Sunday, July 31, 2005

Robin Williams' Two-Tiered Retaining Walls

With a hat tip to the Blue Blogging Soapbox, who in turn pointed to the following story at A Canadian Econoview, Don't These People Learn?

The post itself is pretty tongue-in-cheek, but the first part is from the New Brunswick Telegraph-Journal:
... Robin Williams and his wife, Marsha, offered to donate $80,000 US to fix a retaining wall and median strip near their home in the city's Seacliff neighbourhood.

City supervisor Gerardo Sandoval balked, fearing Williams would be getting preferential treatment. Sandoval said he didn't want the city to go "down the slippery slope" of putting privately funded projects ahead of those needed in less affluent areas.

But after city staff assured him that Williams' generosity would free up funds for poorer neighbourhoods, Sandoval joined nine colleagues in voting unanimously Tuesday to accept the comedian's gift.

City officials said the funds will be used for new benches, irrigation, planters and bronze memorial plaques.
Then, somewhat facetiously, the author goes on:
What will actually happen is that as the rich start to buy their own bronze memorial plaques, their own retaining walls and their own median strips, support for the publicly funded median strip system will fall, leading not to increased funds being available for poorer areas but to a reduction in total public funding for median strips. And before you know it, every median strip in San Francisco will have two tiers.
A little bit of hyperbole, but if you read it for what it is, it's kind of funny. Anyway, what this did do is make me think.

Remember, I'm 100% behind publicly funded health care, but I'm also realistic enough to realize that the current model we're employing isn't working. If the public health care system cannot or will not (if the current Liberal government has its way), then we must allow some private delivery of health care.

Now, the concern that the article addresses is the belief that allowing for-private health insurance will redirect funds away from the public system. I don't think that's the big problem - I think the legitimate concern is the quality of care in both systems. This was raised as a problem with Ralph Klein's "third way" of health care (CBC,
Better rooms, hip replacements for those who can afford it: Klein) - essentially, with the right dollars, somebody would be entitled to better health care than someone in the public system, who would only get the basic, no frills care. The slippery slope would then lead to bare bones care in the public system, with the best care only available privately.

I think there is a way that could be explored, which Robin Williams did to get the retaining wall fixed. Mr. Williams didn't just go out, hire a contracting company, got everything fixed, and then went about his merry way. He gave the money to the government to do the repairs.

Now, I'm only thinking of this off the top of my head right now, so I might need some time to flesh this out. But, suppose instead of invisibly swiping the Visa at the doctor's office -
all payments must be remitted through the provincial ministry, who would review the expenditures and monitor quality (if you're going to open it wide open) OR kind of the standard idea - the private clinics would be licensed by the provincial governments to deliver certain services it needs delivered to target health care delivery problems.

I'd like to flesh the first idea out later, but I'm a bit long weekended out right now.

Happy Lord Simcoe Day!!


Anonymous said...

The problem isn't money.It is the limited number of doctors and nurses. In your example if 100% of the contrcators are busy building roads, then pulling some of them over to Robin Williams job means he gets services but the rest of the public has to wait for the road jobs longer.

Jim (Progressive Right) said...

Your interpretation of the example is based upon the assumption that there are no other contractors out there. That's not quite true and it is about money.

Even waving the magic wand to begin streamlining approval of foreign-trained doctors takes money:

Plan will help too few
foreign doctors, CMA says

In addition, there is a lack of resources, technology, etc.

From, Why Not Ease the Doctor Shortage with Foreign Graduates?, with links to the College of Physicians, and the Ontario Medical Association.

The bottom line, "We want to continue to reduce barriers to the recruitment, registration, training and education of doctors in this province."

All this takes money. Lots o'cash.

So, you've got three options to fund this additional training, making salaries and benefits lucrative enough for doctors/nurses work here without long hours, and providing them the support and equipment they need.

(1) Raise taxes.

(2) Shift spending away from less effective or less critical programs (ie. gun registry) and priortize health care spending.

(3) Allow private health care delivery, under government control. Encouraging doctors who have left our public system to come back, deliver the care they can.

Obviously, #2 is the most logical but it isn't going to happen under a Liberal government despite all their rhetoric.

So, in light of inevitable and further charter challenges, (see here), we need to deliver option 3 the right and fair way - Or, at least be open to the discussion.

It's not a boogeyman.

Anonymous said...

There are a limited number of doctors, nurses and hospital rooms. All are at capacity now. Or maybe you are just going to bake a larger pie!

Anonymous said...

The retaining wall example is, in fact, instructive. The only way that public healthcare can both improve and survive along with a parallel private system is if the consumers of private healthcare pay the entire cost of adding new doctors to the system (either through tuition incentives or salary increases) and continue to pay into the private system.