02/2002: The Pulse

Published February 1, 2002

Ontario’s The National Post recently conducted a new survey of Canadian public opinion on a host of health care issues. The results are a fascinating mix, including the following tidbits:

  • Only 10 percent of Canadians think their health care services have improved “over the last couple of years,” while 62 percent think they have gotten worse. This is an improvement from the last survey (February 1999), when the numbers were 6 percent and 79 percent, respectively.
  • When asked which country has “superior” medical technology, 57 percent said the U.S. and only 14 percent said Canada.
  • When asked who is doing the best job in health care, the top two categories were doctors in general practice (27 percent) and registered nurses (20 percent). When asked who is doing the worst job, the top two categories were the provincial health ministry (24 percent) and the federal department of health (17 percent).
  • When asked if it was a “good idea” to add certain services to the system, 90 percent supported more home care, 84 percent supported more “walk-in clinics,” and 73 percent supported going to nurse practitioners rather than doctors “at the first sign of illness.”
  • When asked if it was “important” that Canada continue to provide “free access to a fairly wide range of services for all or almost all,” 88 percent said it is and only 9 percent said it is not.
  • When asked if it was “important” that “provincial governments exercise central control over the entire health care system in great detail,” 71 percent said it is and only 24 percent said it is not.
  • Similarly, 60 percent disagreed with the idea that “patients would be treated better if the money flowed through them.” Yet 50 percent supported the idea of considering Medical Savings Accounts, while 45 percent did not.

Source: “Special Report: State of Health Care,” The National Post, November 17, 2001. http://quarterlyreport.nationalpost.com

Ontario Premier Misses Opportunity

The Ottawa Citizen expressed disappointment that Ontario Premier Mike Harris isn’t doing more on health care in his waning days in office. In an editorial, the paper criticizes him for doing nothing more than asking the federal government to spend more money, when he could be suggesting innovations like MSAs.

Source: “A Missed Chance for a Healthy Exchange of Ideas,” The Ottawa Citizen, November 27, 2001.

Alberta Health Reform Report

In Alberta, a new report on health care reform “won’t fly in the face” of the Canada Health Act, according to the Calgary Sun. The article says a draft of the report included raising premiums, adopting MSAs, and taxing benefits as possible solutions to rising costs. Provincial Health Minister Gary Mar is encouraged that federal Health Minister Allan Rock has recently said the Canada Health Act “wasn’t the Bible” and may be subject to modernization.

Source: Nova Pierson, “No Major Health Act Fights on the Horizon,” The Calgary Sun, November 17, 2001.

Heart Surgeon Tells Canadians to “Stop Pretending”

The Toronto Star profiles Dr. William Keon, one of Canada’s top heart surgeons, who has been serving on a legislative committee looking at health reform in Canada.

The committee, chaired by Senator Michael Kirby, has released a report urging Canadians to look at reforms such as hospital user fees, MSAs, more private clinics, and a tax on received medical services.

The article says Dr. Keon is not very comfortable with politics or ideology, but he sees profound problems in a system that absorbs 44 percent of Ontario’s total government spending (up from 33 percent five years ago), but still has problems that get worse every year.

“He thinks (Canadians) owe it to themselves and their children to stop pretending the health care system is fine, or temporarily indisposed,” the article says.

Source: “A Doctor’s Worried Plea,” Toronto Star, November 10, 2001.

Ontario Hospitals Want Honest Debate

The Ontario Hospital Association is also worried that Canadians are in a state of denial, according to the Ottawa Citizen. The group commissioned a poll that found most Canadians oppose user fees, MSAs, competition between hospitals, and reducing coverage for wealthier citizens. Yet the poll also found only “lukewarm” support for the current system.

All this frustrates OHA head David MacKinnon, who is quoted as saying, “We just have to get off that business that whenever anybody pokes his head above the trench to put forward an idea, somebody takes a shot at him or her. … If we’re all bounded by our own ideologies and preconceptions we’ll fail.”

Source: David Rider, “Hospitals Urge Open Debate,” The Ottawa Citizen, November 7, 2001.

Alberta Taxpayers “At Breaking Point”

Back in Alberta, the head of the provincial reform commission, Don Mazankowski, testified before Senator Kirby’s national commission that, “The burden of taxation on Albertans is almost at the breaking point.”

According to an article in the Edmonton Journal, Mazankowski said “Alberta must consider increasing health care premiums and making patients pay for medical procedures currently covered by medicare.” But union leaders and liberal critics called such talk a “betrayal” and accused both Kirby and Mazankowski of being associated with businesses that would profit from a break-up of Canada’s universal coverage system.

Source: Shawn Ohler, “Mazankowski Proposes Patient-Pay Health Care,” Edmonton Journal, October 18, 2001.

Health Care Will Consume 53 Percent of B.C. Budget

Senator Kirby also made an appearance in Vancouver, where he told a symposium that British Columbia is on its way to spending 53 percent of the provincial budget on health care.

An article in the Vancouver Sun says British Columbia is already embracing private/public partnerships for new hospitals and considering user fees and supplemental private insurance. It cites Premier Gordon Campbell as saying “most reformers agree that medical services should be free to the poor and less so for the middle class and wealthy.”

Source: Pamela Fayerman, “B.C. Patients Told They’ll be Paying More,” Vancouver Sun, October 23, 2001.

Conning Releases New D-C Study

Back in the U.S. of A., another new study on Defined Contribution has been released, this one by Conning & Company, an insurance industry services firm.

Company Vice President Samuel Levitt is quoted in a press release as saying, “We now see the kind of incremental approaches in health care benefits that signal a shift towards defined contribution. And, we also see clearly that employers, insurers, and employees all have something to gain from this shift.”

The study is huge (some 125 pages) and expensive ($575), but the press release, table of contents, and introduction are all available for free.

Source: http://www.conning.com/researchnew/pressreleases/011126.asp

Crain’s: D-C is “Next Big Idea”

Crain’s New York Business included an article about Defined Contribution, which it calls “the next big idea in health care coverage.”

The piece focuses on Novartis, which has signed up with Lumenos for 2002 enrollment. Novartis spokesman Bill Flannery is quoted as saying “It’s the first step in changing the company’s entire philosophy about health coverage.” The article says the various consumer-driven companies can expect enrollment of about 500,000 employees in 2002.

Source: http://www.crainsny.com/article.cms?articleId=15081&a=a&bt=Novartis

Greg Scandlen is senior fellow in health policy at the National Center for Policy Analysis in Dallas, Texas. To sign up for his free weekly e-newsletter, Scandlen’s Health Policy Comments, log on to http://www.ncpa.org/sub/. For back issues of the newsletter, go to http://www.ncpa.org/sub/shpc/. Scandlen can be contacted by email at [email protected].