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“I am a Canadian, free to speak without fear, free to worship in my own way, free to stand for what I think right, free to oppose what I believe wrong, or free to choose those who shall govern my country. This heritage of freedom I pledge to uphold for myself and all mankind.” ~~ John G. Diefenbaker

FELDSTED: Our health care system is in shambles, and it isn’t hard to figure out why

Our health care system is in shambles, and it isn’t hard to figure out why – political interference.

We need health care professionals to set out reasonable standards for public health care procedures and services. We need to have their plans peer reviewed, and when we are satisfied, write the standards into regulations and then get out of the road.

Let the people delivering services decide how to best do it.

We are wrong to avoid allowing private enterprise delivery of health care … and that is why standards of service delivery and patient care are important. Private delivery does not mean lower standards. We already have a complex schedule of costs for medical procedures. We allow money “X” amount of money for a hip replacement. Some will be easy, others complicated but we fund them at an average. Private clinics would receive the same funding.

The fly in the ointment is infrastructure. Currently, taxpayers fund all of the facilities, equipment, supplies and services such as cleaning, food and laundry. We need to establish what those costs are and make allowance to compensate a private sector facility for part of its investments in infrastructure. Over time, we shift part of the unfractured costs to the private sector and use private sector infrastructure development costs as a template to keep public sector investment costs down. 
The objective is not to make entrepreneurs rich -- or to give preference to people with money. We have to greatly enhance medical care efficiency, and service delivery, to all Canadians, irrespective of domicile.

History shows that governments have no incentive to do more with less. There is no government enterprise that is efficient and effective. Bureaucracy and operating costs increase annually whether services delivered stay the same or shrink.
We need the innovations that private enterprise and non-profits bring to the table. An outstanding example is the STARS air ambulance service operating in the three prairie provinces. It was not a government imitative. The original aircraft and crew was funded by Lions International, and its expansion was funded by the petroleum industry. Big bad oil helped to bring ambulance services to remote areas those of us who live out here are most grateful for.

Provinces can’t allow private health care delivery because Ottawa won’t let them. Ottawa insist that would violate terms of the Canada Health Act and if provinces offend, they will not receive federal health care funding.

No one has ever explained how that is in the best interests of Canadians needing health care.

We must end this ridiculous federal - provincial power struggle and focus on what is best for our society. It is not autocratic health care rule by our federal government. Provinces deliver our health care. Federal health care responsibilities for aboriginals, prison inmates and military personnel have all been farmed out to the provinces.

The federal government contends that because it provides a health care fund transfer to provinces, it has the right to dictate equality of services across the nation. It is not about equality of services; it is about retaining government control over health care.

Here is what I believe we need to have done:

  1. get the federal government out of health care -- stop health care transfers – and transfer tax points to the provinces instead so they collect the entire tax to fund health care 
  2. reduce federal taxes accordingly 
  3. allow private enterprise and non-profits to provide health care services that meet health care and patient care standards 
  4. improve efficiencies to deliver more services for the same or less money.

Governments are failing to keep up with the demand for health care services. We must innovate or see more people unable to access the care they need.   

John Feldsted
Political Consultant & Strategist
Winnipeg, Manitoba


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