Our Health Care Systems Are On Life Support!

I don't have any stats or charts to back this up, but I think here in Quebec we'd be better off under the PQ than the Charest Liberals - Charest said somewhere that he backs private health care, I haven't heard that from any PQ person - but to be honest, I haven't looked. I think private clinics need to be banned and the public health system fully funded. The following link is still relevant - perhaps needs to be updated a bit:

Leading Economist Shatters Myth That Public Health Care is 'Unsustainable'; Pins Blame for Soaring Costs on Private Health Care Spending

George, I bow to the more knowledgeable amongst us on babble, as I can't answer your excellent question.

Interesting discussion. Moving from "introductions" to "body and soul".

 I think George's questions are good ones.  I also think attempting to put the puzzle together is also a good exercise.  The Sunshine List only puts a few bits of change towards the answer though.  While asking why the heads of some hospitals get that much money isn't a bad question or even an issue it is a very small one in the context of what I think George is asking.  Salary question while they make great points that can be used effectively to make political hay regardless of where one stands are very minor in any questioning of 'where the money is going.'    Just a brief scan through the list indicates how minor.  The majority of salaries listed are between the 100,000 to 200,000.  Heads of hospitals and other insitutions appear to range from between 400,000 to 700,000 for the most part with most falling closer to the lower end.   Even so rounding every one those up to the million mark for ease of calculation, lets say 100 of those people are making that much cash.  (No I haven't counted them all but from brief scan 100 is appears to in the ball parkev).  So 100 X 1,000,000 = 100,000,000.      Now of course 100,000,000 is no small chunk of change but relative  to questions of where a budget estimated at 45,000,000,000 is going  doesn't cover much.   It's peanuts.  Even if my ball park is way off, its double the amount of people making near that salary is still minor.

Would be nice though to have a whole list totaled to get an idea of how the majority of these salaries (l the numerous 100,000 to 200,000) add up.

I think the key to Georges questions of where's the bulk of the  money is and how it's used  in the budgetary lines 1405  "Ontario Health Insurance Program" and 1411 "Local Health Integration Networks and Related Health Services"  about 38 of the almost 45,000,000 budget estimate.   Not totally positive but I think the salaries on the Sunshine list would fall into those lines.   Even if the total salaries of those people added up to a billion or even two billion it does little to illuminate where most of the money goes towards. 

So yeah that's my really long winded way of saying that the Sunshine List salaries aren't  that important in answering an overarching question about 'what happens with the money."   More a distraction really.

Don't know much about Steve and unfortunately can't watch the video though I'd be interested in seeing it.  Do you know if there is a transcript available?

I know what the Sunshine list includes and what people on are responsible for.   What I'm suggesting is that focusing on the 'amount' of the salaries as some sort of determining factor in the context of the question of 'where is all the money' is framing it way that isn't going to go far in answering the overall question.  The salary 'amounts' don't amount to much in the context of the entire budget.  I agree completely that knowing what our taxes are paying for is important.   Salary levels on the sunshine list don't go far at all in answering that question.   What those people 'do' in their jobs in terms of having a say in determining where the bulk is going would and in that context it wouldn't matter if they were being paid 50,000 or 2,000,000 dollars a year for those jobs.  

I live in one of those locations where there has been for some time a lack of family physcians and spent time having to use the local emergency room for any health care needs.  I eventually managed to get on with someone in the next town over and consider myself lucky to have done so.  The waiting lists in my area are quite long.     I also have lived in a location where it wasn't difficult to get a family doctor at all and walk ins for quicker appointments quite accessible.   My parents sat in 'orphan' limbo for 2 years  before getting a family doctor.  In their town they solved the lack by setting up an clinic for the thousands of people who couldn't get one while they worked to get family doctors to move into the town.  Around here it's front page news when a doctor decides to move and work in the area.    

In these cases the lack of family doctors is a result of many different factors, some which speak to the design of the system and some factors that have little to do with the design but the desires of people beyond their choice of profession and the system that profession functions in.    Not having money for those doctors was not the main factor though.  One, as you commented on is an overall lack of doctors in basic numbers but it goes beyond that to a lack of overall numbers in the type of doctors in this case doctors that choose to go into family medicine in the first place.  This is most definately a problem.  People are choosing family medicine less and less.    So to understand why this the case the question to explore is 'Why don't more people that go into medicine choose family medicine, especially since there is an obvious demand for it?" 

   Another main factor at play is the distribution of those doctors that do exist.  The current system does not force doctors to go where they are necessarily needed most.  They have a choice of where to work and live.   In my area the choice of where people want to set up and live their lives is just as much a factor of getting doctors as any questions about about budgets and tax money.   In a nutshell less people and doctors seem to want to live in more rural areas then more urban ones.   Most every municpality and health authority around here has some sort of doctor search committee. In knowing a few different people who have worked on those commitees over the years the biggest determining factor of getting a doctor to set up shop has very little to do with anything budgetary or moneyish, it's life and lifestyle.  So when a doctor is found, asked or shows interest they spend more time showing the town, the area, services, schools, culture and everything else that people might factor into where they choose to live.  It's quite literally having to "sell", small town life and our town in particular as a great place and way to live and for younger doctors, raise a family if they have one or eventually raise a family.

     Sometimes things go farther and places will offer incentives, like in one case paying for Canadian certification for a doctor from Russia in exchange for a minimum number of years of work.  Other places have gone so far as to help pay for medical school for young people in their in exchange for them promising to come back when schooling is done.  Why? Because it's not that young people from these areas don't go into medicine it's that the trend is once they leave and build lives wherever they attend school more choose to stay in that sort of life rather then returning.  This rural to urban movement with young people  is a generalized pattern overall that doesn't just pertain to medicine.   It's just a known thing around here that once the youngins leave to go off to school only a few  of those  will ever trickle back when they are done.  

 In terms of system design and the distribution issue it's a tough one to deal with because that factors at play are more then just money issues.   Beyond getting more doctors trained and trained in ratio of the types that are needed so the overall pool is bigger how do you get them into areas where they are needed?