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Health Care Costs and Standards

8 May 2005, TheTyee.ca

THE ISSUE

The B.C. Liberal government has contracted out cleaning and food services in hospitals. In Abbotsford, it granted a 30-year contract for the financing, construction and operation of an entire hospital to the only private bidder. The Liberals tout the need for competition to protect the public purse. The NDP insists health-care standards will erode.

Of course, it's complicated

Doctors' offices are private, for-profit businesses, as are most labs that process medical tests. Under the NDP, private clinics provided day surgery at premium rates to Workers Compensation Board clients, to get them back to work quickly and save money. In opposition, the Liberals opposed this "two-tier" policy. In government it became their policy.

The bottom line

What kind of privatization is acceptable? What independent mechanism will your government provide to protect standards? What will you do to ensure the public gets value for money?

Green Party of BC

Private doctors offices as "for profit" businesses are an established medical reality and their ability to operate as such does not necessarily compromise universal health care accessibility, although concerns have been noted about the 'revolving door' aspect that seems to typify how some doctors maximize patient numbers at the expense of time per patient. One answer is to provide more full-time salaried medical staff at clinics controlled by the Ministry of Health. Privatizing service delivery pushes the boundary between profit margin and service delivery to the next level. The HEU strike highlighted deteriorating services at hospitals caused by outsourcing. The motivation of companies to maximize their bottom line can only come at the expense of workers and patients in terms of salary and standards. The GPBC would restore the contracts of HEU as a first step to keep this essential service public. The private hospital proposed by the BC Liberals is clearly an attempt to bring in a US-style health care scheme, a notion that GPBC rejects.

Democratic Reform BC

The party supports the Canada Health Act. Health insurance plans and hospitals should be administered on a not for profit basis by a public authorities. Further privatization and contracting out of work critical to maintaining healthy hospital and care facilities should be resisted. A DR BC government will provide for quantifiable measures of health care delivery, and regulate reporting procedures, so that the Auditor General and Ombudsman can independently hold both public and private service providers accountable. Two-tier systems that create special classes of citizens are unacceptable. Universality, compassion, equality of access, timely and effective service delivery, preventative health care initiatives, home care, and inclusive coverage for essential dentistry, eye care and certified alternative medical practitioners are all part of DR BC's plan for health. A DR BC health care review will evaluate whether administrative cost reductions and greater equality of access can be achieved by eliminating Health Care Premiums. Lyne England, Oak Bay-Gordon Head, DR BC Health Critic, 250 658-8593, england@drbc.ca

NDP

The platform devotes seven pages to health care, in which the failings of the Liberal government are stressed. The NDP plan calls for "strengthening hospitals, not closing them," for "innovative ways to reduce waitlists and expand long-term care" and for reduced "reliance on hospital care". It tops Gordon Campbell's broken promise of 5,000 new long-term care beds with a commitment to 6,000 new beds by 2009. It promises $75 million for a waitlist reduction strategy, 200 new acute care beds, and specialized surgical and diagnostic tests. It promises to increase the role of nurse practitioners create family diagnostic centres offering a range of services, and improve home care for seniors. All are widely touted money-saving strategies. But on the questions we've asked above, there are no clear answers.

BC Liberals

The platform is a breathless litany of numbers. "This year, we will spend over $3 billion more on health care than when we came into office. That represents an increase of over $8 million a day, $300,000 an hour, nearly $6,000 a minute, and almost $100 a second - seven days a week, 365 days a year!" It touts reducing waitlists. Yet in 2002, Premier Gordon Campbell said he would not commit to shorter waitlists, and a close analysis of the figures shows significant failure to accompany some success. The Liberal platform rightly trumpets increased training opportunities for doctors, nurses and nurse practitioners, and it notes big salary increases for nurses and doctors. But as with the NDP platform, there are no direct answers to the questions we've asked above.

Is there a cure for our increasingly costly health-care system?

 [Tyee]