Quote:
Originally Posted by Ozy_Flame
I would like to see small pilot projects in different parts of Alberta that tests two systems - single-payer, private delivery healthcare, and the other does full public, extra funding, beefed up classic Canadian model. The purpose of this would be to see how these results would work in an Albertan context, and whether each of them (or neither of them) are sustainable.
Then, on completion, assess the benefits and the negatives, and try and put a system together that capitalizes on the good parts and adjusts the not-so-good parts.
Both pilots would be developed by neutral healthcare professionals and with input from economists, scientists, and the community for local specifications. Scientific methods would be at the absolute heart of both pilots.
I don't trust the UCP to actually execute a project properly (pilot projects are crucial to projects in my industry to determine if something can scale), but I think with ample funds to conduct both, it would be interesting to see.
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Experimenting on the populous like this is largely considered unethical. Especially with the opening hypothesis is that you will do harm to some.
And we don't really need to studies, the results are pretty clear, the cheapest most effective healthcare systems all generally look like; universal public funding, with high cost infrastructure investments owned by the government, and owner/operator frontline/preventative care delivery.
Many of the solutions are also fairly clear, but many of them are invest now to reap benefits in 10+ years; More educational spots, lighter education before specialization, cracking down on pseudo medical services draining resources and time from the system, clawing back on corporate ownership of clinics, government support to setup private delivery clinics where the owner is part of the day to day operation (maybe after x number of years working in a GP office or residency in Alberta).
There are also problems that aren't so clear, like how we can get doctors billing for outcomes instead how many patients they can rip through in an hour. But the solution we don't need is more corporate ownership of what should be public infrastructure. If you were going to run a trial, should be on solutions to billing for quality over quantity in front line care, but even that can't really be addressed until you solve the staffing shortage, by educating more doctors/nurses.
On the funding side, I things become a lot less clear, you can really mess around with things in a lot of different ways. Universal insurance premiums, consumption taxes, moderate front line user fees. In general with taxes, I am a big fan of taxing on the income side as soon as money is earned, some times taxing vices if there is a strong argument for the public benefit from those taxes, and leaving everything else alone. Then paying for everything out of general funds. I think the biggest problems in our tax system are the ways in which people can shelter or differ tax payments almost indefinitely (the government shouldn't be in the business of giving people with savings interest free loans), and the amount of red tape you would create for tax payers and the government to setup another system of collecting taxes. Given that a massive fraction of Alberta budget goes towards healthcare, you can't really talk about healthcare solutions without talking about how to get more out of your tax policy.
All of that said, I'm fairly sure that getting rid of 1 big bureaucracy in favour of a bunch of smaller fiefdoms is only going to throw fuel on the waste fire.
But I suspect that is the plan when the system you have is better than the system you want, you need to diminish what you have before pushing the change.