Health care costs: putting our worries in context

Why there’s no need to panic about the quality of care in Canada

by John Geddes

Worry about the cost of Canadian health care is growing among those who pay attention to how governments pay for programs, which is a good thing. But I think we should get straight on the strengths of the system before we start arguing in earnest about how to reform it.

The Organization for Economic Co-operation and Development set a grave tone earlier this fall by warning that Canada’s public health spending is unsustainable; among those who took note was former prime minister Brian Mulroney. But the Paris-based OECD was only echoing earlier pleas from the likes of former B.C. finance minister Carole Taylor and former Bank of Canada governor David Dodge, who have both called for a candid, national conversation about containing the rising costs of care.

Indeed, that debate must begin soon if serious ideas are to be hammered out in time for a new agreement between Ottawa and the provinces on health transfers when their current deal runs out in 2014.

My own inclination is to view the public insurance model as basically sound. Still, I can see that the provinces are struggling to pay for care that often falls short of what we’d like. So, in a bid to jar myself into the more open mindset Taylor and Dodge encourage, I figured I should consider the arguments coming from those with the opposite bias.

Fortunately, the Fraser Institute seems to offer up the very thing: a report published just last month called Value for Money from Health Insurance Systems in Canada and the OECD, by Brett Skinner and Mark Rovere. As you’d expect from the right-leaning institute, their report presents a challenge to those of us who think well of the Canada Health Act and all it has wrought.

“Despite being ranked as the sixth most expensive health insurance system in the world in 2007,” Skinner and Rovere write, “Canada ranked below the majority of the other 27 OECD countries in almost every indicator of medical resource availability and the ouput of medical services for which comparable data were available.”

That’s a pretty disturbing overview—very expensive, lousy outcomes. But look a little closer. Skinner and Rovere list 18 indicators based on OECD data, all concerning diagnostic or surgical procedures, ranging from the number of MRIs per million people to the number of appendectomies per 100,000.

In fact, Canada performed better than the OECD majority on seven of those statistics, including the number of knee replacements and the number of bypass surgeries. To me, scoring below average in 11 of the 18 categories doesn’t back up the claim that Canada fell short “in almost every indicator.”

More important, though, is what these indicators actually indicate. It’s probably significant, for example, that Canada has fewer curative care beds per capita than most OECD countries (although we have more than the usually well-regarded Swedes and Finns), but should we really worry about performing fewer tonsillectomies than the OECD average?

To me, the grab bag of procedures listed by the Fraser Institute as indicators of value for money seem a strange mixture of the evidently significant and the seemingly irrelevant. I was surprised that the OECD would choose this particular list of benchmarks for the quality of health systems.

But then I found out the OECD does no such thing. I looked up the OECD’s own report Health At A Glance 2009, and turned to the chapter conveniently titled “Quality of Care.” The chapter expressly sets out to provide some guidance when it comes to answering this question: “Which areas of the health care system are providing value-for-money and which show opportunities for performance improvement?”

Unlike the Fraser Institute in its “value for money” assessment, the OECD’s “Quality of Care” chapter does not put much stock in procedures-per-capita numbers. Instead, it looks at 11 indicators, focusing on factors like avoidable deaths in hospital and delivery of preventive measures.

Canada scores better than the OECD average on eight of the 11 indicators. On two indicators, the Canadian outcome is mixed. On just one, Canada scores worse than the OECD average. It doesn’t take long to look at the tables, but here’s a brief summary.

— The sole category where Canada clearly does worse than the OECD average is in-hospital fatalities after strokes.

— The story is mixed for Canada on diabetes: slightly higher than average acute diabetes complication rates, but lower than average rates of amputations caused by diabetes. As well, on early childhood vaccination rates, Canada’s story is split: better than the average on measles, but worse on hepatitis B.

— Canada performs better than the OECD average in avoidable admissions for asthmas and bronchitis; on avoidable admissions for heart failure and high blood pressure; on deaths from heart attacks in hospitals; on unplanned hospital readmissions for mental disorders; on screening for cervical cancer; on mammography; on survival rates for cervical cancer and colorectal cancer; and on getting senior citizens their flu shots.

It would be foolish, of course, to argue that we should all relax just because Canada scores so well compared to similar advanced nations according to nearly all of the OECD’s quality-of-care indicators. Provinces nonetheless face escalating costs that are likely to worsen as the population ages. Individuals still feel justifiably annoyed when they have trouble finding a family doctor or wait for hours in an emergency room.

But let’s not go into this complex debate in an ill-informed panic over the basic standard of health service Canadian are now getting for their tax dollars. Based on the reasonable indicators chosen by the OECD for the purpose of making international comparisons, care here is better than average pretty much across the board.




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Health care costs: putting our worries in context

  1. I have yet to see a proposal for how such a "national, candid conversation" on the costs of health care could actually take place.

    I am not convinced that we will ever have a reasonable *public* debate on how best to allocate public resources, the issues are far too complex for most people to get their heads around. I'm also cynical about leaving it to the *experts* as they all seem to have a narrow perspective or vested interest.

    • Regular people like me are too stupid to figure it out, and the smart people are too sneaky to implement a good system.

      Damn it!

  2. I have yet to see a proposal for how such a "national, candid conversation" on the costs of health care could actually take place.

    I am not convinced that we will ever have a reasonable *public* debate on how best to allocate public resources, the issues are far too complex for most people to get their heads around. I'm also cynical about leaving it to the *experts* as they all seem to have a narrow perspective or vested interest.

  3. One of the things about being an average citizen is the lack of capacity – in time, training or inclination – to assess complex studies from an objective point of view. I am sure someone relying on the Fraser Institute's review would read it and come to a probable conclusion, based on the assumption the FI was doing its job in good faith.

    Your review demonstrates that the FI may not have done their review well. Or does it? Maybe you have applied some of you own sleight of hand to influence my opinion your way. Without the time, inclination or training to do the basic research myself on this and the literally dozens of topics discussed here and elsewhere on a daily basis, how can I possibly tell?

    Is it possible we have all become so numbed by this kind of intellectual hocus pocus that we just shrug and accept that just about everyone writing about something has an axe to grind and is willing to spin it out of proportion?

    If so, is it any wonder cynicism is so prevalent and voter turnout is so low? How can we insist on a higher standard?

    • When has the Fraser Institute done anything in good faith?

      Have the released where they get their funding?

      • To be honest, my point wasn't to focus on the Fraser Institute or to imply one side or institution or media outlet is holier or more evil than another. As far as I am concerned, there's plenty of shame to go around.

        The ad hominem dismissal of the FI implied in your rhetorical question is symptomatic of most "think tanks", political parties, media outlets, foundations, you name it. As news consumers we are inundated with bogus interpretations of data foisted on us by every part of the political spectrum and breathlessly reported by media untrained and uninterested in parsing the truth from the fiction.

        • To my mind, we–the engaged average citizen–must work together. You are quite right that we all don't have time to investigate every report that comes out from everyone to determine if they skewed the facts–as they seem to do almost anytime somebody looks. And yes, we have to look at the individual (like Geddes) to determine if in fact HE skewed the facts. But if we got together, Liberals, Conservatives, NDPs, and had one from each party look at this thing together, one from each party look at that thing together, the biases would cancel themselves out, and we'd probably come up with something fairly near reality.

          The thing is, that takes organization and nobody wants to trust anybody to even do that. We all talk about working together, but we don't really mean it. This is supposed to be what Parliamentary committees do. But now I can understand why they are so often dysfunctional.

      • Fraser institute methodology:

        first you take your preconcieved theory. Add a dash of cherry picked facts, a smidgin of pure BS and voila, you have homemade simplistic pie. Be warned however, if undercooked it may turn out half baked.

  4. One of the things about being an average citizen is the lack of capacity – in time, training or inclination – to assess complex studies from an objective point of view. I am sure someone relying on the Fraser Institute's review would read it and come to a probable conclusion, based on the assumption the FI was doing its job in good faith.

    Your review demonstrates that the FI may not have done their review well. Or does it? Maybe you have applied some of you own sleight of hand to influence my opinion your way. Without the time, inclination or training to do the basic research myself on this and the literally dozens of topics discussed here and elsewhere on a daily basis, how can I possibly tell?

    Is it possible we have all become so numbed by this kind of intellectual hocus pocus that we just shrug and accept that just about everyone writing about something has an axe to grind and is willing to spin it out of proportion?

    If so, is it any wonder cynicism is so prevalent and voter turnout is so low? How can we insist on a higher standard?

    • West coast? Good article though. I've never even heard of Dr Evans. I wonder why the FI didn't ask him for advise for their 'report'?

    • West coast? First time i've heard of Winnipeg being "west coast"…

      • Winnipeg hasn't been in the West since the Renegades folded. :)

      • Is there any place in the country that is further from a coast?

        • Manitoba has a coast sourstud. Have you ever heard of Hudson Bay?

          Other directions for the geographically challenged. Get in your car, put on the radio and wait for the Tragically Hip to come on: "The 100th meridian, where the great plains begin!"

          • Winnipeg and Manitoba aren't really the same thing.

    • Geez … doesn't anybody read? UBC, where Dr. Evans works, is somewhere west of
      Winnipeg.
      And, Dr. Evans, along with Raisa Deber at UofT, and Dr. Michael Rachlis have done
      more actual work on health care systems than all the interchangeable ideologues
      combined …. worldwide.

      • On the plus side we learned that Manitoba has a coast.

  5. You are so a communist!

  6. You are so a communist!

  7. When has the Fraser Institute done anything in good faith?

    Have the released where they get their funding?

  8. West coast? Good article though. I've never even heard of Dr Evans. I wonder why the FI didn't ask him for advise for their 'report'?

  9. West coast? First time i've heard of Winnipeg being "west coast"…

  10. To be honest, my point wasn't to focus on the Fraser Institute or to imply one side or institution or media outlet is holier or more evil than another. As far as I am concerned, there's plenty of shame to go around.

    The ad hominem dismissal of the FI implied in your rhetorical question is symptomatic of most "think tanks", political parties, media outlets, foundations, you name it. As news consumers we are inundated with bogus interpretations of data foisted on us by every part of the political spectrum and breathlessly reported by media untrained and uninterested in parsing the truth from the fiction.

  11. It may sound a tad nutbars, but I think that Canada desperately needs to have a high-profile, First-Ministers Conference hosted by the Premiers, their provincial Finance Ministers, and their provincial Health Ministers. I think this needs to be done whether the Federal Government sends a delegation or not – in order for the issue to be taken seriously, those in charge of Healthcare need to start working comprehensively. Big questions need to be posed and answered.

    Have any of the provinces found any means whatsoever to save on costs in any departments? Can these hypothetical savings be implemented in other provinces?

    These are just two solid examples out of dozens of possible, pertinent questions that could, and frankly should, be asked in a public setting. Hopefully, this would bypass the rigmarole the current federal minority parliament can present. This should be driven by the provinces, not the feds.

    • Hmmmm, some sort of Council, you mean? Involving members all across the Federation? A bold idea, to be sure, but whatever would you call it?

  12. It may sound a tad nutbars, but I think that Canada desperately needs to have a high-profile, First-Ministers Conference hosted by the Premiers, their provincial Finance Ministers, and their provincial Health Ministers. I think this needs to be done whether the Federal Government sends a delegation or not – in order for the issue to be taken seriously, those in charge of Healthcare need to start working comprehensively. Big questions need to be posed and answered.

    Have any of the provinces found any means whatsoever to save on costs in any departments? Can these hypothetical savings be implemented in other provinces?

    These are just two solid examples out of dozens of possible, pertinent questions that could, and frankly should, be asked in a public setting. Hopefully, this would bypass the rigmarole the current federal minority parliament can present. This should be driven by the provinces, not the feds.

  13. Living in France right now, I've noticed two strengths in our system: 1- You show your provincial health card, you get checked, you don't pay a dime. I find it quite ludicrous that in France you must pay the doctor, who fills out a form that you then must fill out the rest, and then mail it to your social security company and wait for a refund. So much bureaucracy…
    2- I really appreciate the large amount of walk-in clinics with several having quite the flexible hours (ie. some open 7 days per week, some till late at night). I know you can wait for several hours (unless you get there when it opens!) before getting any service, but I enjoy having the ability to simply walk in and wait, as opposed to having to make an appointment with a doctor in France. Having said that, in my experience, you can usually get appointments the next day… But on-the-go healthcare appeals to me, what can I say?

  14. Living in France right now, I've noticed two strengths in our system: 1- You show your provincial health card, you get checked, you don't pay a dime. I find it quite ludicrous that in France you must pay the doctor, who fills out a form that you then must fill out the rest, and then mail it to your social security company and wait for a refund. So much bureaucracy…
    2- I really appreciate the large amount of walk-in clinics with several having quite the flexible hours (ie. some open 7 days per week, some till late at night). I know you can wait for several hours (unless you get there when it opens!) before getting any service, but I enjoy having the ability to simply walk in and wait, as opposed to having to make an appointment with a doctor in France. Having said that, in my experience, you can usually get appointments the next day… But on-the-go healthcare appeals to me, what can I say?

  15. Fraser institute methodology:

    first you take your preconcieved theory. Add a dash of cherry picked facts, a smidgin of pure BS and voila, you have homemade simplistic pie. Be warned however, if undercooked it may turn out half baked.

  16. Fraser institute toady.

  17. Fraser institute toady.

    • Oops…that was for communist epithet chucker wsam :)

  18. Winnipeg hasn't been in the West since the Renegades folded. :)

  19. Have the figures and mthods used by the Fraser Institute been evaluated by a third party? The default when considering that organization is that its numbers are unreliable unless proven otherwise.

  20. Have the figures and mthods used by the Fraser Institute been evaluated by a third party? The default when considering that organization is that its numbers are unreliable unless proven otherwise.

  21. Oops…that was for communist epithet chucker wsam :)

  22. Is there any place in the country that is further from a coast?

  23. Manitoba has a coast sourstud. Have you ever heard of Hudson Bay?

    Other directions for the geographically challenged. Get in your car, put on the radio and wait for the Tragically Hip to come on: "The 100th meridian, where the great plains begin!"

  24. Winnipeg and Manitoba aren't really the same thing.

  25. Hmmmm, some sort of Council, you mean? Involving members all across the Federation? A bold idea, to be sure, but whatever would you call it?

  26. Regular people like me are too stupid to figure it out, and the smart people are too sneaky to implement a good system.

    Damn it!

  27. Geez … doesn't anybody read? UBC, where Dr. Evans works, is somewhere west of
    Winnipeg.
    And, Dr. Evans, along with Raisa Deber at UofT, and Dr. Michael Rachlis have done
    more actual work on health care systems than all the interchangeable ideologues
    combined …. worldwide.

  28. Mr. Geddes fails to understand the distinction between the outputs of “health insurance” and the outputs of “medical treatment”. Health insurance is a way to pay for medical goods and services; it is not responsible for health outcomes. The state of medical knowledge, practice and technology produce health outcomes.

    Mr. Geddes opines that medical goods and services are not needed in the same quantities as the rest of the OECD, but it stands to reason that if we have fewer medical goods and services than comparable countries, our health insurance should cost less. In fact the opposite is true; Canada spends more and we get less of the things that health insurance buys, relative to other OECD countries.

    Therefore, by definition the Canadian “HEALTH INSURANCE” system produces very bad “VALUE FOR MONEY,” relative to comparable countries.

    Brett J. Skinner
    Director Health Policy Research
    Fraser Institute

  29. Mr. Geddes fails to understand the distinction between the outputs of “health insurance” and the outputs of “medical treatment”. Health insurance is a way to pay for medical goods and services; it is not responsible for health outcomes. The state of medical knowledge, practice and technology produce health outcomes.

    Mr. Geddes opines that medical goods and services are not needed in the same quantities as the rest of the OECD, but it stands to reason that if we have fewer medical goods and services than comparable countries, our health insurance should cost less. In fact the opposite is true; Canada spends more and we get less of the things that health insurance buys, relative to other OECD countries.

    Therefore, by definition the Canadian “HEALTH INSURANCE” system produces very bad “VALUE FOR MONEY,” relative to comparable countries.

    Brett J. Skinner
    Director Health Policy Research
    Fraser Institute

    • OK, we are getting poor "VALUE FOR MONEY"? (No shouting please). But does it follow that we would get better under some other system, like, I don't know, a privatized system? No it does not.

    • I am pleased you decided to joint this discussion Dr. Skinner. The assertion above (and in the report) that seeks to separate health insurance outputs from medical treatment outputs certainly helps to push the question of value into the domain of economics. Unfortunately it is also deeply flawed. Anyone who has spent time overseas (or even in the US) understands that the nature of health insurance (combined with public subsidies for facilities such as hospitals, ambulance services and training of doctors, nurses and other health care providers) profoundly influences not just the quantity of health care put also its quality and priorities. If economists interested in mechanisms of funding health insurance are not willing to address such issues, frankly their opinions are largely irrelevant to the current public discussion.

      To go further and use the term value for money to describe such a simplistic economic analysis borders on fraudulent. When one considers health care, the principle outcome to be considered has to be health.
      Within your system, a pediatrician that routinely had the tonsils removed from each of her patients would be contributing value for money, whereas the more prudent assessment of real need and counselling patients as to their best options contributes nothing. Indeed, our entire populations health would be better off if fewer antibiotics were given to children, yet that takes time & effort. Prescribing a quick fix is easy.

      I hope the Frasier Institute will make a substantive contribution to the discussion about health reform. The dialogue needs articulate voices from the right that address the needs for priorities, efficiency and individual choice. The report in question does not even attempt to make that needed contribution.

  30. Mr. Geddes is also wrong when he states we made selective use of the data and mischaracterizes the data we used. Our study, which is based on peer-reviewed methodology, used all available data from the OECD for medical goods and services – the things that health insurance buys – which is what we clearly said we were measuring.

    Brett J. Skinner
    Director Health Policy Research
    Fraser Institute

  31. Mr. Geddes is also wrong when he states we made selective use of the data and mischaracterizes the data we used. Our study, which is based on peer-reviewed methodology, used all available data from the OECD for medical goods and services – the things that health insurance buys – which is what we clearly said we were measuring.

    Brett J. Skinner
    Director Health Policy Research
    Fraser Institute

      • A single report by published by the left-wing Canadian Centre for Policy Alternatives and written by a left-wing academic who favours higher taxes is your basis for that statement? Your biases are showing.

  32. Well, I guess that settles that … Mr. Geddes is wrong. We can look forward to David Gratzer
    returning in glory from his exile at the Manhattan Institute and saving our pennies for our
    health savings accounts. Life is good.

  33. Well, I guess that settles that … Mr. Geddes is wrong. We can look forward to David Gratzer
    returning in glory from his exile at the Manhattan Institute and saving our pennies for our
    health savings accounts. Life is good.

  34. OK, we are getting poor "VALUE FOR MONEY"? (No shouting please). But does it follow that we would get better under some other system, like, I don't know, a privatized system? No it does not.

  35. To my mind, we–the engaged average citizen–must work together. You are quite right that we all don't have time to investigate every report that comes out from everyone to determine if they skewed the facts–as they seem to do almost anytime somebody looks. And yes, we have to look at the individual (like Geddes) to determine if in fact HE skewed the facts. But if we got together, Liberals, Conservatives, NDPs, and had one from each party look at this thing together, one from each party look at that thing together, the biases would cancel themselves out, and we'd probably come up with something fairly near reality.

    The thing is, that takes organization and nobody wants to trust anybody to even do that. We all talk about working together, but we don't really mean it. This is supposed to be what Parliamentary committees do. But now I can understand why they are so often dysfunctional.

  36. On the plus side we learned that Manitoba has a coast.

  37. I'd have to agree with Mr. Skinner. Geddes complains that the Fraser Institute is selective with their data. Yet as Skinner explains, they were clear about what they intended to measure and they did so. Meanwhile Geddes is far more selective of data. He tries to counter the Fraser argument by going over only the data on health outcomes, in which Canada is rated favourably.

    Many of the glaring issues that face the Canadian health sector are not measure by the OECD at all. There is a section on Access to Care, and the entire section focuses on coverage and inequality. Canada may fare well in the OECD report in these regards, but what good is universal coverage if you have to wait months for essentially any procedure? And what good is universal coverage if we have one of the greatest shortages of doctors? We all have the "right" to a doctor but there is no question many will go without one anyway because there are simply not enough to go around. The primary problem with Canada's health system is scarcity, in pretty well any form: personnel, diagnostic machines, hospital beds, you name it. Yet we pay more than most countries. Yet not a word about this from Geddes.

    There is a table on "Unmet need for a medical examination, selected reasons by income quintile", yet suprisingly (or not) Canada is not even in the table, and this would unquestionably represent the biggest problem with Canada's health system! This is the only place where you might see a hint of Canada's terrible 8 hour average ER room waits, and there is nothing to be found.

    The only hint of this great failing of scarcity comes from "Acute care hospital beds per 1 000 population", where Canada ranks 25th, well below average, yet Canada ranks 6th in expenditures. Perhaps Geddes can comment on that – that is exactly indicative of what the Fraser Institute is saying. Geddes claims "care here is better than average pretty much across the board" yet he fails to mention this particular failing, and he fails to mention Canada's well-below average rating of 27th in the number of practising physicians, amongst others. So who is the one being selective?!! We have few doctors and we have few hospital beds, few diagnostic machines and long ER waits, yet somehow Canada has better health outcomes? If health outcomes is simply the measurement of death rates for fatal disease, then perhaps Canada is average, but that is hardly a reasonable measure of health outcomes, there is a lot more to health care than that. This is misleading commentary from Geddes at its best.

  38. I'd have to agree with Mr. Skinner. Geddes complains that the Fraser Institute is selective with their data. Yet as Skinner explains, they were clear about what they intended to measure and they did so. Meanwhile Geddes is far more selective of data. He tries to counter the Fraser argument by going over only the data on health outcomes, in which Canada is rated favourably.

    Many of the glaring issues that face the Canadian health sector are not measure by the OECD at all. There is a section on Access to Care, and the entire section focuses on coverage and inequality. Canada may fare well in the OECD report in these regards, but what good is universal coverage if you have to wait months for essentially any procedure? And what good is universal coverage if we have one the greatest shortages of doctors? We all have the "right" to a doctor but there is no question many will go without one anyway because there are simply not enough to go around. The primary problem with Canada's health system is scarcity, in pretty well any form: personnel, diagnostic machines, hospital beds, you name it. Yet we pay more than most countries.

    There is a table on "Unmet need for a medical examination, selected reasons by income quintile", yet suprisingly (or not) Canada is not even in the table, and this would unquestionably represent the biggest problem with Canada's health system! This is the only place where you might see a hint of Canada's terrible across the board 8 hour average ER room waits, and there is nothing to be found.

    The only hint of this great failing of scarcity comes from "Acute care hospital beds per 1 000 population", where Canada ranks 25th, well below average, yet Canada ranks 6th in expenditures. Perhaps Geddes can comment on that – that is exactly indicative of what the Fraser Institute is saying. Geddes claims "care here is better than average pretty much across the board" yet he fails to mention this particular failing, and he fails to mention Canada's well-below average rating of 27th in the number of practising physicians, amongst others. So who is the one being selective?!! We have few doctors and we have few hospital beds, few diagnostic machines and long Er waits, yet somehow Canada has better health outcomes? This is misleading commentary from Geddes at its best.

  39. I am pleased you decided to joint this discussion Dr. Skinner. The assertion above (and in the report) that seeks to separate health insurance outputs from medical treatment outputs certainly helps to push the question of value into the domain of economics. Unfortunately it is also deeply flawed. Anyone who has spent time overseas (or even in the US) understands that the nature of health insurance (combined with public subsidies for facilities such as hospitals, ambulance services and training of doctors, nurses and other health care providers) profoundly influences not just the quantity of health care put also its quality and priorities. If economists interested in mechanisms of funding health insurance are not willing to address such issues, frankly their opinions are largely irrelevant to the current public discussion.

    To go further and use the term value for money to describe such a simplistic economic analysis borders on fraudulent. When one considers health care, the principle outcome to be considered has to be health.
    Within your system, a pediatrician that routinely had the tonsils removed from each of her patients would be contributing value for money, whereas the more prudent assessment of real need and counselling patients as to their best options contributes nothing. Indeed, our entire populations health would be better off if fewer antibiotics were given to children, yet that takes time & effort. Prescribing a quick fix is easy.

    I hope the Frasier Institute will make a substantive contribution to the discussion about health reform. The dialogue needs articulate voices from the right that address the needs for priorities, efficiency and individual choice. The report in question does not even attempt to make that needed contribution.

  40. Apologists for the medical bureaucracy want to keep their hands in your pocket, and only their hands, so they hate the idea of medical professionals competing with each other to provide better treatment.

  41. News flash Philanthropist. In many places medical professionals are working to provide the best treatment they can in impossible conditions. Maybe you should do a couple of shifts as a volunteer at the University of Alberta Hospital emergency department, which is in "catastrophic collapse" according to the head of the Alberta Medical Association. I know some people like to embrace conspiracy theories but the truth of the matter is that knee-jerk decisions were made to close facilities and not build old-folks homes. We have fewer beds now than we did when our population was substantially smaller. People are being looked after in hallways and the tv rooms and still the emergency rooms are over-flowing with admitted patients.

  42. News flash Philanthropist. In many places medical professionals are working to provide the best treatment they can in impossible conditions. Maybe you should do a couple of shifts as a volunteer at the University of Alberta Hospital emergency department, which is in "catastrophic collapse" according to the head of the Alberta Medical Association. I know some people like to embrace conspiracy theories but the truth of the matter is that knee-jerk decisions were made to close facilities and not build old-folks homes. We have fewer beds now than we did when our population was substantially smaller. People are being looked after in hallways and the tv rooms and still the emergency rooms are over-flowing with admitted patients.

    • Exactly. And apologists for the medical bureaucracy will deliver more of the same until someone is legally allowed to show them it can be done better without all sorts of government interference. Question: did the government medical bureaucracy close any offices? Are their desks out in the hallways?

  43. If there is a shortage of old-folks homes, I'd like to see the private sector step up and seize the business opportunity.

  44. If there is a shortage of old-folks homes, I'd like to see the private sector step up and seize the business opportunity.

  45. Exactly. And apologists for the medical bureaucracy will deliver more of the same until someone is legally allowed to show them it can be done better without all sorts of government interference. Question: did the government medical bureaucracy close any offices? Are their desks out in the hallways?

  46. A single report by published by the left-wing Canadian Centre for Policy Alternatives and written by a left-wing academic who favours higher taxes is your basis for that statement? Your biases are showing.

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