last, ahead of the United States, when comparing 11 high-income countries.

www.google.com

 

[SeaKingTacco]

Very true, it requires management and there are ways and means to do that.

It is actually pretty straight forward.

Constantly buy PPE over time, which spreads out the expiry dates. Track each box/carton/container while stored!

When each box of PPE gets close to expiry (say- 10% remaining shelf life), ship it to hospitals to get consumed. Or send it to the third world as foreign aid.

Beyond the initial purchase costs to carry a bigger stock, it actually only really costs the system some people to act as warehouse custodians.

 

[The Bread Guy]

.... it actually only really costs the system some people to act as warehouse custodians.

Not as sexy as "lookit what we did!", but vital.

 

[Brad Sallows]

"This paper has introduced a new way of measuring the efficiency of health systems.Unlike previous work in this area, we have specifically defined the broad set of goals of the health system such as responsiveness (both level and distribution), fair financing, and health inequality, in addition to the more traditional goal of population health. "

"We made up own own criteria". Reminds me of the way the Economist measures "democracy".

I was looking for results, meaning health care outcomes, not an arbitrary aggregate measure of efficiency. Nevertheless, by their chosen measures, many other countries are superior (albeit not "vastly"). No data in the report, so I can't tell which ways the conclusions might be cooked.

The US has a starkly two-tier (results) system because of the gap between what people with private insurance get and what people with Medicaid get. Nothing to change what I already know: quality of health care in the US is generally outstanding, but health insurance stands in the way.

 

[Colin Parkinson]

It is actually pretty straight forward.

Constantly buy PPE over time, which spreads out the expiry dates. Track each box/carton/container while stored!

When each box of PPE gets close to expiry (say- 10% remaining shelf life), ship it to hospitals to get consumed. Or send it to the third world as foreign aid.

Beyond the initial purchase costs to carry a bigger stock, it actually only really costs the system some people to act as warehouse custodians.

You buy in lots and make those lots available for purchase at a reduced cost to Health authorities or ear mark them for disaster relief before they expire. You be best hiring a company like Amazon to design your system and warehouse to ensure a good flow of new and outgoing supplies. the first couple of years will be messy, but afterwards you have good sources to acquire and dispose of the stock.