Saturday, July 18, 2009

The purposes of journalism

"The stenographers of power will always find work. As will the trumpeters of fame. I.F. Stone wrote not to create a sensation, or to promote himself (or his 'brand'), but to change the world." John Ibbitson quotes from D.D. Guttenplan's Stone biography in a review in today's Globe.

Friday, July 17, 2009

Health cuts unnecessary and a broken promise

The Campbell government has decided the province’s sick and injured should carry a chunk of the recession’s burden.
The health authorities - more than three months into the fiscal year - have been told to make $360 million in spending cuts.
They’re looking for administrative savings, of course.
But they are also planning layoffs, longer waits for surgery and cuts in acute and residential care.
The government has decided that keeping the deficit small is more important than maintaining health care at the current level. People should limp longer with their bad knees or wait longer for care.
Governments can do what they want. But we’ve just been through an election campaign. And the Liberals did not talk about reducing the level of health care in the interests of fiscal responsibility. (And the other parties and media, myself included, did not raise the issue effectively.)
Quite the contrary. They promised to protect health care.
Health Minister Kevin Falcon wrote to the health authorities Wednesday. (Or, more accurately, public affairs staff drafted a dozen versions of a letter really aimed at managing media coverage.)
After 535 words setting out all the great things had been done in the last few years, Falcon got to the point.
The authorities had submitted budgets based on maintaining care. The government wanted $360 million cut.
That’s a 3.5-per-cent cut. After years of funding shortfalls, the health authorities and hospitals have ground costs out of the system. There are always savings to be had — you can stop cutting the lawns, cut corners on cleaning costs or cancel travel.
But those won’t add up to $360 million.
Vancouver Coastal plans to reduce surgeries by three per cent and Fraser Health is cutting the number of elective surgeries and limiting MRIs.
The Interior Health Authority is looking at capping or reducing community care and making people wait longer for elective surgery. It’s also cutting jobs and freezing clinical hours. The Northern Health Authority is reducing nursing care.
The Vancouver Island Health Authority is putting off maintenance, freezing programs and plans to reduce “volumes of elective surgeries, procedures and diagnostics” to stay within the funding. (It also plans to sell off property to make up for the operating deficit, much like selling the furniture to pay the mortgage. The next payment comes, and then what?)
The authorities have acknowledged that care will suffer — fewer surgeries, for example, means people will wait longer. That sounds OK, unless you’re the one limping on a horribly painful kneee.
You could make the case for health cuts. The recession means less revenue for government. Why shouldn’t people accept reduced care?
But that is not what the Liberals promised during the campaign
So where is the mandate for reduced health care - longer waits for surgery, delays in tests to determine what treatment is, or isn’t, needed?
This is about $360 million. What would be wrong with an increase in MSP premiums — which are graduated to the ease the burden on low-income families — to make up the shortfall. For a singe person, all that would be needed would be a $12-per-month increase to maintain health care at last year’s level; for a four, about $3.50 a person a month.
We can afford it. Health care costs have been increasing faster than the overall inflation rate. But we’re older and the treatments have got slicker and more expensive. We still want them for our family members.
And health care remains a bargain. In 1995, health costs consumed about 6.6 of provincial GDP. Last year - 13 years on - it was seven per cent. There are cost pressures that have to be addressed in the coming years, but no crisis.
But, for whatever reasons, the government has decided that it’s time to go backwards on health care for British Columbians.
Footnote: The NDP challenged the timing of the announcement, accusing the Liberals of hiding the cuts until after the provincial election. The delay – whatever the cause – results in deeper cuts as savings must be found in the remaining months of the fiscal year.

Thursday, July 16, 2009

To steal a head, RailGate A-Go-Go.....Who Knew What When?

A useful look at the destruction of potential evidence in the B.C. Rail corruption trial is to be found here.
Come on. This can't be happening in an advanced democracy in 2009.

Tuesday, July 14, 2009

IHA chair thinks two-tier care just fine

The Interior Health Authority chair, responsible for an organization delivering care to 720,000 British Columbians, believes two-tier care should be allowed in Canada.
And he doesn't see why the health care system should be providing residential care for frail seniors who can't live on their own any longer.
You have to admire Norm Embree's candour in raising such radical positions.
And he made it clear he was expressing his personal opinions.
But it's hard to see how most people living in the interior could feel comfortable with Embree as the health authority chair.
There are some big challenges ahead for all the health authorities. Provincial funding isn't enough to meet the care needs. The five regional authorities have to cut $320 million.
Embree's comments raise doubts about his commitment to the basic values and functions of our health care system.
His opinions are legitimate, if extreme, contributions to the discussion on health care. But they raise questions, coming from a B.C. health care leader.
In an interview with Don Plant of the Kelowna Daily Courier, Embree said it might be time to abandon the principles of medicare and allow people to pay for faster, better care.
"We're already multi-tier - we already go to Washington for private care - why not have it here,'' he asked.
Embree, to his credit, took the same position a few days later in an interview with Robert Koopman of the Kamloops Daily News when the issue of two-tier care came up.
"I have no problem with it. We've had two tiers for years, but nobody wants to admit it," he said, citing the ability of patients to the U.S. for speedier treatment.
Not every could afford that, Embree acknowledged.
"That's the nature of two tier - if you can, you do it. If you can't you hang in there," he said. "I've got nothing philosophically against it. As long as we maintain universal access and portability, I've got no problems with it."
That's one view of health care.
The Canadian view, expressed in the Canada Health Act and B.C.'s Medicare Protection Act, has been that your income shouldn't determine the kind of health care you receive.
If two little girls are sick, each should get the same care. The fact that one had poor parents wouldn't put her at greater risk. Embree's approach would see the poor child "just hang in there."
Embree's views on residential care for seniors raise as many questions.
"The Canada Health Act doesn't say anything about providing housing for everyone," he said. "Now everyone expects the health-care system to provide a room and a place."
It's true. The Canada Health Act doesn't include residential care and intermediate level nursing home care in the category of covered services.
But more than 5,500 Interior residents are in residential care or assisted living beds. If providing that care is not considered part of the health system, how are they to afford the $4,500 a month for a private care home? Pensions are a fraction of that amount and savings would quickly be exhausted.
So what becomes of the people who can't care for themselves and need help with meals or medical care or bathing?
They get worse and worse, I suppose, until they are admitted to an acute care hospital bed. That's a far more costly option, poorer for the senior and those beds aren't available for the patients who need them. (Between 10 and 15 per cent of acute care beds are already occupied by people waiting for long-term care.)
Embree's comments follow Health Minister Kevin Falcon's musings about allowing two-tier care in an interview with the Vancouver Sun. He later said he only meant for non-essential treatment.
A full debate on health care is welcome. But it's hard to see how the public can have confidence on a government-appointed health authority board chair who doesn't support the most basic principle of Canadian health care.
Footnote: Kelowna radio station AM 1150 tried to find out what Falcon thought of Embree's comments. They were told the minister was not available for comment on the topic "today, tomorrow, next week or indefinitely."