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'Blow Up' BC Healthcare System, Says Liberal Mayne

As his fellow Lib leader candidates tip-toe around health reform issue.

By Andrew MacLeod, 25 Jan 2011, TheTyee.ca

BC Liberal Ed Mayne

Former Parksville mayor Ed Mayne, running for BC Liberal leader.

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Although two of the candidates to lead the BC Liberal Party were recently ministers of health and another practiced medicine for 32 years, talk about radically reforming the system for delivering medical care in the province is so far being left to outsider Ed Mayne.

Asked for his best suggestion to improve the public health care system, the former Parksville mayor and Tim Horton's donut store chain executive said he would "blow it up."

Considering the health services ministry spends roughly 44 cents of every dollar that passes through the provincial government, managing the system will be a large part of the new premier's job. While it's unlikely others will advocate blowing the system up, none have said much about what they would do.

The Liberals' most recent health minister was Kevin Falcon. His leadership campaign has focussed more on the economy and transportation than it has on health, though he has dedicated a page of his website to the topic.

On it he describes his own family's experience with the health care system and stresses that he understands the need for a strong, sustainable public system.

He suggests better health promotion and disease prevention as ways to keep people out of hospitals, and says, "I believe the key is to be more creative and more innovative on how we get as much patient care as possible out of those billions of dollars."

The website doesn't offer examples of how he would do that, and Falcon didn't respond to several requests for an interview.

Falcon talked reform

As health minister, Falcon made sometimes controversial forays into reforming the system. There was a plan -- made public thanks to Saskatechewan's premier -- to promote "surgical tourism" and bring patients from across Canada and from outside the country to B.C. for surgery.

He also earmarked a small portion of the health care budget for patient-focussed funding so that hospitals or other providers would be encouraged to compete against each other for patients. Critics said Falcon's change would likely increase costs.

Falcon also hiked the amount 20,000 seniors living in residential care would have to pay.

Moira Stilwell's biography on her leadership website highlights her three decades as a doctor, her work at B.C. Women's Hospital in Vancouver and her desire to create "positive change."

Her campaign announcements since she entered the race in November, however, have been about student loan interest rates, infrastructure funding for post-secondary institutions and raising the minimum wage. While there were indications she would unveil a health care platform Jan. 25, she did not respond to requests for an interview.

'Hell on wheels': Abbott

George Abbott, who was health minister before Falcon, acknowledged the size of the issue in a recent appearance at the Truck Loggers Association conference in Victoria.

As baby boomers pass their 65th birthdays, it will make a big difference by both reducing the number of taxpayers and increasing the demand on services, he said. A decade ago, eight per cent of the provincial population was over 65 years old. Today it's 15 per cent and in another decade it will be over 25 per cent.

"That's going to have a dramatic impact on our ability to deliver health and education services and other important services of government," Abbott told the conference. "I used to tongue-in-cheek say as the health minister, 'I'm glad I got to do this job when the job was easy.' It is going to be hell on wheels for a health minister 10, 15, 20 years from now with the demand and the cost of the system."

The province's changing demographics are the greatest challenge to the health care system, Abbott said in an interview. "There will undoubtedly be much pressure on the health care system," he said. It will need additional resources put into it as well as finding ways to do things better, he said.

In particular, he advocated expanding primary care, where health care professionals work as part of teams and family doctors are no longer necessarily the gatekeepers into the system. "It is a way of moving away from what has been the dominant paradigm in health care," Abbott said.

Focussing on primary care has had good results in the Northern Health Authority, where the large distances between population centres have necessitated doing things differently, he said.

Abbott said health care questions have come up occasionally but have not been dominant on the campaign trail, where he's been to more than 100 meetings in 50 communities.

'Blow it up': Mayne

Asked for his best idea to improve the health care system, Parksville mayor Ed Mayne said he would "blow it up and start all over again."

When medicare started in the 1960s, all it paid for was doctors and hospitals, and in those days hospital stays were rare, said Mayne. "If we still had just that parameter, medicare would be very, very sustainable," he said. "But medicare has grown in multitudes over that period of time."

People tend to blame the "damn" unions, doctors and management, he said. "Medicine is death by a thousand cuts. It's all of those things. They all need to be looked at... Do we need six different health authorities with all the management staff that they have?"

Mayne said that he is taking lipitor, a prescription drug used for lowering blood cholesterol. Every two or three months when it is time to renew the prescription, his doctor asks him to come in for a visit, which costs the system, he said. "You do that every day, 100 doctors, how much does that add up to?"

Fixing how health care is delivered is too much of a political hot potato for the politicians to deal with, and the civil servants have too much vested in their current empires, he said. The government needs someone to come in from the outside with a fresh perspective who can make the hard decisions, he said.

A job for a business exec

Mayne said someone like his friend Paul House, the executive chairman at Tim Horton's could do the job. "He's the fellow who took Tim Horton's from where it was to where it is," said Mayne, who was a Tim Horton's vice president in Ontario before moving west.

Mayne said he offered House a dollar a year to come reinvent B.C.'s health care system. "That's really what you need to have. It was tongue-in-cheek to him, but you need to have a person who has that ability and that integrity and that honesty to say, 'This is what it's going to take to change it.'"

A stripped-down system would cover doctors, nurses and hospitals, but nothing else, he said. Things like residential care for seniors, addictions counselling and prescription drugs would all fall outside the system, he said.

"I'm not saying you don't pay for it, you just have a true accounting of what is what," he said. "I'm not saying they're wrong, but they're over and above. That's another budget."

The BC Liberals will pick a new leader on Feb. 26 to replace Premier Gordon Campbell, who in 2006 launched a Conversation on Health with the public that resulted in no obvious changes to the system.

Former attorney general Mike de Jong and former cabinet minister and on-leave radio talk show host Christy Clark are also seeking the job. Neither responded to The Tyee's requests for interviews.

"We haven't heard any significant statements from the Liberal candidates," said Lew MacDonald, co-ordinator of the B.C. Health Coalition. The BCHC will release an open letter later this week that it is sending to the candidates in both Liberal and NDP races, he said. The letter asks them to commit to blocking the proliferation of for-profit private clinics, investing in home and community care and stopping the charging of hospital user fees.  [Tyee]

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  • Fiat lux

    1 year ago

    So, how would people,

    So, how would people, especially old people, pay for "anything else", when prices and the cost of living are going up, incomes shrink every day and nobody has savings any more ?

    Private providers ? We can see enough, how they treat patients and their own staff.The licence to steal from the public.

    PPPs ? The biggest and stupidest racket going. The government may not have to borrow, but has to pay through the nose, forever, many times over, endlessly, than if they had borrowed and paid it off.

    Ed Deak.

  • Skywalker

    1 year ago

    It is a bit much.

    The Liberals have made it a point to ensure that extra dollars from health care have gone to their friends. Doctors, construction companies, big pharma and the private companies that provide hospital services. Now they cry about the increased costs.

  • Booker

    1 year ago

    bull

    So if if the Liberals are interested in reducing costs (and who isn't?) why are they getting rid of the Therapeutics Initiative which researches drug effectiveness and thus saves money from being spent on ineffective or unsafe medications? Why did leadership candidate, George Abbott, add the elaborate placebo treatment known as acupuncture to the MSP when he was Health Minister? The Liberals have not inspired confidence in their handling of health care, and considering that is one of the key functions of a provincial government, they shouldn't be given another chance at it.

  • offended

    1 year ago

    Ed Maynes is being foolish.

    And ignorant.

    You can't make every health issue go away by "better health promotion and disease prevention as ways to keep people out of hospitals".

    Here's a fact; all people die. They don't die because they're healthy.

    They die despite having eaten well and taking care of themselves.

    Some of us have chronic diseases that just happen through no fault of our own; blaming people for illnesses is ignorant. And mean.

    BTW Ed, your doctor monitors your Lipitor use to see how you're doing. Any responsible doctor should do that with that particular medication. Maybe if you followed your own advice, you wouldn't have to take it? See, it's your own fault you have cardiovascular issues.

  • VivianLea Doubt

    1 year ago

    if any system needs to be blown up...

    we might consider the Tim Hortons chain.It is okay, apparently to produce, market, and sell highly-manipulated food that offers a dismal nutritional profile. This allows executives to make the food so cheap it is attractive to consumers, but perilous to their health...and then we tell these same consumers that the health care system is too expensive?

    Why not ask the purveyors of nutrionally-compromised food to pay a higher share of health care costs?

  • Van Isle

    1 year ago

    As I figured out years ago

    As I figured out years ago our Federal and Provincal Governments want our health care system to fail. There have been more study groups/reports gone around in this country over the years, which gives a blue print on how to fix it, and what do our Governments do?; sweet-fuck-all. [UNSUBSTANTIATED CLAIM REMOVED. -MODERATOR.]

  • For a better world

    1 year ago

    The True Cost of Health Care

    No doubt the cost of delivering health care is expensive. What is the true cost? Is it really "...44 cents of every dollar that passes through the provincial government...", and what is that percentage based on?

    What would the cost of health care be if all provincial revenues and expenditures were included in the provincial budgets?
    How would that percentage change if the revenues of all Crown and quasi-Crown Corporations were included?
    What would the percentage be if the operations of all 3P developments were included in the budget?
    What would the percentage be if all corporate development benefits and full revenue streams were included (such as full gas & oil royalties, stumpage fees, and other reduced development revenues)?
    How would that percentage change if the resource sector paid for their own hydro transmission lines?
    How would the relationship change if Corporate and Bank taxes were returned to the pre-2001 period?

    I'm sure Will McMartin has valid perspectives on total health care costs and its relationship to a total and valid provincial budget. He would probably be able to prove that privateers continue to "cherry pick" and take an ever increasing amount out of the health budget.

  • Jerry Munro

    1 year ago

    When and With The Help Of...

    There is no real reason anyone should be surprised by any of this. It has been in the cards and coming on since the late 70s, and the headlong retreat of all parties from the brief Social Democratic State of capitalism. And it is part of what is, in the end, going to drive the working class into the arms of revolution, radical socio-economic transformation, whatever you want to call it.

    Along with the drive of all the parties of the right, and to a lesser degree the so-called "left" or "left lite", to render "public" medical care dysfunctional and unworkable, has parallel with that been the ruling class driven undermining of the entire social safety net (pensions, welfare etc.), the undercutting of working class share in wages, the intensification of work, and the insecurity of working class life generally. Everyone, mom, dad, kids and increasingly grandparents, are now all working for "The Man", many at two jobs, without benefits, ad nauseum.

    And anyone who can't by now see where this is all leading to, is either on opium or has their head up where the sun never shines. There is no "if". It is but a matter of "when".

    I mean, it's a piss, of course. But I thank you, you ruling class and besotted minions. We couldn't ever hope to do it without you.

    I've been ready for decades. The rest of you better get ready. 'Cause it's gonna get worse. Up to now it's been a slow, steady drip. From here we really begin to get down and into it, with the help of the likes of Ed Mayne. And the "business friendly" weaknesses of the likes of the NDP, the Greens, and the trade union leadership.

  • Bytesmiths

    1 year ago

    Yea, let's emulate the US! NOT!

    The Liberals seem to wish they lived in the US, where health care costs twice as much (as a fraction of GDP, or as per-capita spending) and delivers two years shorter lifetime, 30% more infant deaths, and five more years of poor health than in Canada. (http://www.NationMaster.com)

    I have a suggestion for Mayne -- move south! I'm sure that, as a relatively wealthy person, he'll have no trouble getting excellent health care there, unlike 20% of the US population who can't afford any sort of health care at all.

  • Fiat lux

    1 year ago

    I came down with a 6" - 15

    I came down with a 6" - 15 cm. colon cancer 2 years ago and because the first operation went wrong, one of the staples was leaking, not the doctor's fault, I ended up with a total of 5 operations. About 3 weeks on life support, no food or water, hooked up to miles of tubes and wires, altogether 44 days in hospital, lost 40 lbs.

    Our American friends are telling us that in the Land of the Free the whole affair may have cost us about $1.5 million, we would have been very happy to pay, as we must have at least a couple of thousand bucks in the bank, so who cares?.

    Years ago, when Gzowsky was still doing interviews on CBC radio, I'll never forget one, when he was talking to a Canadian doctor, taking some advanced kidney training in Baltimore.

    The Dr. said, he was spending more time on paperwork and fighting with insurance companies, even for permission to send and ambulance to pick up somebody, than on his patients.

    He was telling of a, then recent, case of a young woman who came down with some serious kidney problem, on life support, etc. Her family had a $1. million insurance, and when it ran out, the company demanded that the hospital pull the plug on her.

    The doctors had to have an emergency meeting, trying to figure out, how to save her life, while also satisfying the hospital's shareholders and management ?

    No wonder they have such large demonstrations against the commie medicare we have here in Canada, when we have to ask permission from government officials even for a lousy aspirin ............

    Just ask the Republicans, and the Tea Party, to tell all the government medicare horror stories and why Obama's effort to bring communism to the country must be opposed, by all the right thinking citizens.

    Including byh the Reform Party here in Canada

    I'm sorry I should have written the BCLiberal and federal Conservative parties, we used to know as fascists, back in my European childhood days.

    Ed Deak.

  • Jerry Munro

    1 year ago

    On Being A Weatherman...

    My wife just had a heart attack, and then following a femoral angio, some serious complications with bleeding and infection. A major crisis time in both our lives.

    But what especially leaps out at me from this experience that began our New Year is, how clear the stress fracture lines are in the BC Medical system. I mean, 12 hour days, three days in a row, on a cardiac intensive care unit, does not leave you with the sharpest staff, functioning at its optimum by the third night. I don't care what anyone says about five days off after that. For those five days, they are somewhere else.

    but the contrast with bedside care, a simple thing like a back-rub or a crotch wash, and interaction with the patients to be on top of what is happening with them, between now and even twenty years ago, is astounding. The deterioration in the quality of care since the 70s is palpable, to anyone with a memory experience that goes back that far.

    And they have deliberately made the system borderline, stressed out and cash strapped dysfunctional, as part of creating a public acceptance for the inevitable coming of privatized health care... Partnerships and all that other Neocon doublespeak bullshit first, of course, but the direction of development and end result are already clear to half a brain. (And I wouldn't want to bet any money that the NDP won't overtly or with silence play a role in facilitating or enabling the shift.)

    The working class public is being set up. And this kind of shit is going to go on across the whole of society, until we are left with a society that has more in common with how it functioned, felt and looked in the 30s, even back to the Industrial Revolution of the 18th and 19th Centuries.

    But what really, really astounds me is, that they clearly think they can get away with it. And though they are thus far, much to my surprise I'll grant, what they, the ruling class are also going to get if they succeed, is the same class war climate that went with those times as well. Though I don't really think, for all our disappointments and disillusionments to date even, that the working class masses are going to allow that to happen to themselves and their families.

    Though we shall have to see of course, and especially in this part of the world, the signs are few and far between I'll grant. But great historical shifts, when they come, more often than not like in Tunisia, Lebanon and Egypt right now, next Jordon, can come on with lightening speed and with earth shaking consequences for Old Orders.

    One really does not need to be a weatherman to know which way the winds are blowing.

  • Fiat lux

    1 year ago

    Jerry....They can get away

    Jerry....They can get away with it, because we live in a "competitive", in other words, a daily increasing fascist society, where all that counts is who can steal the most from the most, in the name of "competitiveness".

    As long as we permit our flea brain economists and paid off politicians to sing the songs of "competitiveness" every time they open their stupid mouths, things will go down hill in accelerated pace.

    The only thing that can cut real costs and provide decent services is not "competition", but "cooperation".

    Hitler was the greatest "competitor" of them all and these bloody fools are singing the same song he used to.

    Ed Deak.

  • alive

    1 year ago

    a fallacy

    By the time the great unwashed public catches on to this scam, we shal wittness the same response that we see in the USA today, namely that we are broke and there is nothing we can do about it!

    There will never be anyone brave enough to say that certain segments of the population has raped the society and should now pay back their ill-gotten gains!

  • ex_nihlo

    1 year ago

    It's Just Business!

    Maybe Mr. Ed would dump "the damned unions" from health care entirely, and bring in Philippinas on guest worker visas, like he does in his Tim Horton's in Parksville?
    And why go to all the expense of using Canadian MD's? Doctors from the third world would probably work for peanuts. By doing this, you can keep labor costs to a minimum, just like Mr. Ed does at his Tim Horton's in Parksville. This guy is a financial genius! He even figured out a way to get product placement, for free, in a public election! You got my Vote Mr. Ed. I mean, it's all just business, right?

  • Fiat lux

    1 year ago

    Ex--Probably the majority of

    Ex--Probably the majority of of doctors in our local hospitals, certainly all the surgeons and specialists, are now South African imports.

    I was operated on by a South African and an Indian. Both first class. My eye doctor who did my cataracts, years ago, in Kamloops, also South African.

    The point is that the education of doctors has been so neglected in Canada, for years, and now we have to rely on imports.

    Political brains !!!!!!!

    Ed Deak.

  • Bailey

    1 year ago

    do-nuts!

    All Mr. Main seems to be proposing is taking out half of what we include in the medical budget; long term care and assisted living and the like. Then creating new budgets to pay for those.

    But they were placed in Health to keep them out of private hands in the first place, and to consolidate management costs by concentrating these closely related functions in one structure.

    Every move to privatize or to disassemble the arrangement works against that rationalized system, creating increased levels of chaos and duplication of effort, higher costs, lower standards and more dissatisfaction.

    Health costs so much because of eveything included under it's umbrella. All those costs must be borne, one way or another, whatever organizational changes you make. From my view, it's dirt cheap for what we get. And very well managed, too.

  • Dan the socialist

    1 year ago

    These low wage neocons

    These low wage neocons pretending to be liberals would privatise health care in a heart beat if they knew they could get away with it.

  • Jerry Munro

    1 year ago

    Betting On The Future...

    "The only thing that can cut real costs and provide decent services is not "competition", but "cooperation"." Ed Deak.

    I agree entirely. Indeed, this needs to become the operative principle across an entirely new, "democratized" economy.

    Though I disagree with you Alive. You have obviously failed to look in depth at and consider working class history ever since capitalism first arose out of feudalism. It has been a history of ever ongoing class struggle with the ruling class. And it was this history that really bore us the brief lived fruit of the postwar Social Democratic State of capitalism. It was not a gift innate to the character and dynamic of capitalism itself.

    The problem arose when the working class and its trade unions became a little too comfortable and sure of their gains, and relaxed their guard. And the corruption and integration of trade union leadership into "big" capitalism was one of its manifestations that is still with us. The outcome has been that the ruling class lost its fear of the working class, and came to conclude, like yourself, that its fighting spirit had been extinguished. Hence, while there were other elements innate to capitalist global development as well, the ruling class decided that the working class was once again ripe for the picking and was no longer fit or able to fight back. Thus far they have guessed right.

    You hold to your negativist social democratic position. (Frank holds to it as well.) I will predict that it is but a matter of time and further development within capitalism. If the working class could organize itself in the illegal and oppressive conditions that prevailed from the 18th and 19th Centuries through the 30s and even into the 40s in part, and secure what it did, as it comes to realize what is happening here, who and where its enemies are, this attempt to drive them back in time and living/working conditions will too be organized against and overcome.

    Hopefully, this time, they will also have come to understand that capitalism itself must be entirely defeated, and that our own collective class power must come to dominate. (Not some party, state or government, but ourselves... as a class.)

    Though I agree, we have yet to see who of us is right, for certain.

  • dorothy

    1 year ago

    Now about the healt care system, er zkuze me,

    the commie evangelium...

    "The only thing that can cut real costs and provide decent services is not "competition", but "cooperation"." Ed Deak.

    I agree entirely. Indeed, this needs to become the operative principle across an entirely new, "democratized" economy.

    -------
    “our own collective class power must come to DOMINATE”.. (my emphasis). “..(Not some party, state or government, but ourselves... as a class.)”

    co-operation???

    I say, ask the people on the factory floor. They remain an untapped source of ideas for massive savings...Yes, I know I'm a broken record, but so is everyone else here, so...

  • ASKBiblitz.com

    1 year ago

    Tax 'extended benefits' supplied by U.S. insurance giants!

    Encouraging employers and unions to purchase 'extended benefits' from voracious U.S. insurance giants - generous contributors, all, to Cdn provincial election campaigns - has torn fissures in our magnificent national single-payer health scheme, which is entirely affordable as long as everyone plays by the rules. If we want to keep our excellent, enviable system, we should guard it jealously and tax the bejabbers out of these other benefits schemes. They represent income, after all, and recipients should pay mightily.

  • Jerry Munro

    1 year ago

    More from the "commie evangelium"...

    Yes Dorothy, there are different concepts of "co-operation" that prevail out there. You have one that equats co-operation with "collaboration". I have one that starts from the premise that private corporate/ ruling class power is demonstrably, over a long history of capitalism, but especially recent history, NOT a suitable partner for the working class to be "co-operating" with.
    That has been tried, over the entire postwar period, as one sided as it was in real practice, and failed.

    And the ongoing deterioration crisis in what was once a great and egalitarian medical system in this country, is but one manifestation amongst many of this fact.

    You, in my view, clearly have your head in another reality from the one I, and I suggest most working class folks, have experienced since especially the 70s. Your attitude, and clinging to this "collaborationist" notion of "co-operation" are part of the problem, again in my view, not the solution.

    A further elaboration of the "commie evangelium"... LOL. 8-D, as you fail to understand it too.

  • eastcoast

    1 year ago

    retirees and the tax rolls

    I keep reading that when people retire they will be removed from the tax rolls. Retirees still have income, and certainly still pay taxes, often at least 30 percent. My father is in his 80's and still pays at least 30 percent of his income in taxes. Most of the elderly people I know have placed only a very minor burden on the health care system. I'm not convinced that the boomer generation, who are generally quite healthy are going to be a great burden on the health care system. Our children, the fast food generation, with more sedentary lifestyles could be a different story.

  • Dan the socialist

    1 year ago

    I think there is a lot of

    I think there is a lot of waste. For starters: Do we really need all the bureaucracy and management? We have 13 provincial ministries and one federal one for what 35 million people??? Seems like over kill to me...Does France have that many? (I guess not fair to compare as we basically get 'bare bones' coverage compared to Europe, we don't even get dental in Canada)

    I wonder too if drug companies and even medical equipment manufacturers are 'milking the system' with management and politico's help? (I know this is a bad example but kinda like the military industrial complex in US)

    The money starts from the tax payer and the Feds distribute it to the provinces and provinces manage it, I wonder how much the feds give the provinces actually reaches the 'front lines'?

    Wouldn't it be better to make the provincial ministry's a lot smaller and have the feds do it all, since we have a very small population in this country? Or maybe have 2-5 health regions? The Maratimes/Quebec could be all 1, the prairies, NWT and Nunavut could be 1, BC/Yukon one and Ontario one?

    Canada has a history in my lifetime of having too much bureaucracy...

  • dorothy

    1 year ago

    Whose evangelium?

    "private corporate/ ruling class power is demonstrably, over a long history of capitalism, but especially recent history, NOT a suitable partner for the working class to be "co-operating" with."

    OK, so with whom would you be co-operating, that you aren't already doing it with?

    I can't credit your facetious distinction between co-operating and collaborating. In the worst case scenario, you are attempting to cast a snide innuendo my way and infer that I am a 'collaborator', and we of European stock all know the connotations of that term. Other than that, is there a difference?

    Yes, those of the private, corporate ruling class are poor prospects for co-operation, as many are sick twisted people, ruled by an abject fear of poverty and insignificance. However, seek first to understand, then to be understood. You can co-operate with anyone, if you know what makes them tick. And I don't see how you will get around them other than by bloody overpowering revolution. They tried that in Russia. Where are they now? You could look at Cuba, but don't then forget that that 'revolution' was led by an insider of the moneyed class, someone who had an understanding of what successful leadership and economic enterprise in Cuba looked like, not by a child of the working class.

    I think you must, in order to gainsay my standing on this with more than just mudslinging, flesh out your ideas more than you have. I am curious to know whom you picture as partners in co-operation and how you will go about putting that co-operation into effect.

    Regarding the medicare system, I'm all for making it federal all the way. I think the provincial jurisdiction allows for way too much local empire-building, mutual ass-buttering, and stupid double or triple bureaucracy, as well as equality in access and received quality is a Charter-protected right and should therefore rest with federal jurisdiction. Not to mention that it would give us far better recourse to know whom we can hold responsible for shortfalls, instead of as now, where responsibility can be thrown back and forth in elaborate diversionary grandstanding.

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