The right to medical equality

FTLComm - Tisdale - May 19, 2000

dominant
theme
In a week's time Ensign will have been published for two full years, each an every day a new story or two and often an editorial. For those ofyou who are frequent readers of this site you perhaps by now categorised Ensign as a site dedicated to concerns about Saskatchewan's and Canada's health care system. That is not the case, but it certainly has been a dominant theme throughout these two years. Were you to check into back issues of other dailies such as the Saskatoon and Regina daily papers, you would find that like us, they have produced a mountain of material on this one topic, because almost every day there is evidence and reports of trouble in this sector of our society. We at Ensign, or reporters and editorial writers, at any of the Daily papers would be remise and guilty of neglect, if we did not put our energy and efforts into a topic that continues to be of such major concern to everyone.

looking
for a plan
Today, I want to deal with this topic in response to the headline in yesterday's article by Mario deSantis where he states that theProvincial Minister of Health is looking for a plan. Mario was distressed at this statement because a plan was made and apparently not followed so that the Minister has been aimlessly wandering about trying to hold things together. A week ago, I listened to the Minister being interviewed by CBC’s Sheila Coles and Ms. Coles put the question to her. “Would there be more hospital closings?” to which the minister said with certainty, that she just couldn't say one way or another.

consequences
of the fiscal stability
It is important to understand that politicians are elected officials, whom we see in leadership roles, but ultimately they are in office to serve us and though we can blame them for decisions they make, we the voter, are responsible for placing them in the position and have to accept responsibility for their decisions. Pat Atkinson and surely her predecessors in that position, have really had a difficult time, as the provincial budget and the federal budget, both deeply reduced their spending to control debt and in the case of the provincial budget, we have seen them achieve a balanced position for several years, but the consequences of the fiscal stability has been less money to do the work needed to be done.

Provide the funding
The response of the health department has been to look for ways and means to reduce costs. On many occasions Mario deSantis haspointed out how these cost cutting measures have actually resulted in additional expense such as the closing of the Plains Hospital and perhaps the closing of most of the rural hospitals. What has happened, and we as voters have to take responsibility for this, is that we as a society have become involved in the operation of our medical system to the extent that our minister of health, her officials and administrators have began practicing medicine without a license. Health care is a complex matter, meant to be done with people who are trained to do the task, yet some how, we have seen a mounting and increasing interference in the process by unqualified individuals. When the minister suggests she needs a plan she should really just mind her own business, which is what we elected her to do. Provide the funding to care for the people of this province.

two models
There are really only two models for provision of health care services that should be used. Fee for service, which is the model wehave developed in North American where when you see a doctor or require treatment, your medical plan pays for the cost of your treatment, or you pay for it out of your pocket. The second model is that of patient medical service as was available in Russia for many years, in which the health of the individual was the responsibility of the state and patients were brought into the doctor's clinic for examination or treatment as needed and in emergencies. Both systems of health care work.

collapse of
the system
What we have is neither. Though our doctors are paid on a fee for service, our hospitals and care facilities work on allocated budgets, budgets that appear not to be related to needs but rather to the amount given them within budgetary constraints.The result is collapse of the system. Hospitals cut staff to reduce expenses or are closed altogether resulting in reduced service and increased demand on remaining services. Cost are increases because everything moves from routine to “emergency”.

establish a
clear direction
It is time that we establish a clear direction of whatwe are doing here, we can either continue with fee for service or an administered social medical system. One or the other will work, but a combination of the two is going to produced even more waste of taxes and declining service to those in need of health care services, and that involves everyone.

fee for
services
Our society and medical practitioners are not ready for a complete Soviet style medical system so let us get a fee for services medical system that works. We all understand demand and supply of goods and services and our system is all in place to proceed with a medical system that can function and work for us. Each time we see a doctor his office bills Medicare for that visit and what ever treatment is carried out. Similarly, for every hospital each patient who receives treatment in that facility results in a bill going to Medicare for that service. The solution to our problems is not to cut costs but increase productivity. We have a backlog of patients waiting for treatment, let us let the hospitals and medical people do their job to their fullest. Hire more staff as needed, reopen closed hospitals as needed, let us get the medical system running. The cost for each service is billed to Medicare and the medical facilities employ the staff they need to do their work efficiently.

to save
money
This all seems to simple but of course we all know why this isn't being done. The government in its efforts to balance its budget has curtailedthe operation of the medical system, deliberately hampering it so that it can not function, to save money. The best thing that the Department of health could do is immediately transfer the operation of all medical facilities to a fee for service footing. Productive work is paid for and the more patients a hospital serves the more money it receives to operate. If we as a people can not afford this service in its present form, then let's address that problem, not get involved in the medical issues of staffing and opening and closing of facilities as cost cutting measures.

demand controlled
It is astonishing that the situation has gotten as bad as it is and that politicians continue to try to find solutions to problems that can not be solved with administrative foolishness. Our medical care system was originally structured to work within a fee for service system and the more sick people a hospital treated the more income came to the facility for it to operate and pay its staff. The system is in place and only needs to be allowed to do its job. By making medical care demand controlled and paid for, the system would function within parameters we all understand.

abuse the system
There are so many who site the reasons for high costs of medical care because of people who abuse the system, or for medical techniques that are costly. I have not once seen examples of people going to see a doctor when it wasn't necessary, in fact it has been my repeated experience, quite to the opposite and because doctors are on a fee for service payment plan, I have seen far to many patients not given the sort of time and care that they deserve. Expensive medical procedures are always going to exist and very ill people require very much more care than others, that is the reason we have medical plans, government or otherwise.

equality
for all
If our public taxation can not afford medical treatment for everyone, then we are saying that only some deserve to live and be looked after. Is that the sort of society we want ? I think not. Either private or public, we as a democratic society are firmly committed to the undeniable principle of equality for all. Therefore, we make our system work or find the funds to make it work, tinkering with or trashing the system should not be an option. If we have to raise taxes, so be it, if we have to impose fees on those who can afford to pay them so be it, but to allow chaos and collapse to occur is unacceptable for us still to consider ourselves civilised people.

Sincerely

Timothy W. Shire


*FTLComm - Tisdale - May 19, 2000*

dominant theme	In a week's time Ensign will have been published for two full years, each an every day a new story or two and often an editorial. For those ofyou who are frequent readers of this site you perhaps by now categorised Ensign as a site dedicated to concerns about Saskatchewan's and Canada's health care system. That is not the case, but it certainly has been a dominant theme throughout these two years. Were you to check into back issues of other dailies such as the Saskatoon and Regina daily papers, you would find that like us, they have produced a mountain of material on this one topic, because almost every day there is evidence and reports of trouble in this sector of our society. We at Ensign, or reporters and editorial writers, at any of the Daily papers would be remise and guilty of neglect, if we did not put our energy and efforts into a topic that continues to be of such major concern to everyone.

looking for a plan	Today, I want to deal with this topic in response to the headline in yesterday's article by Mario deSantis where he states that theProvincial Minister of Health is looking for a plan. Mario was distressed at this statement because a plan was made and apparently not followed so that the Minister has been aimlessly wandering about trying to hold things together. A week ago, I listened to the Minister being interviewed by CBC’s Sheila Coles and Ms. Coles put the question to her. “Would there be more hospital closings?” to which the minister said with certainty, that she just couldn't say one way or another.

consequences of the fiscal stability	It is important to understand that politicians are elected officials, whom we see in leadership roles, but ultimately they are in office to serve us and though we can blame them for decisions they make, we the voter, are responsible for placing them in the position and have to accept responsibility for their decisions. Pat Atkinson and surely her predecessors in that position, have really had a difficult time, as the provincial budget and the federal budget, both deeply reduced their spending to control debt and in the case of the provincial budget, we have seen them achieve a balanced position for several years, but the consequences of the fiscal stability has been less money to do the work needed to be done.

Provide the funding	The response of the health department has been to look for ways and means to reduce costs. On many occasions Mario deSantis haspointed out how these cost cutting measures have actually resulted in additional expense such as the closing of the Plains Hospital and perhaps the closing of most of the rural hospitals. What has happened, and we as voters have to take responsibility for this, is that we as a society have become involved in the operation of our medical system to the extent that our minister of health, her officials and administrators have began practicing medicine without a license. Health care is a complex matter, meant to be done with people who are trained to do the task, yet some how, we have seen a mounting and increasing interference in the process by unqualified individuals. When the minister suggests she needs a plan she should really just mind her own business, which is what we elected her to do. Provide the funding to care for the people of this province.

two models	There are really only two models for provision of health care services that should be used. Fee for service, which is the model wehave developed in North American where when you see a doctor or require treatment, your medical plan pays for the cost of your treatment, or you pay for it out of your pocket. The second model is that of patient medical service as was available in Russia for many years, in which the health of the individual was the responsibility of the state and patients were brought into the doctor's clinic for examination or treatment as needed and in emergencies. Both systems of health care work.

collapse of the system	What we have is neither. Though our doctors are paid on a fee for service, our hospitals and care facilities work on allocated budgets, budgets that appear not to be related to needs but rather to the amount given them within budgetary constraints.The result is collapse of the system. Hospitals cut staff to reduce expenses or are closed altogether resulting in reduced service and increased demand on remaining services. Cost are increases because everything moves from routine to “emergency”.

establish a clear direction	It is time that we establish a clear direction of whatwe are doing here, we can either continue with fee for service or an administered social medical system. One or the other will work, but a combination of the two is going to produced even more waste of taxes and declining service to those in need of health care services, and that involves everyone.

fee for services	Our society and medical practitioners are not ready for a complete Soviet style medical system so let us get a fee for services medical system that works. We all understand demand and supply of goods and services and our system is all in place to proceed with a medical system that can function and work for us. Each time we see a doctor his office bills Medicare for that visit and what ever treatment is carried out. Similarly, for every hospital each patient who receives treatment in that facility results in a bill going to Medicare for that service. The solution to our problems is not to cut costs but increase productivity. We have a backlog of patients waiting for treatment, let us let the hospitals and medical people do their job to their fullest. Hire more staff as needed, reopen closed hospitals as needed, let us get the medical system running. The cost for each service is billed to Medicare and the medical facilities employ the staff they need to do their work efficiently.

to save money	This all seems to simple but of course we all know why this isn't being done. The government in its efforts to balance its budget has curtailedthe operation of the medical system, deliberately hampering it so that it can not function, to save money. The best thing that the Department of health could do is immediately transfer the operation of all medical facilities to a fee for service footing. Productive work is paid for and the more patients a hospital serves the more money it receives to operate. If we as a people can not afford this service in its present form, then let's address that problem, not get involved in the medical issues of staffing and opening and closing of facilities as cost cutting measures.

demand controlled	It is astonishing that the situation has gotten as bad as it is and that politicians continue to try to find solutions to problems that can not be solved with administrative foolishness. Our medical care system was originally structured to work within a fee for service system and the more sick people a hospital treated the more income came to the facility for it to operate and pay its staff. The system is in place and only needs to be allowed to do its job. By making medical care demand controlled and paid for, the system would function within parameters we all understand.

abuse the system	There are so many who site the reasons for high costs of medical care because of people who abuse the system, or for medical techniques that are costly. I have not once seen examples of people going to see a doctor when it wasn't necessary, in fact it has been my repeated experience, quite to the opposite and because doctors are on a fee for service payment plan, I have seen far to many patients not given the sort of time and care that they deserve. Expensive medical procedures are always going to exist and very ill people require very much more care than others, that is the reason we have medical plans, government or otherwise.

equality for all	If our public taxation can not afford medical treatment for everyone, then we are saying that only some deserve to live and be looked after. Is that the sort of society we want ? I think not. Either private or public, we as a democratic society are firmly committed to the undeniable principle of equality for all. Therefore, we make our system work or find the funds to make it work, tinkering with or trashing the system should not be an option. If we have to raise taxes, so be it, if we have to impose fees on those who can afford to pay them so be it, but to allow chaos and collapse to occur is unacceptable for us still to consider ourselves civilised people.

	Sincerely
	*Timothy W. Shire*