Canadian COVID-19 News

[hpeer]

But there's the rub though. How do we maintain a system with a bit more capacity in it, so that it can more easily accommodate the occasional upsurge in demand. But also be cognizant and responsible in the use of taxes. What's the balance?

Look at all the ways we spend those health dollars. How many are spent trying to save folks from self destructive life choices? Smoking, drug use, obesity, etc.

It is probably worse in the US. Here I see the inner city schools gutted. Which is really stupid because we are under investing in our future.

Here is an idea; reduce RN hours to 30 or 24 per week but retain the same salary. Then you end will have a trained and active work force who has some excess capacity to ramp up in tine of need. And also reinvest in the inner city schools which, in the US at least, are a disgrace. The money would come from not treating folks who have not taken personal responsibility for their health.

Does it not make sense to invest in our future rather over extending the lives of folks who are a net drain? Sounds harsh dosen’t it. But how is it more harsh than condemning kids with horrible schools?

But it is impossible for humans, or at least Westerners, to make these decisions.

So we have chosen our fate, and then bitch about it. It points to systemic problems in our culture.

[goboatingnow]

I don’t think it’s possible to build excess capacity into healthcare systems outside pandemic style responses. Healthcare demands will always consume whatever resources that are available. No politician is going to let healthcare resource lie idle simply because it’s there as a surge capacity.

[Scorpius]

Originally Posted by goboatingnow

I don’t think it’s possible to build excess capacity into healthcare systems outside pandemic style responses. Healthcare demands will always consume whatever resources that are available. No politician is going to let healthcare resource lie idle simply because it’s there as a surge capacity.

Well, you could start by clearing the backlog of hip and knee replacements, etc.

[goboatingnow]

The money would come from not treating folks who have not taken personal responsibility for their health.

A hallmark of developed economies is the collective societal resources are still use to help those that through their own fault found themselves in trouble. No more then mountain rescue or sea based rescue regularly expends effort to recover people that would otherwise win a Darwin Award.

Secondly it’s a slipperier slope and we’ve been here before. The creation of the Untermensch is not some thing we need. It’s a short step from obesity to mental health or “ gays “ or wherever.

[hpeer]

Originally Posted by goboatingnow

A hallmark of developed economies is the collective societal resources are still use to help those that through their own fault found themselves in trouble.

Does that not describe children??

I understand this is primarily a Canadian discussion and I don’t know near enough about Canadian educational difficulties to engage on that topic. Yet I think it is fair to look south to see what the future bides.

And the US city governments are severely derelict.

At some point financial decisions need to be made, and those decisions will have a human face. Which face it is is the only real decision.

I am not saying which decision you need to make, but pointing out that there are costs not readily seen.

I agree that it is bloody unlikely politicians will ever allow some excess medical capacity to exist, but that is not their fault. Politicians only ever give us what we want.

Give this a thought; over the last 100 years we have moved from a principally agrarian society to industrial to service. When it normally took 85% of the population to feed us we now do it with less than 10%. We are by all historical standards filthy rich. By todays world averages we live like kings. The problem isn’t we have too little, but that we are unsatisfied with what we have.

[Mike OReilly]

I certainly don't have answers to Canada's healthcare challenges. I appreciate the difficulty governments face when trying to balance health expenditures against an insatiable demand, while also facing an equally strident drive for lower taxes.

But at the same time, it's clear (to me) that Canada's support of our healthcare systems have eroded over the last couple of decades. Two simple metrics illustrate the point.

I already mentioned this, but Canada used to rank #2 in healthcare expenditure per capita; distantly behind the USA (b/c the USA is such an outlier). Today we've fallen to something like #10. This is because we've reduced relative funding, and other countries have increased. We could, if we wanted to, increase funding and raise our ranking here.

Physicians per capita have likewise fallen. We've never been the top, but we've been in the top ten as of a couple of decades ago. This has steadily eroded to now we're somewhere around the 35th spot.

The markers indicate (to me) that Canada has allowed our healthcare system to diminish over time. I put this down largely to the very real fiscal pressures governments face. But if we really want to build added capacity in our systems so that they can better respond to rare events like Covid-19, we can do it. But it will require that we build our systems back up to what they once were.

But this costs money; i.e. taxes. And few of us here will vote for a politician who promises to raise our taxes.

[Scorpius]

Originally Posted by hpeer

Does that not describe children??

I understand this is primarily a Canadian discussion and I don’t know near enough about Canadian educational difficulties to engage on that topic. Yet I think it is fair to look south to see what the future bides.

And the US city governments are severely derelict.

At some point financial decisions need to be made, and those decisions will have a human face. Which face it is is the only real decision.

I am not saying which decision you need to make, but pointing out that there are costs not readily seen.

I agree that it is bloody unlikely politicians will ever allow some excess medical capacity to exist, but that is not their fault. Politicians only ever give us what we want.

Give this a thought; over the last 100 years we have moved from a principally agrarian society to industrial to service. When it normally took 85% of the population to feed us we now do it with less than 10%. We are by all historical standards filthy rich. By todays world averages we live like kings. The problem isn’t we have too little, but that we are unsatisfied with what we have.

PLEASE DO NOT compare Canada with the US. I know there is a great tendency by Americans and others around the world to lump us together. I know, and I saw it when cruising and otherwise travelling throughout the world. However, we have just as many differences as we do similarities. Our government structures are very, very different. The American federal government was designed to be completely different from the British system - and Canada's system is very much a copy of the British system. The allocated functions, regulatory and taxation systems at the federal, province (state) and municipal levels are very different between the two countries and, most germane to this thread, our health care systems are very, very different. Your comment re municipal governments is generally inapplicable to Canada.

Under our federal system we elect our government roughly every four years (similar to the US although ours are not on a fixed schedule) but our Prime Minister gets his job by first becoming the leader of the majority party in the House of Commons - a screening process that generally does a pretty good job of filtering out the idiots and a**holes. Since our Senate is much weaker than the US one, our Prime Minister has pretty well all the powers of President, Speaker of the House, and Senate Majority Leader, all rolled into one person. It was this HUGE power that the Framers of the US Constitution railed against and so came up with the "separation of powers" concept which is such a major foundation of the document and the American form of government. That system worked pretty well until the Republican Party (at that time lead by Newt Gringrich I believe) declared that they would do everything they could to embarrass, humiliate, and render ineffective any and every Democrat government and President in order to increase their popularity with the electorate. "I shall rise up by pushing my enemies down, not by rising above them". The result has been a pretty ineffective government ever since - because, IMHO, of the Separation of Powers tenet of the US Constitution.

Yes, as head of both the Legislative and Administrative branches of the Canadian government, the Prime Minister has immense power and, with a majority government (a topic for another time) can do almost anything he wishes providing the members of his own party support him and the actions are legal (as determined by our judicial system - which IS independent). But at least, under this arrangement, THINGS GET DONE. And if we the electorate don't like the way things got done, we throw the bastards out at the next election.

Perhaps this great power of our Prime Minister (and our provincial premiers) explains why the "fully vaccinated" (for Covid-19) rate in Canada is above 80% while the US rate hovers down around 60%.

As Winston Churchill once remarked, it's a terrible form of government - but it's the best in the world.

Yes, we certainly have our problems but please don't transfer the American model to or over Canada. We are very, very different countries with some similar and some very, very different challenges and solutions. We are NOT walking down the same path although as one of our most famous Prime Ministers (and father of the current one) said ""Living next to you [the US] is in some ways like sleeping with an elephant. No matter how friendly and even-tempered is the beast, if I can call it that, one is affected by every twitch and grunt." We have to be aware and careful.

I do however generally agree with your concluding statement: "By todays world averages we live like kings. The problem isn’t we have too little, but that we are unsatisfied with what we have". However I'm not sure how that fits in the context of the rest of your post. If you are referring specifically to our health care systems (different as they are) then I'm not sure I do agree. Health care is a conundrum. It's basic premise (with very few exceptions) is that, although (so far) everyone dies once, every effort must be made to prevent death. This is very, very expensive and, as we get better and better at preventing death through new techniques, equipment, drugs and training, costs go up exponentially. It's unsustainable - but the solutions are unthinkable.

[GordMay]

Originally Posted by goboatingnow

I don’t think it’s possible to build excess capacity into healthcare systems outside pandemic style responses. Healthcare demands will always consume whatever resources that are available. No politician is going to let healthcare resource lie idle simply because it’s there as a surge capacity.

Indeed.

“It is a commonplace observation that work expands so as to fill the time available for its completion.”

British naval historian, and author, Cyril Northcote Parkinson wrote that opening line, for an essay in The Economist in 1955*, and the concept known as ‘Parkinson’s Law’.
His example, of the Royal Navy, during and after WWII, also suggests, that more can be accomplished with less, in time of need.

* ➥ https://www.economist.com/news/1955/...parkinsons-law

[GordMay]

OECD data [1] shows that, even in normal times, Canada has fewer hospital beds per person, than almost any other developed country .

In terms of ICU capacity [2], we count approximately half as many beds, per 1,000 inhabitants, as the United States, and nearly a third less than Germany. On average, the U.S. has one ICU bed for roughly very 4,100 citizens. In Ontario, that ratio is one to 6,000.

[1] ➥ https://data.oecd.org/healtheqt/hospital-beds.htm
[2] ➥ https://www.oecd.org/coronavirus/en/...-beds-capacity

[goboatingnow]

All developed nations with socialised healthcare (of whatever hue) struggle with the balance between the insatiable cost of modern medicines and its practitioners and the drain it places on tax resources. In Ireland 80% of the budget is consumed by three departments , health , social welfare and education. Each vies with the other to top the pile expenditure wise. ( this year health is way out on top)

Salaries in medicine are totally out of line. One thing that needs to change is the restricted nature of medical education , demand is kept high by few places attracting only the very brightest. We should have lots more places created and lower the barriers to medical education

Taxpayers are unfortunately the worst adheres to “ eaten bread is quickly forgotten “. On the one hand , calls for more services supported by taxpayers abd on the other hand whinging taxes are too high.

Mind you in the last few years demands to further cut personal taxes have not got much support amongst the public. The trend these days is for people to advocate more extensive supports , and government services.

[Mike OReilly]

Originally Posted by GordMay

OECD data [1] shows that, even in normal times, Canada has fewer hospital beds per person, than almost any other developed country .

In terms of ICU capacity [2], we count approximately half as many beds, per 1,000 inhabitants, as the United States, and nearly a third less than Germany. On average, the U.S. has one ICU bed for roughly very 4,100 citizens. In Ontario, that ratio is one to 6,000.

[1] ➥ https://data.oecd.org/healtheqt/hospital-beds.htm
[2] ➥ https://www.oecd.org/coronavirus/en/...-beds-capacity

Thanks Gord, another excellent metric. Canadians have this out-sized sense of pride around our public healthcare system. But compared to most other rich developed nations' systems, we should have little to be proud of. We really only look good compared to our southern neighbours, which as I say, are huge outliers.

[Mike OReilly]

G&M:
Quebec to expand use of COVID-19 vaccine passports to liquor, pot stores

Quebec is expanding its vaccination requirement to provincial liquor and cannabis stores, and warning that other retail is next,...

The measures in Quebec are part of an effort to clamp down on unvaccinated residents, who are far more likely to be hospitalized with COVID. The latest wave has put unprecedented strain on the province’s medical system.

I suggested this a long time ago. I bet this will inspire many currently "hesitant" people to get vaccinated. I hope other provinces follow suit.

I wouldn't want to see this expanded to true essential services like grocery stores, but it's hard to argue that liquor stores are "essential." And I say this as one who sure loves his booze.

[Zippee]

I don’t think it’s possible to build excess capacity into healthcare systems outside pandemic style responses. Healthcare demands will always consume whatever resources that are available. No politician is going to let healthcare resource lie idle simply because it’s there as a surge capacity.

The BIG stumbling block in the US is that our so-called "health system" has been taken over by huge, private conglomerates who sole focus is profit. Decades ago we had many public and non-profit hospitals that were well funded to better serve the public needs.


Those days are long gone. The privatization of hospitals led to a kind of "just-in-time", "just enough" facilities to serve the most profitable health needs. There is now no excess capacity, by design - it just isn't profitable. These private conglomerates in general cannot be ordered to provide capacity, and our politics - while easily passing massive tax breaks for them - cannot or will not invest sufficient money in providing that needed excess capacity.


The post which claims that it "isn't possible to build in excess capacity" is absolutely true now. But it sure was before the privatization....

[Lake-Effect]

Originally Posted by Mike OReilly

Thanks Gord, another excellent metric. Canadians have this out-sized sense of pride around our public healthcare system. But compared to most other rich developed nations' systems, we should have little to be proud of. We really only look good compared to our southern neighbours, which as I say, are huge outliers.

The most important health system metric is outcomes, not expenditures. It seems we Canadians get a good bang for our healthcare buck, and care is universal. I'm proud of that. But yes I'd like to see a bit more reserve capacity in the system. Canada punches above its weight in medical research; I'd like to see this continue and maybe we could become a greater leader in medical education too.

Interesting as this digression has been, overall capacity is not the point I was trying to make here. I was just trying to point out that we are coming up to the 2 year birthday of the pandemic, yet we don't yet seem to know what to do in the face of yet another predicted wave, in terms of medical response?

(then again, our healthcare system hasn't yet buckled, so maybe we are hitting the right balance, and I'm just focusing on the complaints of those stuck doing the heavy lifting)

[danstanford]

Originally Posted by Lake-Effect

(then again, our healthcare system hasn't yet buckled, so maybe we are hitting the right balance, and I'm just focusing on the complaints of those stuck doing the heavy lifting)

There is no way to avoid feeling the stress of those stuck in the medical field these days, particularly the ones who show up and do the work of those who do not show up. I know the stress I feel about those who are sick without looking them in the eye is bade enough but to be tasked with their care and unable to help more has got to be soul sucking.