CKNW Editorial
for January 12, 2000

Let my crystallize my thoughts on health care but first I must say that I was disappointed in yesterday’s great debate amongst the Leadership hopefuls for the NDP. Quite clearly they had all agreed that they should be nice to one another so as not to get any bad sound bites. That’s perhaps sound strategy but I doubt it. Looking ahead to a future election I suspect that most listeners felt that they hadn’t heard any evidence of leadership from any of them. In fact they all seemed to be saying that they wanted to return to old NDP principles … that should scare the pants of most voters.

It’s disappointing that one cannot get any thoughtful positions from any of them on health care – just mindless platitudes about the sanctity of the health care system. It remains to be seen if Gordon Campbell will be any more adventuresome on the subject.

Let me lay before you some of the problems as I see them.

we have never bothered to define the extent of treatment we are prepared to pay for out of public dollars By not doing that we have created two, I would submit, unhelpful situations.

we have new and spectacular medical innovations we have not budgeted for and we have accepted all of them, uncritically, as part of what we will pay for.

we have no rationality in what services we will fund and what we will not.

We allowed ourselves to be seduced into a national health care program because of the then 50 cent dollars that were available. We’re now stuck with the federal regulations, thus inhibiting our ability to solve out problems without the federal money … since they downloaded their responsibilities on the provinces.

This relates to #1. We are unable to have any sort of public debate on what we will insure and how we will pay for it because it is not politically correct to do so. This is wrong – and self destructive.

The healthcare system has changed beyond the wildest imaginations of those who founded it. When you go back to the sixties and seventies you see a system which, by today’s standards is pretty primitive. Diagnostic tools such as Cat Scans and MRIs were unknown. So were organ transplants. Polio was still the great killer in North America where in other parts it was smallpox.

The medical advances made since have increased lifespans and our enjoyment of life but, far from reducing the costs of medicare have increased them. For, speaking frankly, it’s cheaper to kill than to take care of. We are all now living into the high medical cost epoch of our lives. I believe that the Health budget is something like $6 billion dollars today – it was $1 billion when I was Health Minister 20 years ago. And it will continue to spiral.

In fact, if anyone were to take a fair overview of the system it is simply out of control. There are, by a large difference, more financial demands upon the system than the system, and thus the taxpayer can afford. Some of these demands can be met by better rationalization of services. As the Health Employees Union says in an ad I half agree with, we must modernize the system. We can move more patients out of institutions into their homes except I must warn that the savings achieved are, to a large degree, illusory. I have no doubt that there is fat in the system. But I will make this statement and stand by it – if, by magic, we could do all the things we should within the current structure we would still be dramatically running behind. For, when you think of it, we haven’t even begun to fully fund many aspects of good health care, chiropractic being but one example.

As I said yesterday, I have no plan or solution. But I will say this – we are going to need huge amounts of capital in the near future – hell, we need it now – and if that’s to come entirely from public funds there will have to be healthy tax increases. Every Health Minister in my memory, very much including myself, has had to juggle and play games with the figures in order to stay alive long enough to pass the grief onto a successor or a successor government.

Yes, I do favour an examination of how we can entice private money into the field. I don’t do this from any philosophical tenet at all but for practical reasons – if we don’t debate the issue and see how we can get private money at the least cost and without it being a threat to the universality of our system, we will be forced to take the private funds with very little leverage as to what the terms will be.

I’m utterly horrified when I hear people saying that there should be no profit involved in health care. Everyone except volunteer groups and parsons are in the system for a profit. Doctors, nurses, orderlies, white collar staff, ambulance drivers, contractors and their labour force that build hospitals, and on the list goes, sell their services for a profit. If we’re going to eliminate private funds as an option, let’s at least stop talking nonsense.

The problems we have are, for the most part, world wide. Surely as both taxpayers and beneficiaries of the health system we must look at all other available models. We must cut out the oneliners, the most infuriating being that those who look to the private system are courting or will unwittingly bring in an American style system. This is the traditional bogeyman of the left and should be banished from our thoughts. No one would ever wish that system or anything like it on Canadians.

My conclusion, after having hands on experience and as an observer is that sooner or later we will have private capital in our system because we have no other choice – surely it makes sense to see how we can get that capital on our terms, not have those terms, under duress, dictated to us.

But to have that debate takes leadership – and we saw precious little of that on the program yesterday.