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Archive for the ‘Health Care’ Category

Last week I noted some ways that healthcare reform in the States could adversely effect Canada. While that possibility is there, the potential to benefit Canada, indirectly, is there as well. Reform in the US takes a two-pronged approach; extending coverage, which has received the bulk of attention abroad for it’s moral implications, and controlling costs, which, while not being ‘sexy’, is a measure that does have some potential relevance for Canada and other countries.

Medical advancements, like other technological innovations, are not zero-sum propositions; pharmaceuticals that were first researched and developed in the States now benefit people around the world. When it is shown that a 50% reduction in surgical mortality rates and a 36% decline in complications can be attained by following a basic checklist, those checklists can be implemented at a larger scale. The same goes for improvements in cost effectiveness.

Just as I imagine that in the long run cost effectiveness measures developed in the US will be a boon to other countries, the US will also hope to be the benefactor of efficiencies gained elsewhere. As Ezra Klein noted:

Even if the bill does a better job than CBO projects, health-care costs will still bankrupt us. This is one small step for cost, one giant leap for coverage. My great hope is that the bill makes thenext steps easier. But there’s still no guarantee we’ll take them.

The same can be said about Canada, and really any industrial country. This graph from the Parliamentary Budget Officers recent Fiscal Sustainability Report features a pretty scary forecast for our future federal debt:

Not all of that sharp upwards climb will be due to increases  in healthcare expenditures, but a lot of it is. The first members of the baby boomer generation are turning 65 this year; couple that with an ever rising life expectancy and you have a perfect formula for endlessly escalating healthcare outlays. For my part, I am an optimist that these are problems that can be solved, and having the US as part of “the club of states who don’t turn their back on the sick and the poor” is a necessary part of the puzzle.

• Diminishing Returns On Canada's Coattails For far too long, Canada has been content to let her international image and reputation warmly bask in the residual glow of glories and [/caption] good works long gone past. However, our squeaky clean image...
• Anti-Olympic Voice Turned Away At Vancouver Airport [/caption] On Saturday, after undergoing several hours of questioning from Canadian customs officials, Martin Macias Jr., an activist with ties to the Olympic Resistance Network attempting to travel to Vancouver to cover and participate in...

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Amidst my general happiness for our American friends in joining the rest of the western world in providing access to health insurance for all of it’s citizens, there are a few aspects of this story concerning Canada that I want to take a look at. Yesterday I heard from a few people that while they too were happy for the American people, they didn’t really care as it would have no effect on them. There’s a few reasons why this is not true, but what immediately jumps out to my mind is the twofold effects of ‘brain drain’.

First, new provisions in the law will allow over 30 million people to gain access to health insurance/care for the first time. Hospitals are going to be adding doctors and nurses to their staffs, and Canada is, and will continue to be a fertile recruiting ground to fill those spots.

Compounding this is the new ability for those who are self-employed to purchase insurance on ‘exchanges’, which will effectively give individuals the same purchasing power as large groups. This will finally make purchasing health insurance for oneself a tenable position. There are many folks who in the past have been turned off from emigrating to the States based solely on the fact that buying healthcare insurance on the individual market was next to impossible. That is no longer the case, meaning that there is that much more intellectual/entrepreneurial talent flowing south.

This country already has a doctor shortage as it is and we should be aware that they will be sought out even more so now by US hospitals. This fact highlights that we need to continue in our efforts to train more physicians as well as increase our acceptance of foreign trained care providers. US health care reform also holds the possibility to have some positive effects on Canada, and I will look at those in post to follow shortly.

• US Affordable Care Act: What's In It For Me? (Canadian Edition) Last week I noted some ways that healthcare reform in the States could adversely effect Canada. While that possibility is there, the potential to benefit Canada, indirectly, is there as well. Reform in the US...
• Canada's Subsidised Culture This is the third in a series of posts highlighting the merits of governement supporting artistic endeavours.  I talked about Canada's government funded public broadcaster, and more specifically CBC Radio 3 here and about Canadian...

• Health Insurance for the Unemployed Baby Boomer If you are a recently unemployed baby boomer, keeping or getting access to health care is critical. At the same time, older workers must preserve...
• Best Reads of the Week: the Inconvenient Truth of the Health Care Debate Edition For some unknown reason, I've been taken aback by the recent debate in government sponsored health care.  Maybe I'm having some sort of an extended...

I’m sure that I am not the only one, who upon hearing that Danny Williams exact location in the US was unknown, thought to themselves ‘Uh oh! Sex scandal!’ It turns out though, that the firebrand Premier of Newfoundland and Labrador has traveled to the States on the advice of his doctors to undergo a form of heart surgery that cannot be delivered on the Rock. Even though his departure from the island does not appear to be tryst related, controversy has nonetheless ensued. Predictably, in the US much hay has been made about the inadequacies of the Canadian healthcare system, but the same thing is being said about the fact that he had to travel out of province at all. It’s worth remembering that Williams comes from an island province with a total population of just over 500,000. I’ll be callous here and suggest that is a good thing that not every surgical procedure possible can be performed in St. John’s. At this time, the exact nature of the procedure the premier will undergo is not known publicly, but it is some kind of heart surgery. Heart surgery. The fact that every type of heart surgery possible cannot performed in Newfoundland should surprise no one.

A facet to this story that is rather interesting, and one that I have not found any specific details on, is what decision making process was made by Mr. Williams and his doctors to undergo treatment in the US. Did he choose to travel to the US rather than visiting another province for reasons of expediency, or is this particular surgery not available in Canada period? Has Medicare played any role in sending him south, or is it only possible due to his own financial wherewithal? With the brouhaha this surgery has generated, I imagine in the next few days we will be hearing more details about the state of, and manipulations to, Danny William’s heart. There are important issues at play here having to with our healthcare system, but the basic fact of having to leave Newfoundland for heart surgery is not one of them.

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