Friday, September 17, 2004
As countries with socialized medicine continue march toward privatization...where is America headed?
[Clifford Krauss, "Canada Agrees to Increase Spending on Its Health Care," The New York Times, 17 September 2004.]
Canadian politicians have made the decision to throw more good money after bad by beefing up health care spending. Few believe that the increase will be sufficient to cover future costs, though, and more doctors are switching to private practice:
Prime Minister Paul Martin gained a major victory for his flagging government early Thursday by reaching an agreement with provincial and territorial leaders that would substantially increase federal spending for Canada's ailing $60 billion national health care system.
After three days of contentious negotiations, the officials agreed to send $14 billion in federal money over six years to the 13 provinces and territories that administer health care, with guarantees of additional 6 percent annual increases through 2015.
Still, the agreement will fall far short of fulfilling Mr. Martin's upbeat pledges in the recent election campaign to "fix the system for a generation," since the increases in spending will barely keep up with rising costs. It will also cut into the government's capacity to manage growing urban problems like homelessness, and to fulfill promises to improve education and rebuild the armed forces, especially if the currently robust economy slows.
Much of the meeting in Ottawa between Mr. Martin and the provincial and territorial premiers was televised, and it highlighted stark shortcomings in the health care system, including the growing shortage of doctors and nurses, the lengthening of waits for cancer care and surgery, and the mounting cost of drugs for an aging population.
"What it does is put the patient - the health care system - on life support, but it does not put it on the road to full recovery," said Senator Michael J. L. Kirby, an influential Liberal who led a commission that studied health care two years ago. He said he regretted that the officials did not consider restructuring how health care was delivered, even if this entailed allowing private clinics to provide services to those willing and able to pay.
"The way health care is structured is unsustainable," Senator Kirby concluded, adding that the country should also consider a national health care insurance premium.
The cost of the public health system is growing at a rate of 7 percent a year, while all government revenues are only growing by 5 percent.
To make up for the shortfall, privatization of medical services is creeping into the system in several provinces. The nation's first private emergency clinic is opening in Quebec next month. Faced with yearlong waiting lists for elective surgery, the Alberta government is considering allowing the establishment of private joint-replacement clinics.
"Events are overtaking the politicians, even if they refuse to acknowledge it," the conservative National Post argued in an editorial on Thursday.
The news comes at the same time that privatization efforts advance in Britain:
With the recognition that consumers should be able to escape bad service, whether that service is publicly or privately provided, there has been a cross-party clamor for greater competition and consumer choice in our public services. There is a new belief that ending public sector monopoly, at least on the supply-side, will help drive technological innovation, make providers more responsive to consumers, and lead to greater adoption of best-practices throughout the system.
Public private partnerships (between the NHS and for-profit commercial ventures) for vital health services are being established across the health system. For example, decontamination services (the collection, cleaning and delivery of sterile surgical instruments), arguably one of the most important elements of modern health care, are to be run by such partnerships.
The Government is also using private provision to make up for the shortfall in NHS care. In fact, on 12 April current Health Secretary John Reid awarded two private not-for-profit hospital groups, Nuffield Hospitals and Capio Hospitals UK, contracts to carry out nearly 25,000 hip, knee and other operations in 50 independent hospitals for the NHS in this financial year.
Waves of independent sector profit-making diagnostic and treatment centres (ISTCs) (which will specialise in orthopaedics, cataracts and so forth) are being launched between 2004 and 2006.
Private contracting is also set to be expanded to diagnostics (x-rays will be sent to India), and chronic disease management; even 'Big Pharma' is involved in some pilots. Private providers are determined to play a key part in the provision of integrated primary care services.
[Clifford Krauss, "Canada Agrees to Increase Spending on Its Health Care," The New York Times, 17 September 2004.]
Canadian politicians have made the decision to throw more good money after bad by beefing up health care spending. Few believe that the increase will be sufficient to cover future costs, though, and more doctors are switching to private practice:
Prime Minister Paul Martin gained a major victory for his flagging government early Thursday by reaching an agreement with provincial and territorial leaders that would substantially increase federal spending for Canada's ailing $60 billion national health care system.
After three days of contentious negotiations, the officials agreed to send $14 billion in federal money over six years to the 13 provinces and territories that administer health care, with guarantees of additional 6 percent annual increases through 2015.
Still, the agreement will fall far short of fulfilling Mr. Martin's upbeat pledges in the recent election campaign to "fix the system for a generation," since the increases in spending will barely keep up with rising costs. It will also cut into the government's capacity to manage growing urban problems like homelessness, and to fulfill promises to improve education and rebuild the armed forces, especially if the currently robust economy slows.
Much of the meeting in Ottawa between Mr. Martin and the provincial and territorial premiers was televised, and it highlighted stark shortcomings in the health care system, including the growing shortage of doctors and nurses, the lengthening of waits for cancer care and surgery, and the mounting cost of drugs for an aging population.
"What it does is put the patient - the health care system - on life support, but it does not put it on the road to full recovery," said Senator Michael J. L. Kirby, an influential Liberal who led a commission that studied health care two years ago. He said he regretted that the officials did not consider restructuring how health care was delivered, even if this entailed allowing private clinics to provide services to those willing and able to pay.
"The way health care is structured is unsustainable," Senator Kirby concluded, adding that the country should also consider a national health care insurance premium.
The cost of the public health system is growing at a rate of 7 percent a year, while all government revenues are only growing by 5 percent.
To make up for the shortfall, privatization of medical services is creeping into the system in several provinces. The nation's first private emergency clinic is opening in Quebec next month. Faced with yearlong waiting lists for elective surgery, the Alberta government is considering allowing the establishment of private joint-replacement clinics.
"Events are overtaking the politicians, even if they refuse to acknowledge it," the conservative National Post argued in an editorial on Thursday.
The news comes at the same time that privatization efforts advance in Britain:
With the recognition that consumers should be able to escape bad service, whether that service is publicly or privately provided, there has been a cross-party clamor for greater competition and consumer choice in our public services. There is a new belief that ending public sector monopoly, at least on the supply-side, will help drive technological innovation, make providers more responsive to consumers, and lead to greater adoption of best-practices throughout the system.
Public private partnerships (between the NHS and for-profit commercial ventures) for vital health services are being established across the health system. For example, decontamination services (the collection, cleaning and delivery of sterile surgical instruments), arguably one of the most important elements of modern health care, are to be run by such partnerships.
The Government is also using private provision to make up for the shortfall in NHS care. In fact, on 12 April current Health Secretary John Reid awarded two private not-for-profit hospital groups, Nuffield Hospitals and Capio Hospitals UK, contracts to carry out nearly 25,000 hip, knee and other operations in 50 independent hospitals for the NHS in this financial year.
Waves of independent sector profit-making diagnostic and treatment centres (ISTCs) (which will specialise in orthopaedics, cataracts and so forth) are being launched between 2004 and 2006.
Private contracting is also set to be expanded to diagnostics (x-rays will be sent to India), and chronic disease management; even 'Big Pharma' is involved in some pilots. Private providers are determined to play a key part in the provision of integrated primary care services.
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