Friday, January 13, 2006

Much Ado About Nothing

Well, it appears various Conservatives and Liberals are all giddy over the fact that 10 years ago, Jack Layton had hernia surgery in a private clinic in Toronto.

They all seem to be stuck on the word "private" and missing the point. "Hypocricy!" they scream.

No, not really.

The NDP position is pretty clear - we are against the expansion of private, for-profit, American-style medicine and are for the enforcement of the Canada Health Act.

"Public funds to support the public system. In the next Parliament, we will
introduce tough new rules in the legislation and agreements that govern federal
transfers to provinces for health care. We will make stable, long-term federal
transfers for health care contingent on a commitment from provinces and
territories that no federal money, directly or indirectly, will be used to
subsidize a new, separate, profit-making private insurance
system covering medically necessary services." (empahsis mine)

The Canadian Health Coalition, a public healthcare advocacy group, has no problem with the Shouldice Clinic due to its non-profit status. Further, it indicates that its model of specialization can be emulated by public clinics, as Alberta has done sucessfully and as has been recommended by the The Canadian Centre for Policy Alternatives and Dr. Michael Rachlis this past December, to drastically alleviate wait times.

"The Shouldice Hospital is not an example of private health care as an
alternative to public health. It does not pose the same threat under NAFTA that
Bill 11 in Alberta poses. Neither does it pose the same threat to public
medicare that Bill 11 poses." from the Canadian Health Coalition.

In short, Jack has nothing to be ashamed of and non-profit clinics like the Shouldice are part of the solution, not part of the problem. They are the model for streamlining the system, when emulated by the public system, as Dr. Rachlis and (unwittingly) the Government of Alberta have shown.

The NDP defends public healthcare not against allies that happened to be private, but against for-profit privatized healthcare such as the Copeman Clinics, which take your money, allow you to jump the queue and drive up the costs of healthcare because they bill provincial health insurance plans higher rates.

And before we get stuck on the semantics of "privatization", lets not forget that when Ralph Klein talks about private options, and muses about violating the Canada Health Act, he isn't talking about non-profit private clinics like the Shouldice either.


At 12:11 PM, Blogger AJSomerset said...

Silence! That's enough specifics! Enough nuance!

I, the public, demand that all issues be couched in simple terms: public vs private. I also demand that we avoid specifics in favour of vague discussion of ideology.

When I am in charge, we'll know what to do with the likes of you. Oh, yes. You and your stinking facts and your reason. Oh, we have lots of walls, and lots of bullets.

At 5:45 PM, Blogger John Murney said...

What you say is true, Mike. Layton said early in the campaign that private clinics are an integral part of medicare. I don't see what the problem is.

At 10:51 PM, Blogger DazzlinDino said...

I'm with Skipppy here, your sense making arguements must be silenced. When the Conservatives win a majority, we will immediately send our Tory Blue military choppers to your house, swing down in our Tory Blue military garb, and whisk your ass away somewhere for immediate deprogramming.....

Ever wonder why they paint military aircraft green, why not blue, like the sky....psssssst military guys, camoflague only works on the ground....

At 1:34 AM, Blogger Candace said...

The only reason this is a "story" is because Jack himself made such a big deal about private delivery of public service. Because you are right - if delivered within the constraints of the Health Act, there is no big deal here. Well, my neice will have knee surgery at a private clinic, at no cost to her parents, within 6 weeks of it being deemed necessary, yet Jack argues against it.

So if Jack will shut up about my niece's knee surgery, I'll shut up about his hernia.

Jack is a bit of a hypocrite IMHO.

At 1:35 AM, Blogger Candace said...

oh, did I mention that she only had to wait six weeks?

At 9:22 AM, Blogger Mike said...


If that kind of "private delivery" is what your are talking about - not above provincial health insurance, not-for-profit, not able to pay to jump the queue, specialized clinics to reduce wait times - then we've never really had an issue with each other, other than miscommunication.

Now, if you are talking about the Copeman Clinic, where you can pay to jump the queue, where they charge the provincial plan at higher rates. If Ralph Klein says the system is unsustainable now (which I don't agree with), imagine after he lets Copeman-like clinics into the province. The for profit clinics, driven by that profit motive, will cut corners, hire less qualified staff at lower rates, understaff and then charge the government plans either extra cash for proceedures or extra unneeded procedures in order to earn more. This may sound like fearmongering, but this is the exact cause of the market failure of health insurance in the US, where procedure by procedure costs are 3 times what they are here and where they spend 15% of their GDP on health, but don't get the services (and not everyone is covered).

So lets agree that private, not-for profit clinics are good and an intergral part of our health system, but private for profits are not. The Shouldice clinic is, then, not different than a walk-in clinic or a single doctors office, which have always been technically "private delivery".


The 3% profit the clinic makes is re-invested back into the clinic itself to maintain its operation, not to pay dividends to shareholders. Also, most profits come from operating on Americans. So perhaps "not-for-profit" is better than "non-profit" in this instance but its a minor distinction. It is certainly not a Copeman clinic. Shouldice is an entirely different beast than that kind of profit making operation.

At 7:02 AM, Blogger Mike said...

No Peter, it doesn't. He was referred there by his doctor and was served on a medically needed basis, not because he paid extra to get service first.

This clinic is part of the public system here in Ontario, not outside it. Its a grandfathered in hospital that does this on a not-for-profit basis.

Until this came up, most people in Ontario, including those that went there, didn't know that technically it was private delivery.

Technically, a walk-in clinic is private delivery, just not a for-profit one that charges and extra bills. The Shouldice is just a much larger version with a particular speciality.

At 9:12 AM, Anonymous Anonymous said...

The Shouldice clinic is PRIVATE FOR PROFIT. Part of the cost is covered by OHIP for Ontario residents only. There is a cash payment required for staying at the facility and Layton would have paid this. He is a hypocrite.

At 9:26 AM, Blogger Mike said...

No jeff, you are wrong. Read the links.

The treatment is fully covered under OHIP. Jack and everyone else that goes there pays with their OHIP card. The cash payment is for AMERICANS who get treatment and aren't covered by OHIP.

The 3% profit is makes is to cover operating costs. The Shouldice does not let you buy your way to the head of the line, it does not extra bill on top of OHIP. As I stated to Peter, it operates exactly like any walk-in clinic in the country and makes any profit off of treating Americans that come up for its speciality services - not Canadians. It doesn't draw its profits from public funds and doesn't violate the Canada Health Act. It has been a not-for-profit (different than non-profit) since before medicare came into existence.

At 5:52 PM, Anonymous Anonymous said...

Day of Reckoning is Nigh. Are you Prepared to Meet Your Maker?

Conservatives and a NEW ERA FOR CANADA.

Let the assimilation commence:

At 5:58 PM, Blogger Mike said...


Don't forget who holds the balance of power...that means we have the plans to the Death Star, Darth Jeff.


Hey, so long as the Liberals are out for a while, I'm ok. Us rag-tag band of Dippers can keep you lot in line.

At 8:22 AM, Blogger Mike said...


According to the link above, from charging Americans $2400 per operation, not from public funds paid for service through OHIP. Once again, this clinic does not violate the Canada Health Act in that respect - no extra billing, no paying to jump the queue.

At 1:42 PM, Blogger Mike said...


No backflips at all. The clinic is a not-for-profit clinic that was grandfathered in to Ontario's healthcare system 40 years ago. It does not charge Canadians for service. Period. For Canadians, it is a non-profit centre. For Canadians it is no different from a public hospital. You don't get extra billed, you can't buy your way to the front of the line and you can't directly purchase services from it. The Shouldice charges OHIP the exact same amount of money as a public hospital, thus it does not make money off of the taxpayer or from any public money. It operates fully and legally within the public system.

Why is this simple concept so hard for you to understand?

Compare this to the Copeman clinics, which will charge you extra and still bill the provincial medical plans, allow you to jump the queue and in general violate the Canada Health Act. They're not even in the same league.

You Peter, are the one who needs to cut the semantic crap. From a Canadian perspective, Shouldice is a non-profit clinic. Now is that what you mean by private? I doubt that. Shouldice is not Copeman. It doesn't maximize profit, it makes a steady amount for reinvestment.

Why is it you cannot see the difference?

At 9:09 AM, Blogger Mike said...


Get a grip. Jack Layton did not know it was a private clinic (most people, including yourself, and people who have actually been serviced there probably didn't know until the story broke). It does not make profit off of Canadians or public money within the Canadian Health system. As far as Canadians are concerned, its not a for-profit clinic and part of the public system. Jack Layton did not spend one penny extra there - he paid with his health card.

The NDP has always stated that there should not be private clinics that make money off of Canadians, that extra bill provincial health plans or allow you to buy you way to the front of the line. The position has always been that no public monies should not be spent at private, for-profit clinics like Copeman. The shouldice is like that.

If by private clinics you mean ones like Shouldice that don't make profit off of Canadians, don't extra bill or allow you to jump the queue, does not use pulbic money for the bottom line then we don't have an argument, I think that's fine.

BTW, An American getting an operation at ANY hospital would have to pay, just like at the Shouldice. The only difference between Shouldice and a public hospital is that Shouldice makes a small profit, for maintaining and upgrading its operations, off of non-citizens procedures. Otherwise it operates exactly like a public hospital. As far as the NDP is concerned, that's OK. The NDP is not ok with clinics making money off of Canadians, charging extra for procedures, allowing queue jumping and making profit off of public money. The NDP would be ok with Shouldice, but not Copeman. Can you see the difference? Or is that a little too subtle for you?

You see Peter, the NDP, being a CANADIAN party, really only cares about the CANADIAN perspective on this and how it affects CANADIANS. Get over it.

Its not like he went to Paul Martin's doctor.

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