OT: Sens Lounge XCVII: "Zorf; 21 times!" Edition

[Fandlauer]

I won't touch anything else as not to get political, but it's going to be nice if we can join the rest of the planet and actually be able to buy a six pack at a corner store. It's time to get out of 1950.

 

[L'Aveuglette]

Ontario, why you have to go and elect Trump north?

 

[Daffy]

Ontario, why you have to go and elect Trump north?

Still was easily the best option. And the results proved most people felt the same. Definitely a poor list of candidates to choose from but change was needed.

 

[PeterSidorkiewicz]

Still was easily the best option. And the results proved most people felt the same. Definitely a poor list of candidates to choose from but change was needed.

Can’t turn down a buck a beer!

The platform of the people.

 

[L'Aveuglette]

Still was easily the best option. And the results proved most people felt the same. Definitely a poor list of candidates to choose from but change was needed.

Easily? You know you're talking about a party with zero platform(populist promises a platform does not make) and a leader that barely graduated high school and has one term as a city councilor as well as being a big Trump supporter, right? What exactly do you think he'll do any better than the NDP would?

 

[CanadianHockey]

Quite a few close races in the GTA and Ottawa where the left split, allowing the PC candidate to win. I'm interested to see demographic breakdowns.

 

[18Hossa]

I won't touch anything else as not to get political, but it's going to be nice if we can join the rest of the planet and actually be able to buy a six pack at a corner store. It's time to get out of 1950.

I can get a 6 pack at my corner store

 

[MakeOttawaGreatAgain]

The worst is emerge in downtown Vancouver

That makes sense, seeing as that's one of the worst areas ever to run an ED.

Like HIPA, I am a nurse (well, still in school). I agree with her on almost every account. There's so many factors that come into play in Canada, and especially in Vancouver, that really, only a few other countries ever have to consider.

In terms of triage (ie, wait times), like HIPA said, there's so much that goes into the decision of how/when to treat a patient. You came into the hospital with pain. The nurses proceeded to check your vitals. Since you waited so long, that probably means your vitals were pretty decent (for an emergency, at least), and your main problem was pain, and they treated your pain (too well, even. According to you). If there's some people in there for a drug overdose (something much more common in downtown Vancouver than in anywhere in France), then on a busy day, they gotta help that person. In their mind, everything is well enough that you can probably wait a bit longer, and they can now save another life. Not only that, but you also do not see all of the people from up north who get emergency flown into Vancouver because the closest other full-facility hospital with a helipad is in Anchorage (slight exaggeration, but only ever so slightly). Give me an example in France where you can be 1,000km from the nearest major hospital.

An X-ray and everything sounds nice, but it's kind of a waste of money and time for a kidney stone. When you are a private business (like in France or in the USA - especially if it is in a nicer area), you don't mind doing a million unnecessary tests, because, hey, more money for you. But when the resources come from the community pool, you need to pinch your pockets where you can.

Like HIPA, I don't even think the funding problem starts with the actual amount of money we put into it. A lot of money is mismanaged, and we do not do nearly enough in terms of health promotion - my primary area of interest. Like you said in an earlier post, put in a few extra bucks in the foundation, and reap the rewards down the line. I don't really want to get into specifics, but there's a lot of money we spend on corrective treatments that could be spent preemptively (think 10's of billions). And, like HIPA says, our government likes to fund things inappropriately, even if one hospital needs more of X, and another needs more of Y.

It's super frustrating that you have so many bad experiences, but please don't lose faith in our system. It has lots of issues, don't get me wrong, I think there needs to be a major overhaul... Bonk is right. Two-tiers always fail, because they favour those with the most money. As a nurse, if you told me I could make $100,000 at the private hospital, or $50,000 at the public (free) hospital... well, I may work at the free one when when I retire, but I like money too much to lie and say I wouldn't work at the place that's offering double with better hours and benefits. You gotta think about supporting your family.

In terms of family doctor shortage, I think there are two main causes (although, the situation is complex and there's much more at play). As HIPA says, we are under-utilizing nurse practitioners - which for all intents and purposes, are basically equivalent to a GP and can do what your GP does. There's lots of drama between GPs and NPs, and there's no reason, other than politics, as to why you couldn't just get a family NP and have peace of mind and quality care.

I think another reason is taxation (and our government in general). You can become a doctor, nurse, or nurse practioner for a fraction of the cost of the same education in the USA. You can leave Canada with very little (comparatively) student debt, and move to a place like Nevada, Oregon, or Alaska, and pay off your debt within a year, you don't have to pay as much in taxes, the dollar is 30% stronger, gas is cheaper, housing is cheaper in general, food is cheaper - ie, health care workers can make way more money, and none of it is coming directly out of health care costs. So, a lot of them leave Canada and move to America after graduation. You don't fix that with funding. Our economy is out of whack (although, even from a critic, it is definitely exaggerated how bad it is), and we are stuck in this positive-feedback-loop where everything seems to be unaffordable, so to compensate we will tax the wealthy / business owners. To compensate for the taxes, prices rise. Now things are more expensive, so we can begin the cycle yet again.

Unfortunately, the solution isn't being promoted by any party on the national level. It's always either lower taxes by lowering spending (leading to lower quality of care immediately), or increase spending by increasing taxes (leading to lower quality of care over time). We could make both people happy if we just spent our money properly, because we could lower taxes (and in turn, prices of everything else) and increase the quality of care, all while remaining universal. But we won't do it, because the return on investment might not be evident for decades.

For example, an idea I have is having some sort of exercise reimbursement. Some of the most common stated reasons for why people don't do weight training is that they do not have time/are tired due to work and just life in general. Well, if you meet the weight training exercise quota (let's say 2 hours per week) for the year, you can get a certain amount of your income tax reduce (if wealthy enough) or receive payment (if not wealthy enough to directly benefit from tax cuts). This means you can take time off in exchange for exercise and personal health management.

Where will these payments come from? Well, there will be a pretty substantial upfront cost to pay everyone to exercise. That said, if you consider that the majority of our health care spending goes to mostly causes that are preventable, reversible, or at the very least, significantly more manageable and affordable with consistent, weight bearing exercise (I have scientific sources). Imagine if 80% of our health care spending went to research instead on rolling people around whose bones are too frail for them to walk, on insulin, on respiratory devices, on cardiac treatments, medications, ect. We can't just cut these people out of the equation, but our goal should be to reduce the total amount of people who have these conditions over time, and not just wait until it's too late and try to band-aid everything as we get there.

The worst part is, everybody knows this is the truth, but everyone has such a "meh" attitude towards it. It always has to be the fault of rich people, or poor people, or conservatives, or liberals, or this politician, or this ideology, or oppression, or whatever it is for each person.

I honestly think we are screwed until we have robots who can run mostly everything for us and it doesn't matter who you are, the robots will just help you. (What's taking you so long, Elon!?). Until then, I hope everyone does their best to try and stay healthy and in shape. Don't be ashamed of your size, shape, or strength. If you try consistently, you'll always at least be better off than the you from yesterday!

Thank you if you made it to the end of my tangent. Also, Dr. Easy, only my arguments against two-tier were directed towards you... it just turned into a rant

 

[DrEasy]

First of all, PolakDave, thanks so much for such a long and detailed post. (same goes to HIPA and Sask)

I said that was my last post on the topic, but since this was addressed to me, just wanted to answer a few points. The rest, which I didn't quote, was super interesting.

That makes sense, seeing as that's one of the worst areas ever to run an ED.

See, I'm not making this stuff up! That emerge in Vancouver looked more like an episode of the Walking Dead.

In terms of triage (ie, wait times), like HIPA said, there's so much that goes into the decision of how/when to treat a patient. You came into the hospital with pain. The nurses proceeded to check your vitals. Since you waited so long, that probably means your vitals were pretty decent (for an emergency, at least), and your main problem was pain, and they treated your pain (too well, even. According to you).

Yes, but only AFTER the many hours of wait. I'm not saying my situation was more urgent than others (given the pain I was in though, I shudder to think what the situation of people ahead of me was). I'm saying it is ridiculous for anybody to have to wait this long. Maybe we're taking this for granted here, because maybe we don't know any better. It doesn't have to be this bad.

If there's some people in there for a drug overdose (something much more common in downtown Vancouver than in anywhere in France), then on a busy day, they gotta help that person. In their mind, everything is well enough that you can probably wait a bit longer, and they can now save another life. Not only that, but you also do not see all of the people from up north who get emergency flown into Vancouver because the closest other full-facility hospital with a helipad is in Anchorage (slight exaggeration, but only ever so slightly). Give me an example in France where you can be 1,000km from the nearest major hospital.

This is a very good point. In Vancouver at least, it's other social problems that bleed, so to speak, into healthcare.

An X-ray and everything sounds nice, but it's kind of a waste of money and time for a kidney stone.

Note that that was my very first kidney stone, so I had no idea what it was. You get deferred pain, so it's in your stomach, your organs, and all sorts of unmentionable areas, and it's pain you've never experienced before. I was throwing up bile. I'm no health worker, but in retrospect it makes sense to me that the first thing they did was to see if it was a kidney stone, which it was.

Oh, and the bill was very reasonable (can't remember how much, but nothing that I couldn't pay on the spot). I don't know how much an X-ray costs here (obviously, thanks to our system) or in the US, but if it's super expensive, well maybe that's another problem worth looking into?

 

[Here I Pageau Again]

Can’t turn down a buck a beer!

The platform of the people.

I mean buck a beer, completely fix hospitals and healthcare, decrease taxes, cut carbon tax.... All while fixing the deficit!!! How could you not vote for him!?

 

[Here I Pageau Again]

That makes sense, seeing as that's one of the worst areas ever to run an ED.

This post was pretty bang on!

Although with prevention, unfortunately you can have all the preventative health care and people still won't use it! Because why do work now when I can get drunk and eat McDonald's! Future me can deal with the consequences! But that's a whole other issue

But yeah you were bang on and unfortunately I'm not sure it will change because most healthcare professionals don't actually want to do what's needed to improve a system and unions step in and stop any positive change from happening while giving people raises further increasing debt


*** Also... You can make 100,000 as a nurse in Canada (it may require working for a few years and a handful of overtime shifts) *** lol

 

[Here I Pageau Again]

Oh, and the bill was very reasonable (can't remember how much, but nothing that I couldn't pay on the spot). I don't know how much an X-ray costs here (obviously, thanks to our system) or in the US, but if it's super expensive, well maybe that's another problem worth looking into?

An x-ray in the States could cost you around $400 or so.

You do address another point though is the cost of healthcare things. Not so much things like xrays or any of that, but specifically the cost of medications. Why the government is at the mercy of drug companies pricing is beyond me. That said, I'm not totally educated in pharmaceutical stuff so I'm not sure the complexity on that issue but it seems crazy that a medication could be thousands!

 

[Here I Pageau Again]

Getting away from politics....

We are moving into an actual house! Yay for a yard!

 

[Daffy]

Easily? You know you're talking about a party with zero platform(populist promises a platform does not make) and a leader that barely graduated high school and has one term as a city councilor as well as being a big Trump supporter, right? What exactly do you think he'll do any better than the NDP would?

I'm not a big fan of Ford but someone else needed a chamce. He was the overwhelming favourite of the people. Lets give him a chance first. And as bad as Wynne was, Horwath might have been even worse. Thank God the NDP didn't get in power.

 

[Upgrayedd]

Still was easily the best option. And the results proved most people felt the same. Definitely a poor list of candidates to choose from but change was needed.

Curious what was better to you on his platform than the other candidates?

 

[Here I Pageau Again]

I'm not a big fan of Ford but someone else needed a chamce. He was the overwhelming favourite of the people. Lets give him a chance first. And as bad as Wynne was, Horwath might have been even worse. Thank God the NDP didn't get in power.

Sorry one more thing.

The interesting thing is that if Ford does what he plans on doing he'll spend more than the NDP planned on doing. Its shocking that people think that cutting carbon tax, corporate tax and not increasing taxes won't mean significant cuts elsewhere and to our healthcare.

Unfortunately we have this silly system where it is spend then cut then spend then cut and we get into this cycle of actually never improving our system long term because people care more about the now.

 

[Daffy]

Curious what was better to you on his platform than the other candidates?

Are you seriously still advocating for Wynne? Horwath is just as bad.

I like the idea of getting rid of the idiotic carbon tax. I like lower hydro rates. Cheaper gas. I don't like wasting tax payer money like the Libs did. We have had the highest hydro rates in NA. Piles of debt. 8 billion in deficits. Countless broken promises. She is as corrupt as they come. Horwath isn't the leader type. And she got destroyed in the debate. She was rude and interrupted everyone the entire evening on top of that. Has some very questionable people working under her too that she needs to answer for and hasn't yet.

We need to give Ford a chance. We needed serious change. He has a lot of work to do. But scrapping the minimum wage hike would be a good start. Cutting hydro and gas costs.

I'm skeptical of course, as I am with most politicians but we needed a fresh start, as is evident by the overwhelming support the PC's got. Lets give the man a chance here.

 

[Nac Mac Feegle]

Wait.....some folks think big oil will give that extra money back to the consumer instead of jacking up the base price of gas and putting the extra profit into their own pockets?

 

[Here I Pageau Again]

What's also interesting is the federal government will carbon tax companies if provinces don't starting in 2018. So cutting the carbon tax is exceptionally stupid.

 

[maclean]

I accept that everyone has different priorities. I just wonder at people that trust a failing businessman to improve the province's books or choose a former high-ranking drug-dealer as the guy to overcome corruption.

 

[PatrickEaves]

You know, most of the time, platform-wise, the NDP in both provincial and federal politics around the country, aren't that bad an option. Unfortunately, usually as a self-fulfilling prophecy, the lack of legitimate candidates that want to run for them result in either wholly unqualified, or complete nutjobs running for them in many ridings. Take two federal elections ago, when the NDP had that huge surge under the last election of Jack Layton. Some of the MP's elected to government were completely useless. You had kids that hadn't completed their first university degree yet, and radical third-wave feminists that had social media posts about culling white men.

Getting away from politics....

We are moving into an actual house! Yay for a yard!

Why would you actually be happy about having to mow the lawn now?

 

[Here I Pageau Again]

Why would you actually be happy about having to mow the lawn now?

That's the man's job!! Lol.

I'm excited to be able to sit outside and have a beer when my baby goes to bed at 645!

 

[MakeOttawaGreatAgain]

Its shocking that people think that cutting carbon tax, corporate tax and not increasing taxes won't mean significant cuts elsewhere and to our healthcare.
Unfortunately we have this silly system where it is spend then cut then spend then cut and we get into this cycle of actually never improving our system long term because people care more about the now.

I actually think corporate taxes are really ineffective and detrimental to everyone and are a contributing factor to many of our social issues, including housing affordability, inadequate wages, unemployment, job insecurity, ect. I find that a lot of people say things like “Well, the corporations are rich and are just trying to make a profit no matter the cost. I don’t personally mind paying more in taxes! Greedy folks!” (I know that's not what you personally are saying, but it's easier for me just to quote you and rant )

But a corporation isn’t a person. It’s an inanimate object run by people to make as much money as possible. By making it more difficult for a business to make a profit (taxation), that business has to offset those costs by either cutting costs (layoffs), stagnating wages, increasing prices, or decreasing the quality of the product/service.

Some of the biggest social determinants of health are poverty and unemployment, so making it more difficult to make a living is only going to strain our health care system more.

But I agree with you whole-heartedly about the cycle we are in. It took a very long time for us to get where we are now (both the good things and the bad), and it will take a long time to fix these problems too.

We have to come up with ways to make it so that people at the bottom make/keep more money (encouraging investments for low-income people), and also trying to promote economics, investments, and profits to kids. Things like putting more emphasis economics / business education in grade school. Also, remove the stigma against profits. Imagine how much better off everyone would be if instead of kids talking about celebrities and Fortnite, they were debating the stock market.

What's also interesting is the federal government will carbon tax companies if provinces don't starting in 2018. So cutting the carbon tax is exceptionally stupid.

I really think that taxing fuel is a bad idea. The BC NDP party is planning a plethora of different methods to tax people for driving – from taxing the fuel you buy to taxing the number of kilometers you drive. It’s easy to say, “oh, just take the bus.” That’s fine for a lot of people, including myself, but places like Vancouver are getting so expensive to live in, that people have to move to the outskirts of the metropolitan area just to pay their rent… But the places they move to don’t pay them enough to afford to live there either, so they need to drive to Vancouver proper or the North Shore (where the wealthier people live, ie. higher wages).

So, I’m already wealthy/lucky enough to be able to bus to work / school in a reasonable amount of time and it’s pretty cheap… I just did the math, and with my bus pass, I am paying about 1% of my daily income for transportation to work. The guy who is less fortunate and has to drive for a few hours each day just to feed his kids is now also being charged for simply trying to make ends meet.

Too poor to afford to work where they live, so let’s now charge them for trying to get to work. Sounds super effective.

Most of our national income is from industries, all of which use carbon-based fuels out of necessity, and likely won’t be able to switch to electric for at least a decade or two. The technology doesn’t exist yet to efficiently power excavators, dump trucks, logging trucks/tractors and other large equipment electrically. Carbon taxing these industries for something they cannot control has so many negative down stream effects; I could be here all day listing them off, but it’s enough to say we would just be shooting ourselves in the foot.

There’s ways the government tries to address this, such as subsidies (which come from taxation, so why not just tax them less in the first place?) and marked fuel – dyed fuel that is taxed at a lower rate and used for heavy machinery (but in my eyes, this just shows that taxing fuel makes it difficult for companies to turn a profit, leading to all of the issues I brought up before).

That said, then how do we deal with funding if we get rid of our only reliable source of income (taxes)? How do we deal with protecting the environment? A lot of these fuel taxes also pay for our roads and other infrastructure, as well. What are the things that we truly believe the government should be responsible for? What do we do? It’s either revamp the system from the ground up or cross our fingers and wait for robots.

The way things are now, everything is seemingly great… I want to compare it to playing ice hockey on a lake in the spring. The lake is still frozen, but it’s starting to melt. If we keep trending the way we are, we are going to be right in the middle of the lake when the ice melts, and then we’re drowning, but we can still skate off the lake and go to the rink to play.

You can make 100,000 as a nurse in Canada (it may require working for a few years and a handful of overtime shifts) *** lol

Oh yeah, totally! I was just using arbitrary numbers to demonstrate that in a two-tier system, private hospitals/clinics can offer compensation that is above a public hospital in the same system. As nurses, you can definitely make six-figures in Canada if you put in the time/effort!

I feel like an essay writer with these last two posts, lol! Sorry if it seemed a little jumbled, but there’s like 4 conversations going on in this thread that are independent but also related, and I tried to address them all.

 

[Here I Pageau Again]

My only point with the carbon tax was that it would be silly for Ontario to get rid of it. Whether you agree or disagree with it, that's not the point I was trying to make.

But the federal government taxes companies a carbon tax for all provinces that haven't implemented one themselves. So getting rid of the tax only means less profits for Ontario with no added benefit to companies or draw for companies to be in Ontario.

I'm not sure of this effects gasoline as well but if it does, man what a terrible financial move! Unless the federal government gets rid of carbon taxing, it would be pretty silly to get rid of it provincially

 

[MakeOttawaGreatAgain]

My only point with the carbon tax was that it would be silly for Ontario to get rid of it. Whether you agree or disagree with it, that's not the point I was trying to make.

Oh, I know that's what you meant, and I feel bad for quoting you. Yours was just the most recent post in the conversation, so I just used you as a jumping board!