Atlantica Party on Health Care in Nova Scotia

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Our health care ideas are larger and more sweeping than the Status-Quo Parties; we need to reform the system.

We all have issues with Nova Scotia's Health Care system; they are symptoms of larger problems, namely Nova Scotia's health care model has reached the limits of what it can achieve. More money, more programs as promised by the Status-Quo Parties is not the answer. In fact there is no more money given the fiscal crisis of the province. The Atlantica Party is proposing fundamental change to our health care model so Nova Scotians will have proper health care now and in the future.

The above image is a 2014 study by the Commonwealth Fund which compared the health care systems of 11 major industrialized nations looking at health outcomes such as Quality Care, Access, Efficiency, Equity, and Healthy Lives. Canada/Nova Scotia came second last close to last-place US! 

Interesting that the US and Canada/Nova Scotia both represent the worst outcomes! And Nova Scotia is already spending the highest proportion of its budget on Health Care than any other province. More money is not the answer.

However the Status-Quo does not want to discuss these ideas. It stifles debate by shouting down new ideas with comparisons to US health care and blindly promising even more money to try and paper over what are fundamental problems.

 

The Atlantica Party’s Solution? Imitate the systems that work best!

The number one ranked system in the world, that of the United Kingdom allows private, for-profit hospitals alongside its public system. Switzerland, Sweden, and Australia, the number two, three, and four ranked systems respectively, all have private and public hospitals, and all charge patients some form of user fee for access, even in their public systems. In none of these systems do the poor go untreated, and in fact, when it comes to equitable and fast access to care, they all vastly outperform our own.

At the same time, the United Kingdom's per capita spending on health care, at $3,405 per annum, is only 75 per cent that of our own. That would be a savings of over $1 Billion in Nova Scotia. And they beat us easily in every health care outcome.

This is what the Europeans do:

1. Allow both public and private operators in all spheres of health care, as long as it is within a universal system financed by government, as is the case in Europe. Note this is not a two-tier system!

  • In Germany for example, private hospitals treat patients who are older on average and who have more serious health conditions than those in public hospitals. The data also show that private for-profit hospitals are better equipped to treat difficult cases and more complex pathologies. Moreover, a larger proportion of beds in these hospitals are reserved for emergency room and intensive care patients. 
  • In France, Italy, Sweden, Switzerland, and many other countries, private hospitals and clinics have long been integrated into the public system. Wait times are shorter in some cases 2 to three times shorter. 
  • The revenues of privately run medical facilities depend on the number of patients they treat. In order to attract clients, they have to maintain their reputations. In a competitive environment where the money follows the patient, hospitals that cut on service quality drive away their clients and simply cannot make a profit. 
  • Patients have greater choice since they can choose which facilities will treat them and public funding follows the patient. This promotes more and greater accessibility for all services such as mental health and family doctors. Currently Nova Scotians have only one provider; government.

2. Charge a small upfront fee, say 5%, for procedures.

  • This reduces demand since it reinforces the notion that health care is not ‘free’.
  • The fee rises in conjunction with the cost of the service usually up to a limit or threshold. This is similar to how most private insurance plans operate with respect to drug purchases. Up to a ceiling and exemptions in special cases of chronic illness or low income.

3. Allow private billing for health care provision. This will also ease supply shortages.

4. Encourage the private health insurance industry.

 

In addition the Atlantica Party will also 

5. Reduce high salaried non-front line administration (as per our Atlantica Budget 2017). 

6. Leave front line health care spending as is.

7. Nova Scotia's health care model is directed by Ottawa so the Atlantica Party would advocate reforming the Health Care Act. If that failed our government would be willing to walk away and go it alone.

 

A health care system can remain public and universal all the while allowing entrepreneurs to compete to provide services, attract patients, lower costs and provide more choice instead of leaving patients trapped in a public monopoly that fails to respond adequately to the demand for treatment. This will benefit ALL aspects of health care for Nova Scotians.

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