Bureaucracy may be necessary, but it is never harmless

There is nothing that bureaucracy cannot make worse

Bureaucracy may be necessary, but it is never harmlessBureaucracy begats bureaucracy, building its own demand and transforming people into managers designed to meet bureaucratic needs. A bureaucracy designed to serve patients ends up serving its creators instead and protects those who work inside. Economist William Niskanen offered a definition of bureaucracies in his book Bureaucracy and Representative Government. Roughly speaking, he says, 1)…

Health care user fees promote equity and efficiency

Offer a small step to solving overconsumption and waste

Health care user fees promote equity and efficiencyTwenty-eight countries have universal healthcare. Twenty-two of them have some form of cost sharing. User fees offer one example. User fees work best as a small, flat fee paid at the point of service. Even a few dollars discourage (rational) people from booking an appointment for what they asked twice previously. User fees shorten the line…

Tone-deaf politicians ignore the realities of health care

Political expediency once again trumps the realities of fixing health care

Tone-deaf politicians ignore the realities of health careCanada’s health-care system continues to implode and fail Canadian patients at a catastrophic level. Systemic problems and staffing issues are overwhelming health care delivery, and people are dying from a lack of proper care. Daily news reports now relate the most egregious dysfunctions as patients sought help and instead found themselves in a chaotic system…

Hospital woes continue to mount – nothing new here

More money won’t solve the systemic, pervasive, and structural issues that plague Canadian health care

Hospital woes continue to mount – nothing new hereHospital staffing in Ontario is in crisis – as it is in Alberta, British Columbia, and the rest of Canada. Provinces are responding with what they perceive as solutions: Ontario is fast-tracking foreign-trained nurses, and Alberta has made the interprovincial movement of professionals easier. But while these moves will help reduce the red tape surrounding…

Why our health system treats Canadians poorly

Do we or the government own our bodies?

Why our health system treats Canadians poorlyFormer B.C. deputy minister of health Lawrie McFarlane’s July 24 commentary on the “Cambie Surgery Centre ruling” (a descriptive that ignores two cancer patients and three children who were co-plaintiffs) contained some valid commentary. The crisis we now face in our health system is there for all to see and observe. Notably, McFarlane offers no solutions.…

Canadian health care at a crossroads

It’s time to stop talking about money and start talking about changing health care

Canadian health care at a crossroadsIt has been a revealing week for Canadian health care and what we have witnessed is not good. In Fredericton, NB, a senior passed away while waiting for care at a hospital emergency department. A witness noted that the man was “clearly in discomfort,” yet it wasn’t enough to gain the attention of health-care workers.…

Canada’s health-care system is irretrievably broken

Drastic changes are needed. Millions of Canadians on wait lists know that. Why don't politicians?

Canada’s health-care system is irretrievably brokenDrastic changes are needed if we are to repair the Canadian health-care system. Millions of Canadians waiting for medically-necessary surgeries and procedures already know that. It’s time for the rest of us to catch up and start advocating for change. At least five million Canadians are without a family doctor. More than one million Canadians…

Why health care can’t change

When it comes to fixing health care, governance matters more than policy

Why health care can’t changeFew voters had first-hand experience with hallway medicine or Canada’s world-famous wait times before the pandemic. Lockdowns changed everything. Health policy failure moved from fear-filled headlines into a tangible crisis everyone could feel. Failure begs for better, or even new policy, to fill gaps. Planners and policy writers jump to offer solutions: surgicenters, funding reallocation,…

Alberta First Nation clinic will cut health-care wait times

The pandemic clearly taught us that Canada’s health-care system needs to reform

Alberta First Nation clinic will cut health-care wait timesIndigenous communities across Canada should learn from an Alberta First Nation that’s establishing a private health clinic to provide services that will reduce the pressure on the public system. The Alberta government recently approved a plan by the Enoch Cree Nation, close to Edmonton, to build a private clinic specializing in hip and knee surgeries.…

Quebec’s ailing health-care system

More than 20 per cent of Quebecers currently don’t have a family doctor

Quebec’s ailing health-care systemBy Krystle Wittevrongel and Maria Lily Shaw Quebec’s health-care system is suffering from poor accessibility. More than 20 per cent of Quebecers currently don’t have a family doctor. The overcrowding of hospital emergency wards and the long wait times that result are also notorious. A key to improving the health system’s capacity is to address…

The consequences of the doctor shortage in Canada are grim

The evidence is overwhelming: Canada needs more doctors

The consequences of the doctor shortage in Canada are grimThe coronavirus pandemic has accomplished what a multitude of government reports could not – that is, to draw Canadians’ attention to a faltering health-care system characterized by a chronic shortage of beds, overflowing emergency departments, and limited numbers of surgical personnel and operating suites. The flaws have been there for decades, but willful blindness on…

Ottawa needs to reset its relationship with drug developers

Politicians have to stop creating impediments to access

Ottawa needs to reset its relationship with drug developersBy Nigel Rawson and John Adams Macdonald-Laurier Institute On April 14, 2022, Health Minister Jean-Yves Duclos announced the federal government’s decision to cancel most of its plan for the Patented Medicine Prices Review Board (PMPRB) to regulate significantly lower prices for new medicines in Canada – a mess created five years ago by then Health…

Parliament’s assisted suicide review is a farce

Why the headlong rush into expansion while so many questions remain?

Parliament’s assisted suicide review is a farceJust six years after legalization, the availability of assisted suicide in Canada is about to expand again. But members of Parliaments and senators who’ll tackle these life-and-death questions don’t have enough time to consider all the weighty matters before them. Much less have they taken stock of how assisted suicide has affected the entire health-care…

Why Canada can’t reform its ailing health care system

Government, medical professionals, and public-sector unions each hold veto power over any innovation

Why Canada can’t reform its ailing health care systemThe Honorable Monique Begin wrote in 2009, “When it comes to moving health care practices forward efficiently, Canada is a country of perpetual pilot projects.” Governments need “financial control” and remain “leery” of committing to programs. Pilot programs are easy to shut down “to avoid criticism” or if “budget priorities shift.” At first glance, we…

Patient care is too important to suffer under central planning

Canada rations care with wait times, limited investment in technology, and by using family doctors as “gatekeepers” to service

Patient care is too important to suffer under central planningDoctors frustrate governments. They think too little about how much health care costs and too much about their patients who need help. The government of Ontario and the Ontario Medical Association arrived at a mediated Proposed Physicians Services Agreement (PPSA) this month. Doctors started to vote on it yesterday, with voting ending on March 27.…
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