Nowhere is this mentality better summarized than this Globe and Mail editorial by Roy Romanow, Linda Silas and Steven Lewis. "Why medicare needs Ottawa" is typical of the health-care propaganda one often hears from Canadians.
Here are seven reasons why a strong federal presence in health care is vital to Canada:
Here's my rebuttal to this nonsense:
Successful nations are built on unifying infrastructure. Think railways and the Trans-Canada Highway, seamless telecommunications networks, the armed forces, regulatory and judicial processes. Health care is a level up in importance because health is a fundamental precondition for full participation in society.
Successful nations are built on unifying infrastructure. Think fascism. Political centralization is not a precursor to success, more-often-than-not it is the antithesis to success and dangerous for a healthy functioning society.
A high-performing nationwide public system contributes enormously to the economy. Businesses don’t have to design and fund complex health plans for their employees. Workers don’t have to worry that taking a job in another province will compromise their health care. Only leadership from Ottawa can guarantee a common set of programs and standards and ensure that program enhancements are available to all Canadians. The 2004 health-care accord acknowledged that Canada’s public coverage of prescription drugs is not up to international standards. Ottawa must insist on improvement and put its money behind it.
A high-performing nationwide public system contributes enormously to the economy. So only bureaucrats with their arbitrary decisions can create high-performing programs and standards that ensure consumer satisfaction. Clearly this is more ideal than millions of individuals making decisions for themselves.
The intelligent use of health information is the key to improving access, quality and efficiency. Analysis and comparison are the midwives of improvement. Canada’ health-intelligence network is unco-ordinated, sluggish, incomplete and fragmented, a clumsy hybrid of paper and electronic records from which anything useful emerges slowly and at great cost. Both leadership and investment from Ottawa on an unprecedented scale are essential to creating high-quality, standardized information that improves clinical practice, policy and accountability.
The intelligent use of health information is the key to improving access, quality and efficiency. The intelligent use of price signals is the key to access, quality and efficiency. "Both leadership and investment from Ottawa on an unprecedented scale" are not the essential ingredients for improving the system. That's just silly. Does anyone seriously believe that federal politicians and bureaucrats are capable of improving a system that is in its current state because of federal politicians and bureaucrats?
Provinces can’t transform their systems on their own regardless of how much money they spend. The politics of health care are simply too fraught, and the vested interests too powerful, to effect large-scale change. Even worse, the jurisdictions routinely engage in unconstructive bidding wars for personnel and are whipsawed by vendors, such as pharmaceutical companies, that exploit their isolation and vulnerabilities. Ottawa should play a major role in creating a more collegial and co-operative federation that overcomes obstacles to reform and bargains more effectively in the public interest.
Provinces can’t transform their systems on their own regardless of how much money they spend. Then by the same logic, neither can Ottawa.
Ottawa could do a great deal to reduce the redundancy and bureaucracy in the system. A great example to emulate is the common process for reviewing the cost-effectiveness of drugs that both eliminated duplicate efforts and the confusion caused by multiple reports. Similarly, the whole area of professional credentials and regulation could be greatly simplified and standardized, with Ottawa promoting and brokering change. Something is wrong when it’s more difficult for some professionals to get licensed in another province than it is for a Polish nurse to get a job in Liverpool.
Ottawa could do a great deal to reduce the redundancy and bureaucracy in the system. They can't do this through simplifying regulations and standardized programs. That is wishful thinking. If past experience is any indication, reducing (and/or eliminating) bureaucracy is dependent on the private ownership over the means of production. In other words, capitalism. Socialism breeds bureaucracy, there is no way around this.
Canadians deserve to know more about where the system succeeds and where it fails. Because Ottawa is not held as politically accountable for health care as the provinces, it’s the ideal mirror to and conscience of the overall system. It shouldn’t only invest in and co-design the health-information infrastructure but also mine that asset to report on how well the system performs, and promote a culture of openness and transparency where independent researchers and health-care providers can do the same.
Canadians deserve to know more about where the system succeeds and where it fails. .... Wait, what? "Because Ottawa is not held as politically accountable for health care as the provinces, it’s the ideal mirror to and conscience of the overall system." Does that make any sense to anyone else?
Ottawa must proudly stand up for single-payer, not-for-profit health care and ensure that its financial contributions reinforce this commitment across the country. Several provinces have turned a blind eye to blatant violations of the Canada Health Act, and Ottawa has stood by in indifference. The country needs to know where its government stands on the basic character and values of medicare.
Ottawa must proudly stand up for single-payer, not-for-profit health care and ensure that its financial contributions reinforce this commitment across the country. In other words, Ottawa must arrogantly (or rather, ignorantly) stand up for socialism, not free enterprise and voluntary exchanges. Ottawa needs to ensure that socialized health-care will continue despite any overbearing costs and lack of basic necessities. Provinces may take matters into their own hands by ignoring the Canada Health Act. Ottawa should punish these dissenters.
If the federal government abdicates, Canadian health care will be increasingly fragmented and costly, and two-tier medicine will grow not because the public wants it but because Ottawa allows and perhaps encourages it. Giving up on medicare is in a sense giving up on the Canadian values that have knit us together. There is more to leadership than writing cheques.
Morons. If two-tier medicine grows and Ottawa does nothing it is probably what consumers really want. Ottawa's persecution of the health industry will come from lobbyists representing special interest groups. The only genuine democracy is that of consumer sovereignty in a free market. "Giving up on medicare" is giving up on the fascist "objective" values that the state has imposed on the populace since childbirth.
There is no more to political leadership than writing cheques with other people's money. The sooner that practice ends, the freer (and healthier) we all will be.
Socialism always fails. Tanstaafl, Canada.