Canadian governments have usurped responsibility for the healthcare of Canadians, but governments fail to meet their responsibilities,
not because of ill will but because there is not enough money. And there is not enough money because governments do not wish to raise the relevant taxes for fear of imposing more burdens on the poor.
In short,the governments have usurped a responsibility they cannot fulfill.To put it bluntly: they promised healthcare,they created a Kafkaesque penal colony.
Our health services need much more money. But the money goes abroad: there is, I found out, a thriving international industry in medical services. The socialist obsession with equality, of suffering, not of health, can easily be replaced by a viable policy of healthcare, provided of course one were to ask experienced people who do not come from the hinterlands .
Bill,
Another article exactly on point, realistic and doable. Thank you for continuing to be the only credible commentator on Nova Scotia public policy issues.
As long as our budgeting model is “I’ve got mine, screw your kids” all of the money in the world will never be enough.
The next canarie in this particular coal mine looks like it will be France. They recently announced a 2 billion Euro government jobs creation program because they have an acute lack of external investment.
“How do we get out of this hole? Dig faster!”
In 2012 France tried to levy a 75% on off tax grab on their rich which is another sign to me of desperate times ahead. Nevermind that it was eventually ruled unconstitutional they did have a flight of people from France to… the Soviet Federation of all places.
Even if NS did have enough rich people to target our anual budget is 9+ billion dollars. It won’t take too long to burn through that particular windfall either.
We don’t have the appetite to do what is neccessary – i.e. spend within our means, and God forbid, lower our taxes. We’d have cut spending somewhere, and then we may look like meanie pants (or more importantly you can’t buy votes by cutting spending). Then we have to address the debt before interest rates rise and our “debt servicing” percentage rises to 10-15% or more of the anual budget.
Unfortunately math and creditors don’t really care about our feelings all that much.
What we need to do in this province is focus on the economy. EVERYTHING else will fall out of that.
In particular we don’t need more people (yet) we need more decent paying jobs. If we don’t have the local skill sets to fill those jobs then more people will come. It doesn’t do us any good to have another 200-300K people in the province if they are not taxable entities who produce more tax than they consume in government spending. That is the cold, hard, logic of it.
I truly think the root issue is our (would be) private sector is capital starved – particularly in segments of the economy that would diversify us out of being based on natural resource extraction that is not neccessarily competitive on the global scale or has a hard boom/bust cycle like off shore oil production.
We have clever people in this province but not all of them have access to capital to boot strap their particular ideas. Anecdotally I know plenty of Nova Scotians involved in startup ventures in Vancouver, Toronto and Montreal. I know a LOT less in Nova Scotia.
We need to attract external investment (not with corporate welfare) but by being one of the most competitive jurisdictions in Canada (again, not with tax payers hard earned money). If we cannot convert the current Canadian to US dollar exchange into investment from US sources then we have squandered a massive opportunity.
You may use my note so that the Canada Health plan be exposed. A personal experience: a few years ago I needed a gastroscopy because of chronic pain.I was told I had to wait eight month. Relatives in Europe arranged for me to have the procedure done within a day after my arrival.A friend of mine and I needed a MRI last fall.We were asked to wait from five to six months.We had it done privately.At the moment I need a hip replacement.I was told it may take from one to
two years to have the operation. I found a private clinic in Germany at which I could be operated within a week (cost for the operation $29,000, funds which could stay in Canada.
Please feel free to use my name. There are many doctors who agree, but cannot speak up.
Yes Bill, but while” there is not enough money”, something that the responsible among us understand, the better heading was as in the Chronicle Herald, Saturday – that what is the needed reform of “Privatize, Decentralize and Revitalize healthcare”, would be ‘right’ for Nova Scotia.
I suggest that part of our problem is cultural. We seem to place more importance on the redistribution of existing wealth than the generation of new. Unless this changes, we will face a lower standard of living as we squabble over the dividing up of a small pie.
Excellent article Bill.
There is a solution, it is called the City of Halifax slush account. The city has benefitted substantially from the policies of the province. It has grown and seen substantial growth it its tax base. The City’s growth has come at the expense of the other municipalities. Effectively it has been a property tax transfer and the big guy has won.
What has the city done with its win fall? Built temples such as the gold plated library and convention center. It is able to build biker ramps off of bridges that cost millions to serve 250 bikers a day. Its recreational capacity has increased 5 fold. Even after all this spending it still has $200,000,000 in secret slush funds. Last year it raised taxes to create another slush fund labelled “future projects” and the Mayor magically offset winter maintenance costs of $13M without batting an eye.
So what is the greatest need (future project) for the residents of the City of Halifax. I suspect health care trumps everything else. The city has all this secret surplus cash available, which means the taxpayers were overtaxed. Seniors in the city have contributed greatly to this slush fund and now they need a medical facility to address their most significant problem. They do not need temples or bike ramps.
Here are the steps to a win win.
-The province “convinces” the city to generously “donate” the $200M as the city’s share of the cost of the new hospital, which the city’s residents, particularly its overtaxed seniors, desperately need.
-The province passes laws which prevent the accumulation of such slush funds in the future. The residents benefit because tax rates would go down, as the current tax rates include contributions that have built the $200M. (strengthening the municipal laws regarding transparency and accountability would also help.)
But there is also another plus– other residents of the province, outside of Halifax, get a new primary care/ trauma center as a payback for years of tax theft at the hands of the city and province.
We can afford temples, duplicate convention centers, bike ramps, $200M slush funds, but we cannot afford a desperately needed hospital. We cannot afford everything but we can afford a new hospital. It is all a matter of priorities. That is where leadership comes in, and I am afraid that is what we lack more than money.
When contemplating the economic situation confronting this province, the word ‘hopeless’ keeps presenting itself…Bill, is there any practical and politically possible way forward that does not involve very tough love and bitter medicine?
Medical Tourism? Really?Y Do you think our “super sub-specialists” will return any ‘profits’ to the public purse? Even it they wanted return the ‘profits’ to do this difficult work, do you really think they would take on this work without any other incentives? Why would they do off-shore patients from other countries when they already deliver such services to other Maritime provinces without any new compensation?
If we had the British NHS model for the majority of health care and privatization for some ‘speciality’ care then the idea might work but that is not likely to happen in Canada. Your suggestion creates two-tier medicine. One can hear the push back already.
Bottom line is to build a new tertirary care facility and do it as soon as possible, as this is more likely to help the greater good, and by making it a modern hospital in all respects this will keep the medical ‘expertise’ here who want to work in our system!
All government programs need a wake -up call. They should publish the revenues and expenses of every department . For each program,do the and then measure the output of each and cost per capita and cost per user , and THEN survey to rank what is needed and what can be decreased .
So many problems,so little money.
We have authored our own conundrum and refuse to rewrite the solutions.
The facts are self evident.
1) To many old people,supported by their progeny,claiming entitlements without regard to costs, obligations or duty.
2) A philosophy that government can provide health care more efficiently than private entities.
3) Poor planning policies by municipalities–witness the difficulty in permitting “granny suites” and small lot, small home building permits.
4) the perception that the elderly with certain ambulatory or minor mental short-comings must be in special homes. Why not consider voluntary placement with (for example) small farm families where the financial assistance paid to the family would enable the owner to remain on the farm on a full time basis and hopefully lead to a successful operation rather than a subsistence living.
5) a requirement that family members bear a certain percentage of care costs .I recognize this is a political anathema as well as an attack on eventual inheritance expectations–but so is capital gain tax on death
To achieve any of the above.requires revision of mind set, but to ignore the situation means the problems will compound at a geometrical pace and lead to eventual bankruptcy or galloping inflation or both
Canadian governments have usurped responsibility for the healthcare of Canadians, but governments fail to meet their responsibilities,
not because of ill will but because there is not enough money. And there is not enough money because governments do not wish to raise the relevant taxes for fear of imposing more burdens on the poor.
In short,the governments have usurped a responsibility they cannot fulfill.To put it bluntly: they promised healthcare,they created a Kafkaesque penal colony.
Our health services need much more money. But the money goes abroad: there is, I found out, a thriving international industry in medical services. The socialist obsession with equality, of suffering, not of health, can easily be replaced by a viable policy of healthcare, provided of course one were to ask experienced people who do not come from the hinterlands .
Detlev Steffen | January 25, 2016 |
Bill,
Another article exactly on point, realistic and doable. Thank you for continuing to be the only credible commentator on Nova Scotia public policy issues.
Robbie
Robbie Shaw | January 25, 2016 |
As long as our budgeting model is “I’ve got mine, screw your kids” all of the money in the world will never be enough.
The next canarie in this particular coal mine looks like it will be France. They recently announced a 2 billion Euro government jobs creation program because they have an acute lack of external investment.
“How do we get out of this hole? Dig faster!”
In 2012 France tried to levy a 75% on off tax grab on their rich which is another sign to me of desperate times ahead. Nevermind that it was eventually ruled unconstitutional they did have a flight of people from France to… the Soviet Federation of all places.
Even if NS did have enough rich people to target our anual budget is 9+ billion dollars. It won’t take too long to burn through that particular windfall either.
We don’t have the appetite to do what is neccessary – i.e. spend within our means, and God forbid, lower our taxes. We’d have cut spending somewhere, and then we may look like meanie pants (or more importantly you can’t buy votes by cutting spending). Then we have to address the debt before interest rates rise and our “debt servicing” percentage rises to 10-15% or more of the anual budget.
Unfortunately math and creditors don’t really care about our feelings all that much.
What we need to do in this province is focus on the economy. EVERYTHING else will fall out of that.
In particular we don’t need more people (yet) we need more decent paying jobs. If we don’t have the local skill sets to fill those jobs then more people will come. It doesn’t do us any good to have another 200-300K people in the province if they are not taxable entities who produce more tax than they consume in government spending. That is the cold, hard, logic of it.
I truly think the root issue is our (would be) private sector is capital starved – particularly in segments of the economy that would diversify us out of being based on natural resource extraction that is not neccessarily competitive on the global scale or has a hard boom/bust cycle like off shore oil production.
We have clever people in this province but not all of them have access to capital to boot strap their particular ideas. Anecdotally I know plenty of Nova Scotians involved in startup ventures in Vancouver, Toronto and Montreal. I know a LOT less in Nova Scotia.
We need to attract external investment (not with corporate welfare) but by being one of the most competitive jurisdictions in Canada (again, not with tax payers hard earned money). If we cannot convert the current Canadian to US dollar exchange into investment from US sources then we have squandered a massive opportunity.
George H. | January 25, 2016 |
You may use my note so that the Canada Health plan be exposed. A personal experience: a few years ago I needed a gastroscopy because of chronic pain.I was told I had to wait eight month. Relatives in Europe arranged for me to have the procedure done within a day after my arrival.A friend of mine and I needed a MRI last fall.We were asked to wait from five to six months.We had it done privately.At the moment I need a hip replacement.I was told it may take from one to
two years to have the operation. I found a private clinic in Germany at which I could be operated within a week (cost for the operation $29,000, funds which could stay in Canada.
Please feel free to use my name. There are many doctors who agree, but cannot speak up.
Detlev Steffen | January 25, 2016 |
Yes Bill, but while” there is not enough money”, something that the responsible among us understand, the better heading was as in the Chronicle Herald, Saturday – that what is the needed reform of “Privatize, Decentralize and Revitalize healthcare”, would be ‘right’ for Nova Scotia.
Gordon a.... | January 24, 2016 |
I suggest that part of our problem is cultural. We seem to place more importance on the redistribution of existing wealth than the generation of new. Unless this changes, we will face a lower standard of living as we squabble over the dividing up of a small pie.
Steve Chipman | January 23, 2016 |
Excellent article Bill.
There is a solution, it is called the City of Halifax slush account. The city has benefitted substantially from the policies of the province. It has grown and seen substantial growth it its tax base. The City’s growth has come at the expense of the other municipalities. Effectively it has been a property tax transfer and the big guy has won.
What has the city done with its win fall? Built temples such as the gold plated library and convention center. It is able to build biker ramps off of bridges that cost millions to serve 250 bikers a day. Its recreational capacity has increased 5 fold. Even after all this spending it still has $200,000,000 in secret slush funds. Last year it raised taxes to create another slush fund labelled “future projects” and the Mayor magically offset winter maintenance costs of $13M without batting an eye.
So what is the greatest need (future project) for the residents of the City of Halifax. I suspect health care trumps everything else. The city has all this secret surplus cash available, which means the taxpayers were overtaxed. Seniors in the city have contributed greatly to this slush fund and now they need a medical facility to address their most significant problem. They do not need temples or bike ramps.
Here are the steps to a win win.
-The province “convinces” the city to generously “donate” the $200M as the city’s share of the cost of the new hospital, which the city’s residents, particularly its overtaxed seniors, desperately need.
-The province passes laws which prevent the accumulation of such slush funds in the future. The residents benefit because tax rates would go down, as the current tax rates include contributions that have built the $200M. (strengthening the municipal laws regarding transparency and accountability would also help.)
But there is also another plus– other residents of the province, outside of Halifax, get a new primary care/ trauma center as a payback for years of tax theft at the hands of the city and province.
We can afford temples, duplicate convention centers, bike ramps, $200M slush funds, but we cannot afford a desperately needed hospital. We cannot afford everything but we can afford a new hospital. It is all a matter of priorities. That is where leadership comes in, and I am afraid that is what we lack more than money.
Barry H | January 22, 2016 |
When contemplating the economic situation confronting this province, the word ‘hopeless’ keeps presenting itself…Bill, is there any practical and politically possible way forward that does not involve very tough love and bitter medicine?
bob mackenzie | January 22, 2016 |
Medical Tourism? Really?Y Do you think our “super sub-specialists” will return any ‘profits’ to the public purse? Even it they wanted return the ‘profits’ to do this difficult work, do you really think they would take on this work without any other incentives? Why would they do off-shore patients from other countries when they already deliver such services to other Maritime provinces without any new compensation?
If we had the British NHS model for the majority of health care and privatization for some ‘speciality’ care then the idea might work but that is not likely to happen in Canada. Your suggestion creates two-tier medicine. One can hear the push back already.
Bottom line is to build a new tertirary care facility and do it as soon as possible, as this is more likely to help the greater good, and by making it a modern hospital in all respects this will keep the medical ‘expertise’ here who want to work in our system!
Allan | January 22, 2016 |
Fairly accurate
Kevin McNamara | January 22, 2016 |
All government programs need a wake -up call. They should publish the revenues and expenses of every department . For each program,do the and then measure the output of each and cost per capita and cost per user , and THEN survey to rank what is needed and what can be decreased .
Peter S | January 22, 2016 |
So many problems,so little money.
We have authored our own conundrum and refuse to rewrite the solutions.
The facts are self evident.
1) To many old people,supported by their progeny,claiming entitlements without regard to costs, obligations or duty.
2) A philosophy that government can provide health care more efficiently than private entities.
3) Poor planning policies by municipalities–witness the difficulty in permitting “granny suites” and small lot, small home building permits.
4) the perception that the elderly with certain ambulatory or minor mental short-comings must be in special homes. Why not consider voluntary placement with (for example) small farm families where the financial assistance paid to the family would enable the owner to remain on the farm on a full time basis and hopefully lead to a successful operation rather than a subsistence living.
5) a requirement that family members bear a certain percentage of care costs .I recognize this is a political anathema as well as an attack on eventual inheritance expectations–but so is capital gain tax on death
To achieve any of the above.requires revision of mind set, but to ignore the situation means the problems will compound at a geometrical pace and lead to eventual bankruptcy or galloping inflation or both
tax
f
bill | January 22, 2016 |