Election Roundtable

After my mother died, my brother quipped sarcastically that no one should be admitted to Regina General unless they first survived two hours on a vibrating gurney.

Saskatchewan spends $4 billion a year on health – 44% of the total provincial budget – on a population of under one million, and those dollars are increasingly directed to more centralized systems of delivery. While debate about "wait times" tends to revolve around diagnostics and scheduling of surgery (especially "elective" surgery such as knee and hip replacement), few consider the "wait time" facing the farmer in Val Marie with a crushed pelvis or severed artery.

For when it is decreed that your local hospital is no longer "economically viable" (a curious complaint to put forward under not-for-profit ideology!), bureaucrats gather a few hundred miles away, debate the best way to release the bad news, and with a big red pen, draw a line through your town. They will apologize, quite properly, while they advise you, quite improperly, to be grateful that health care is still "free." You'll just need to start out a little earlier in the morning to get to it.

Welcome to zero-tier health care.

While the sacred cow of "universality" grazes on in the world of the reality-challenged, vast regions of the country are being transformed into zones of health care prohibition.

With every new cut, more and more rural Canadians are faced with travelling long distances over crumbling roads to seek emergency care - the "vibrating gurney" of the rural ambulance. The only thing "universal" about the system is the rate of taxation and the powerlessness of the very people who pay the bills - the taxpaying patients. The patient taxpayers.

After waiting 10 days on oxygen in an intensive care ward, where it was more likely that a knowledgable visitor would tend to a distressed patient or dysfunctioning equipment than any of the five nurses charged with holding down chairs, we began to wonder when the lung specialist planned to show up to discuss our mother's condition.

He had to be reminded, as it turned out. Standing over the duct-taped linoleum, he shared the diagnosis and advised it was terminal. With no hope of treatment, we arranged for her return by ambulance the 120 miles to our local rural hospital, where she was finally treated for pain and was tended to by a nurse she knew as a friend. Thank heaven for small mercies - for it had been slated for closure earlier that year.

The "not for profit" lie is so bold, so obvious, so outrageous, that it's difficult to understand how it's survived this long.

The truth is precisely the opposite. Everyone in the Canadian health-care system, from top to bottom - from doctor, to nurse, to bureaucrat, to cleaner, to kitchen staff - has a guaranteed profit, guaranteed payment, often in wages that eclipse those in the private sector, regardless of quality or timeliness of patient care.

And even this isn't enough for some - they demand guaranteed patients, through the eradication of what private sector competition there is.

The only participant who lacks a guaranteed return under this "not-for-loss" monopoly is the one paying the bill, the patient whose assets are involuntarily seized through taxation to keep the hulking, insatiable bovine alive and belching. The most powerful check and balance of all - the ability of the customer to refuse payment to protest inadequate service - has been removed from the equation.

Discussing the abysmal quality of care my mother received with a friend who works in the bureaucracy, I suggested that the imbalance might be partially restored through a holdback system, in which a percentage of wages or fees would be released only upon patient or family signoff - in the way that holdbacks are used in the construction industry to ensure the job is well and truly complete.

She disagreed with the idea, for, as she correctedly argued, "Some people might withhold payment unfairly."

To which I replied; "Welcome to the world the rest of us live in."