This article from 2015 shows how the Canadian government sees its healthcare providers, not as a resource but as a drain on resources. I’d come up with a newer article, maybe something in 2017 or 2018, but the 2015 article has the best quote, which I’ve bolded below.
First, some context: “Queen’s Park stopped talking with Ontario’s doctors back in January and is cutting services to save money… In early February, the provincial government decreed that medical services be cut by an average of 5 per cent. This includes a cut to all doctors’ fees by 3 per cent as well as cuts to primary care and specialist services originally designed to assist complex patients. ”
Now the most important quote in the article: “If doctors see more patients than the arbitrary limit the government has set — government will force physicians to pay back any amount over their imposed limit.”
Parse that sentence a moment. If doctors do too much doctoring, they have to pay for it. On its face, this seems ridiculous. Doctors offer a valuable service, and they’re penalized for performing it? What crazy land have we entered?
Let us for a moment consider the land of the sane. In the land of the sane, health care is a business, and a business generally has two categories of workers: line and staff. Line workers generate revenue by directly participating in the company’s line of business. Staff workers consume revenue in their roles supporting the line positions. A smart business seeks to balance the two kinds, maximizing the number of line positions while minimizing the number of staff positions.
In the business of health care, doctors and nurses generate revenue, lots and lots of revenue. We value our lives, and pay commensurately. Unfortunately, we don’t have enough doctors and nurses, so their value rises. (There are, of course, other reasons for the high prices in the U.S., but this is the crux of the problem, and the only part I’m addressing in this post.)
However, health care isn’t a business anymore in Canada; it’s a government service. Government: that is our crazy land, where taxes generate revenue and any service performed is a cost. Any service. Doctors, police, even tax collectors are staff functions. They consume revenue, and use of their services must be constrained. Who holds the equivalent of line positions in this crazy land? Politicians.
The logic of this crazy land requires service cuts in areas of the highest demand, but logic in the world of the sane tells college students to avoid such industries. Sane logic says increased competition reduces costs; crazy logic pretends that you can put a cap on demand and slow cost increases (even crazy logic no longer pretends it will reduce costs).
Remember this when you hear someone say, “If only we treated health care the way Canada does.”