I would argue that other provinces have even more severe healthcare issues and backlogs. AB has been making progress, particularly in surgical wait times. People wait 6 months to see a surgeon now instead of 2 years. Surgeries are then scheduled within 3-6 months after seeing the surgeon.
Nenshi has never struck me as someone very smart. But I think defending a failing status quo is foolish. I’m an Albertan and welcome a dual system. Done wisely, it will improve care for everyone. And it will be good for patients for doctors to have to provide more service and build relationships with patients rather than how things are in many places right now.
I suspect Nenshi hasn’t talked to enough Albertans or he’d realize that not everyone hates what the UCP is proposing. And they will all hate having Carney involved if he gets involved.
There has always been two tiered health car and those who can afford it head outside the country. Now, that money can stay in the system. When my buddy when to Latvia for a knee, he paid 13.5. I asked my surgeon buddy what he charges in Alberta and he said 20K. I am just thankful he has stayed in Canada as these surgeons can go anywhere and we are darn lucky they are staying here. I have also been to private clinics (and have not paid), and you know the first clue it is a private clinic? Nice furnishings and no waiting. (Mayfair diagnostics for one...) . If Carney wants to use the Canada Health Act, this is a dangerous game, as you can bet Brookfield had benefits (like big law and Accounting firms in Canada) where key employees get shipped to the USA is there is any wait in Canada for treatment!
Healthcare is broken across the whole country. It’s time we had mature conversations about fixing it. Every province has different issues, so the fixes are different. The European hybrid models deliver better care with less cost … we should be looking to emulate those. But we can’t even start these conversations because of NDP screeching. Canadian healthcare will never improve as long as we let the NDP hijack the conversation before it’s off the ground.
FTR … it’s not about money we already spend far more per capita than most of the OECD. MONEY will not solve our issues.
You have to take a country’s GDP into consideration. 10% of Canada’s GDP is not the same thing as 10% of Germany, France or the United States. Our current total dollar expenditures are still a little more than half of the US per capita as a result, but people expect US wait times and drug access.
We still spend the lowest TOTAL dollars on hospital beds among these major nations.
Respectfully disagree Rob. The Canada Health Act exists for this very reason. The withholding of federal health dollars is an extremely powerful lever. It DOES control health care spending. If we just ignore Smith's clear lies about not messing with public health care, and patients paying out of pocket, about the very clear corrupt care scandal and her very likely enriching herself and her friends at the public trough, this dual practice model directly contravenes the Canada Health Act, and is not permitted. Smith has been a complete disaster on the health care file, ("fix health care in 90 days"). Wait times are up, private care is up, emergency room waits are at historical highs, and now we have a confusing quadrupled bureaucracy administering things where nobody knows whose responsible for anything. Agree Nenshi has been a massive disappointment, but somebody has to keep Smith accountable to the actual rules. But don't worry friends, the rich folks will get their hips done quickly, Smith and her pals will make record profits, and the donations will keep flowing.
> Respectfully disagree Rob. The Canada Health Act exists for this very reason. The withholding of federal health dollars is an extremely powerful lever.
Powerful how exactly? What I mean is... what is the goal and how will withholding federal dollars achieve that goal?
I'm going to assume Mr. Nenshi's goal is "get Danielle Smith to back down".
Now... do you think Mr. Carney withholding health care funding from Alberta will achieve that goal?
Because I don't. First, I think Mr. Carney is likely to ignore Mr. Nenshi because he's politically and economically wiser than Mr. Nenshi. But let's imagine Mr. Carney does start withholding health care money from Alberta. The immediate outcome is going to be a super-charging of the seperatist movement and a constitutional challenge that will tie this all up for years.
And of course Ms. Smith gets an iron-clad excuse for any bad economic performance and any and all failure of anything the Alberta health system. Anything wrong with the financial or health situation is because the LIBERALS (emphasis hers) are taxing Albertans to pay for Quebec health care and not Albertan health care. Albertans have to pay the tax, get no benefits and then those arrogant jerks who look down on you laugh at you while spending your money. (That's what's going on Facebook for the voters.)
Seriously, how do you see this playing out? What is the goal and how will Mr. Nenshi doing this achieve that goal?
I agree, if the federal government were to withhold funding for Alberta healthcare as a result of Smith's increased privatization, the emotional and political response would be to blame Carney, but it wouldn't be factual or logical. I appreciate that doesn't matter but its an important distinction. The federal government has the legal authority to withhold public health care dollars 1:1 for every dollar of private health care provided (its existed for a long time, and that exact withholding has occurred for decades. It has to this point been a small number). Carney is no fool, and I don't think he is a coward, and like Farkas completely skewered Smith last week with some basic facts, Carney could do the same. The stakes are very high. Public health care is literally at risk, and Smith is working hard to dismantle and discredit it. As per Nenshi, as I said I think he's a huge disappointment and the wrong person for the job, but the leader of the opposition is literally paid to hold the government to account.
Is it to "skewer Smith"? Because if so, that's a dumb goal.
Oh yeah... she'll be totally skewered ... in the view of progressives who will applaud. So now what... The Alberta separatists get a huge boost, the UCP gets a bump in the polls so of course Ms. Smith doubles down, successfully blaming all failures on Ottawa when she's speaking to the only people who matter (which is Albertan voters who put her in power, NOT progressives), and then launches escalating rhetorical attacks on Ottawa while likely also pursuing constitutional challenges to tie Ottawa's attention up in the courts. Separatists up, unity down, Americans with another wedge to hurt us, Ottawa distracted and Albertans getting sub-standard health care funding while paying for full health care funding for everyone else.
How is this a win for Canada?
Is that really the goal? Winning what amounts to a debate club argument to get cheers from progressives for "skewering" Danielle Smith while hurting Canada?
No, the goal is very simple. To protect public health care. Its not more complicated than that. I agree, the politics will be messy (they are anyways), and Smith will blame Ottawa (she already does anyways). Health care wont save the separatists, thats a losing lot in every dimension. So what, we should just let Smith destroy public health care, in violation of the Canada Health Act, so we dont upset her, so we dont upset the separatists, so we dont upset the Americans? Where is the conviction in that?
That's too vague to be a goal. You might as well say the goal is to have more good things in Canada and fewer bad things.
Specifically... what do you think this move by Mr. Nenchi will achieve? Is it just to make a rhetorical point? Is it to make Ms. Smith reverse course? Is it to get Mr. Carney to change the Canada Health Act so that Ms. Smith's move becomes the model for Canada so that we become like France & Britain in public health care delivery? Is it to have Mr. Carney ignore him so that the Canada Health Act is effectively changed without changing it on paper? Is it to make Albertans suffer underfunded public health care so they see the light and elect the NDP to get their health care funding back?
I disagree it's a vague goal. It's very simple. My answers to your questions: I think Nenshi is trying to force the federal government to get formally involved , in defense of the health act being violated. In doing so, it will hopefully be upheld, like legislation is supposed to be. That's the goal. If that doesnt make sense to you or satisfy you, Im sorry I dont know what to say to make it so. I can't simplify it any more than that.
The biggest violator of the Canada Health Act is the Federal government who reneged on their funding formula 30 years ago. The fact that people keep thinking the Feds are the heroes of health care stuns me.
Nenshi affirms that is a resolute leftist that has nothing but contempt for markets.
Not that Smith is materially better in respect of health care reform.
Want better service and quality , pay for it. Like any other commodity.
And regardless of leftist rhetoric, health care is commodity. It has real costs that cannot be ignored. And you get what you pay for.
Smith should have simply allowed Alberta doctors to simply allow their services made freely available. Any Albertan should have the right to spend their after tax dollars as they wish.
In doing so, the real value of thier service is set by markets.
Canada's existing system denies that right and that efficiency.
No one can expect Nenshi to relate to any of this.
But Smith should have.
A public health system and private insurance or self insurance are not mutually exclusive.
The most absurd point from the Alberta left is that "medicare" defines what being a Canadian is.
But instructive as to why Canada is so economically dysfunctional.
> Want better service and quality , pay for it. Like any other commodity.
Are you sure you meant to say commodity?
A commodity a very specific kind of economic good or service. It is a good or service that is interchangeable with any other good or service regardless of who produces it. It's things like natural gas. If your natural gas suddenly starts coming from a different well owned by a different company, you don't care. That's different from non-commodity goods like sushi. You very much care if door-dash swaps out their sushi supplier to be a local gas station rather than a high end restaurant.
Respectfully I strongly disagree, and I think are completely incorrect. 'Health care is a commodity' is false. Do you pay for your own private fire department? Your own private police force? Your own private food inspection agency? Your own private legal system? Public services are not commodities. They are expensive, and they protect a social service and network. The Canada Health Act enshrined the now Canadian value that health care is a public social responsibility. Health care is not just for the rich, as you've suggested.
2. Have you ever had a health care encounter with a peer nation to Canada either personally or with a close family member?
3. Have you considered the difference between public health care and public insurance? Your family doctor (if you have one - I don’t) is a private provider working within the public insurance system.
Appreciate the discussion. I think I know where this is headed but happy to play along. To answer your questions: 1. I think Canadas values are similar but not the same as the countries listed. Those countries have a much longer held class system entrenched in them and as result they are comfortable with massive disparities in educational and health care access. 2 Yes and Yes. Have worked in one of the countries listed and have had family receive care there. 3. Acutely aware of the difference. I work in health care.
Thanks for the response. Based on answers 2 and 3 I’d be interested to know your thoughts on Canada versus the other country in question as a point if comparison visa-vi quality of delivery.
As to question 1 I’ll say maybe to some… but not to most. Most of the OECD countries would be considered more “socialist” than Canada on the whole, excepting for their opinions Health Care delivery models apparently here it seems.
I agree most western european countries are more socialist for sure. Different taxation, different social supports. As it relates to the 3 countries you specifically listed education and health care have a very clear class based history that prevails today. If you are of even basic means in those countries you will almost certainly send your kids to private or boarding school (which differs markedly from here). The public schools are lesser. For health care, its more complicated than that. The public systems are well funded and functional but the delivery of care is a bit messy. They perform at a lower level (from my personal experiences and observations) than a typical Canadian hospital in general, and especially for emergencies and after hours care. They rely very heavily on a pool of international residents from poorer nations to staff the hospital, admit and care for patients, operate on them, etc. The consultants/faculty, in surgery in particular, are heavily motivated to serve their private practices at the expense of their public ones. You dont want to have an after hours emergent surgery there, you will NOT see the consultants/faculty, and they will not do your surgery..you will be cared for by residents or IMGs. The consultants view their public work as an obligation and act of good will in many respects.
The physician compensation is complicated there. They typically have a very flat pay scale for specialists there, compared to here, and the senior/established surgeons do absolutely as much private work as they possibly can for extra income.
Just because I can't help myself... his use to the term commodity is likely incorrect because the services aren't interchangeable between providers, but those examples you gave... they actually make Ms. Smith's point that Canadians should have more access to private health care, not be effectively barred from accessing it unless they're rich enough to travel for it.
Private police department? Yes, many people do. It's called private security and people can work in both.
Private legal system? Yes, some people use public defenders when accused of a crime, other people use high priced lawyers. And yes, lawyers can legally work in both.
Private fire department? Actually.. yes, some companies do have that when they need on-site immediate response and waiting for the fire department just isn't an option.
In none of the above cases do you lose access to the public system because you also use the private system.
Food inspection you have a point, but that's not parallel to doctors and providing health care to patients... that's parallel to the Canadian medical association and licensing bodies.
You're just arguing and being contrarian to amuse yourself. Your examples are completely bogus. Private security is not the same as policing (hmm think jails, arrests, think transnational or international policing, detective agencies, etc). Hiring your own counsel is not a 'private legal system' (maybe think courts, legislation, sentencing, judges, your expensive lawyer provides none of those). Private fire services are not the same as publicly provided fire departments. You cant hire one for your home in Mount Royal Calgary just because you are rich (your private fire company doesnt tie into public hydrants, scale high rises, respond to motor vehicle collisions). You're arguing in circles, have fun.
> You're just arguing and being contrarian to amuse yourself.
No, I'm really not.
Your examples just don't show what you want them to.
You brought up those examples, but food inspection aside, they all just prove the point that mixed public/private delivery including paying for better service works and doesn't destroy the public delivery.
They all have a mix of private and public with some people not using private security at all, while some people use private security a LOT. While the public police system provides basic security to all Canadians because we can all dial 911 and have the police show up, some people get more responsive and immediate security because they have private security and they pay for it.
Your original question was if someone paid for their own private police force. **Yes!!!** Some people DO pay for a private police force and as a result, they get better policing than I do.
Your "what about police & fire" is a good argument against privatizing the police and making all security a fee for service business because in that case you eliminate the basic public security. But no one is proposing that for health care. (Or for the police).
I agree its massively expensive (& growing). But I disagree its 'unsustainable'. That's a philosophical position. If you think its too expensive to be paid for publicly, then you will favor it being paid for privately, and all that comes with that. Alternatively, if you think its a critical public service, then you will favor public dollars paying for it. There is no way around how incredibly expensive it is aside from looking for cost savings and efficiencies within how its administered and delivered. There is room for savings there for sure, but it likely wont massively turn the dial unfortunately.
At the end of the day universal Public Health delivery has proven itself as a failed delivery model. The parochial and ideological view of Universal Public Health Care as this type of virtuous Canadian identity needs to end. At this point the data is overwhelming and completely damning. Yet we still have large segments of Canadians making arguments in its defense basically on feels.
The other argument I hear a lot in AB is that somehow this is a UCP or Danielle Smith problem. Well then what about BC’s disaster of a system? What about Manitoba’s? What of Ontario? If it’s not a government specific problem, and it’s not a funding problem (and empirically it’s quite obviously not), then it’s a problem with the system itself. Time to address reality. I have zero issues with the policy proposals being made by Danielle Smith and the UCP, and when it gets down to brass tax - a majority of Albertans won’t either. We’re modeling after what works elsewhere and acknowledging what we have doesn’t.
Understand your position. That doesnt make it fact however. We share different 'opinions' on this issue so no need to go back and forth about our opinions. You are incorrect however, that the 'data is overwhelming and completely damning', quite incorrect. There is considerable evidence that the introduction of private surgery increases, not decreases wait times, and the benefits are enjoyed by the wealthy (we have both Albertan, Australian, and Ontario data). Further, cross jurisdictional comparisons are challenging. Europe is not Canada. They have massively more providers per capita, massively more beds per capita, a totally different compensation system for physicians, a totally different taxation structure, a different social ethos, well entrenched (and in some places legislated and regulated) private health insurance (kind of like our Blue cross but different). You are not in position to speak for 'majority of Albertans', in fact, the 'data' shows most canadians are strongly in favor of preserving universal health care. And lastly, No, we are not 'modelling what works elsewhere'....literally none of the european countries are comparable to Smith's new found model, not in terms of staffing, not in terms of insurance, not in terms of their base levels of delivery, not in terms of funding. Given you like quoting sources I suspect you are well aware of the data/position papers/academic literature on this issue, and you are chosing to quote those which suite your bias. I am happy to do the same if you wish.
I’m happy to hear how sources such as the C.D Howe institute, and a study using OECD meta data are biased? It’s been these studies combined with my own anecdotal experience with Canadian Health care that has formed my opinion. Also Universal Health care should not be confused with Universal Public Health Delivery. This goes back to differentiating between insurance and delivery.
Why does Europe have massively more providers per capita? Id like to know? Why do they have massively more beds? They pay less per capita than us? My bet is that incentives are in place to create this environment. The market is allowed to play a part, and the most minimum of competitive friction has sharpened their delivery models. Canada has relied on central planning to provide health care exclusively, and now we have an overfunded and under performing system.
We also don’t acknowledge the inherent 2 tier system that already exists. Thousands of Canadians seek treatments and surgeries in the US alone, nevermind outside of that. That money leaves Canada and never comes back.
This idea as well of equality at all costs is also rediculous to me. An NHL player tearing an ACL is not the same as me doing it. The function of time is far more important and costly to them. And so we see ALL of them leave Canada for any surgery they ever receive. But sure, we get to pretend we’re all equal… Should Mark Carney be forced to wait in an ER room with a suspected heart attack, or should he be able to receive timely care because his health impacts far more people than mine does. Cold assessment maybe? But absolutely true.
At the end of the day, we also need to start openly acknowledging Canada has a major problem retaining our talent in this country. If we are going to ensure our best and brightest can’t as a matter of religious principle, have access to Health care delivery at least in the same league as what exists elsewhere (namely the US), we will continue to lose them. And this includes many of our Doctors, surgeons and nurses.
The universal public delivery proponents have had decades to right the ship in our system, all we have is continued in decline. And the only solution I’ve heard from them is to throw more money at it. What is Nenshi even saying for solutions beyond preaching platitudes in order to fix the public system? What is anyone saying? At this point I, and I’ve seen polling to suggest, most Canadians, are ready to move on and look for other solutions that do include more private delivery options. Otherwise I’m all for ears as to how we can fix an already highly funded system without throwing more good money after bad.
> "Hey ChatGPT... Can British doctors work in private health care and public health care at the same time? Oh also... tell me about French doctors. Can they do the same thing? Oh and one last question... What about Canadian doctors? Can they work in private and public health care at the same time?
While I agree that the federal government has a role to play, Naheed Nenshi might do well to temper his instinctive desire to "make common cause" with more frequent resort to the sort of hard-nosed political realism that good politicians use to good effect when trolling for public support.
Ultimately, Nenshi and his party must put a compelling alternative vision on the table, one that puts to bed the inevitable UCP claims that all the NDP really wants to do is to increase taxes. In my view, many Albertans are as angry as Canadians in other provinces are about how successive provincial governments in Alberta have played politics with the medical care system, to the detriment of outcomes for patients.
I would be wary of any revamp that boosts the incomes of private insurers and doctors who want to be in a position to charge big fees direct to consumers for medically necessary procedures (knee operations are medically necessary, in my view).
Mostly, I agree with you. But three things. One - the new availability does not break a promise as no Albertans have to pay, everyone can instead choose to wait until the system deigns to serve them.
Two - the NDP are missing opportunities to contribute. The NDP could lean on the union to allow test technicians to work on the weekend without claiming OT, and thereby be able to claim they contributed to reduced wait times.
The NDP could lean on the unions to get rid of the rule that overtime must be offered by seniority, thereby being able to claim they assisted in cost reductions that would release money to pay for more operations and also show up as decreased wait times. In addition, greater availability of OT for younger nurses could reduce the number of young nurses who leave the profession.
Three - Hear me out - the UCP are smart to support public health care by allowing public system dollars to pay for timely care here at home. Recently I have reliable information from several people paying $20,000 to $30,000 for timely out of province operations. A significant proportion of society can afford a one time bill of $30,000. It's possible that soon a large number of people will stop relying on the public system for operations, definitely leading to a reduction of support for public health care.
If the NDP truly wanted to support public health care they would recognize reality and either support the UCP's move, or lean on the union to allow job reductions in administration/ a more efficient public system, and spend the released money on reducing wait times for operations.
I disagree. I don’t think we need a fight exactly but it has been a common occurrence with Premier Smith and the UCP to observe their lack of knowledge about provincial authorities under the 1982 Constitution. (E.g., treaty rights, pardons for Coutts border protesters). Since Health is a shared jurisdiction I think it’s worthwhile for some clarification from the Federal Health Minister. Alberta has jurisdiction for service delivery within the Canada Health Act, not authority to alter the fundamental principles of public health.
The NDP nationally but especially in Alberta is owned by the public sector unions. Utterly beholden to them, especially teachers and nurses. It's sad to be honest.
The left in Alberta sees Ottawa as a "civilizing" force that brings law and order to the frontier. There is a reason why 98% of ND's are nationalists when you couldn't even get 98% of people to agree the world is round.
Two tier health care is the natural order of the world, just like there is two tier education or legal representation. There has always been a charity stream and a private stream. The left in Canada uniquely wants everyone to receive a universal handout so that everyone suffers equally and so that the poor aren't resentful.
It's just a wonder why doctors tolerate this arrangement. Lawyers would never tolerate banning private criminal defense for example. Imagine if lawyers had to work out of the Legal Aid system on the criminal side. (Justice is a right after all). The lawyers in Parliament would get rid of the CHA in a few days.
The biggest issue with Canadian health care are that Canadians fight our class wars proxy wars with health care policy. Like the Brits do with education and the French do with culture.
The NDP have an opportunity to get creative on this or any other issue, and appeal to voters with true innovation and leadership. As others have pointed out, there are lots of functional models in western countries to study and draw inspiration from. It is an odd choice to instead go tattling to Dad in Ottawa.
I would argue that other provinces have even more severe healthcare issues and backlogs. AB has been making progress, particularly in surgical wait times. People wait 6 months to see a surgeon now instead of 2 years. Surgeries are then scheduled within 3-6 months after seeing the surgeon.
Nenshi has never struck me as someone very smart. But I think defending a failing status quo is foolish. I’m an Albertan and welcome a dual system. Done wisely, it will improve care for everyone. And it will be good for patients for doctors to have to provide more service and build relationships with patients rather than how things are in many places right now.
I suspect Nenshi hasn’t talked to enough Albertans or he’d realize that not everyone hates what the UCP is proposing. And they will all hate having Carney involved if he gets involved.
There has always been two tiered health car and those who can afford it head outside the country. Now, that money can stay in the system. When my buddy when to Latvia for a knee, he paid 13.5. I asked my surgeon buddy what he charges in Alberta and he said 20K. I am just thankful he has stayed in Canada as these surgeons can go anywhere and we are darn lucky they are staying here. I have also been to private clinics (and have not paid), and you know the first clue it is a private clinic? Nice furnishings and no waiting. (Mayfair diagnostics for one...) . If Carney wants to use the Canada Health Act, this is a dangerous game, as you can bet Brookfield had benefits (like big law and Accounting firms in Canada) where key employees get shipped to the USA is there is any wait in Canada for treatment!
Healthcare is broken across the whole country. It’s time we had mature conversations about fixing it. Every province has different issues, so the fixes are different. The European hybrid models deliver better care with less cost … we should be looking to emulate those. But we can’t even start these conversations because of NDP screeching. Canadian healthcare will never improve as long as we let the NDP hijack the conversation before it’s off the ground.
FTR … it’s not about money we already spend far more per capita than most of the OECD. MONEY will not solve our issues.
You have to take a country’s GDP into consideration. 10% of Canada’s GDP is not the same thing as 10% of Germany, France or the United States. Our current total dollar expenditures are still a little more than half of the US per capita as a result, but people expect US wait times and drug access.
We still spend the lowest TOTAL dollars on hospital beds among these major nations.
Respectfully disagree Rob. The Canada Health Act exists for this very reason. The withholding of federal health dollars is an extremely powerful lever. It DOES control health care spending. If we just ignore Smith's clear lies about not messing with public health care, and patients paying out of pocket, about the very clear corrupt care scandal and her very likely enriching herself and her friends at the public trough, this dual practice model directly contravenes the Canada Health Act, and is not permitted. Smith has been a complete disaster on the health care file, ("fix health care in 90 days"). Wait times are up, private care is up, emergency room waits are at historical highs, and now we have a confusing quadrupled bureaucracy administering things where nobody knows whose responsible for anything. Agree Nenshi has been a massive disappointment, but somebody has to keep Smith accountable to the actual rules. But don't worry friends, the rich folks will get their hips done quickly, Smith and her pals will make record profits, and the donations will keep flowing.
> Respectfully disagree Rob. The Canada Health Act exists for this very reason. The withholding of federal health dollars is an extremely powerful lever.
Powerful how exactly? What I mean is... what is the goal and how will withholding federal dollars achieve that goal?
I'm going to assume Mr. Nenshi's goal is "get Danielle Smith to back down".
Now... do you think Mr. Carney withholding health care funding from Alberta will achieve that goal?
Because I don't. First, I think Mr. Carney is likely to ignore Mr. Nenshi because he's politically and economically wiser than Mr. Nenshi. But let's imagine Mr. Carney does start withholding health care money from Alberta. The immediate outcome is going to be a super-charging of the seperatist movement and a constitutional challenge that will tie this all up for years.
And of course Ms. Smith gets an iron-clad excuse for any bad economic performance and any and all failure of anything the Alberta health system. Anything wrong with the financial or health situation is because the LIBERALS (emphasis hers) are taxing Albertans to pay for Quebec health care and not Albertan health care. Albertans have to pay the tax, get no benefits and then those arrogant jerks who look down on you laugh at you while spending your money. (That's what's going on Facebook for the voters.)
Seriously, how do you see this playing out? What is the goal and how will Mr. Nenshi doing this achieve that goal?
I agree, if the federal government were to withhold funding for Alberta healthcare as a result of Smith's increased privatization, the emotional and political response would be to blame Carney, but it wouldn't be factual or logical. I appreciate that doesn't matter but its an important distinction. The federal government has the legal authority to withhold public health care dollars 1:1 for every dollar of private health care provided (its existed for a long time, and that exact withholding has occurred for decades. It has to this point been a small number). Carney is no fool, and I don't think he is a coward, and like Farkas completely skewered Smith last week with some basic facts, Carney could do the same. The stakes are very high. Public health care is literally at risk, and Smith is working hard to dismantle and discredit it. As per Nenshi, as I said I think he's a huge disappointment and the wrong person for the job, but the leader of the opposition is literally paid to hold the government to account.
Okay... so again... what IS the goal?
Is it to "skewer Smith"? Because if so, that's a dumb goal.
Oh yeah... she'll be totally skewered ... in the view of progressives who will applaud. So now what... The Alberta separatists get a huge boost, the UCP gets a bump in the polls so of course Ms. Smith doubles down, successfully blaming all failures on Ottawa when she's speaking to the only people who matter (which is Albertan voters who put her in power, NOT progressives), and then launches escalating rhetorical attacks on Ottawa while likely also pursuing constitutional challenges to tie Ottawa's attention up in the courts. Separatists up, unity down, Americans with another wedge to hurt us, Ottawa distracted and Albertans getting sub-standard health care funding while paying for full health care funding for everyone else.
How is this a win for Canada?
Is that really the goal? Winning what amounts to a debate club argument to get cheers from progressives for "skewering" Danielle Smith while hurting Canada?
Is there another goal I'm not seeing?
No, the goal is very simple. To protect public health care. Its not more complicated than that. I agree, the politics will be messy (they are anyways), and Smith will blame Ottawa (she already does anyways). Health care wont save the separatists, thats a losing lot in every dimension. So what, we should just let Smith destroy public health care, in violation of the Canada Health Act, so we dont upset her, so we dont upset the separatists, so we dont upset the Americans? Where is the conviction in that?
> To protect public health care.
That's too vague to be a goal. You might as well say the goal is to have more good things in Canada and fewer bad things.
Specifically... what do you think this move by Mr. Nenchi will achieve? Is it just to make a rhetorical point? Is it to make Ms. Smith reverse course? Is it to get Mr. Carney to change the Canada Health Act so that Ms. Smith's move becomes the model for Canada so that we become like France & Britain in public health care delivery? Is it to have Mr. Carney ignore him so that the Canada Health Act is effectively changed without changing it on paper? Is it to make Albertans suffer underfunded public health care so they see the light and elect the NDP to get their health care funding back?
Seriously... what's the goal?
I disagree it's a vague goal. It's very simple. My answers to your questions: I think Nenshi is trying to force the federal government to get formally involved , in defense of the health act being violated. In doing so, it will hopefully be upheld, like legislation is supposed to be. That's the goal. If that doesnt make sense to you or satisfy you, Im sorry I dont know what to say to make it so. I can't simplify it any more than that.
The biggest violator of the Canada Health Act is the Federal government who reneged on their funding formula 30 years ago. The fact that people keep thinking the Feds are the heroes of health care stuns me.
Nenshi affirms that is a resolute leftist that has nothing but contempt for markets.
Not that Smith is materially better in respect of health care reform.
Want better service and quality , pay for it. Like any other commodity.
And regardless of leftist rhetoric, health care is commodity. It has real costs that cannot be ignored. And you get what you pay for.
Smith should have simply allowed Alberta doctors to simply allow their services made freely available. Any Albertan should have the right to spend their after tax dollars as they wish.
In doing so, the real value of thier service is set by markets.
Canada's existing system denies that right and that efficiency.
No one can expect Nenshi to relate to any of this.
But Smith should have.
A public health system and private insurance or self insurance are not mutually exclusive.
The most absurd point from the Alberta left is that "medicare" defines what being a Canadian is.
But instructive as to why Canada is so economically dysfunctional.
> Want better service and quality , pay for it. Like any other commodity.
Are you sure you meant to say commodity?
A commodity a very specific kind of economic good or service. It is a good or service that is interchangeable with any other good or service regardless of who produces it. It's things like natural gas. If your natural gas suddenly starts coming from a different well owned by a different company, you don't care. That's different from non-commodity goods like sushi. You very much care if door-dash swaps out their sushi supplier to be a local gas station rather than a high end restaurant.
Respectfully I strongly disagree, and I think are completely incorrect. 'Health care is a commodity' is false. Do you pay for your own private fire department? Your own private police force? Your own private food inspection agency? Your own private legal system? Public services are not commodities. They are expensive, and they protect a social service and network. The Canada Health Act enshrined the now Canadian value that health care is a public social responsibility. Health care is not just for the rich, as you've suggested.
I’m going to ask a series of question’s I’m hoping you’ll consider.
1. How do you consider Canada’s values in relation to England, France, Spain and Germany? I could continue a list of European countries that have both public private mixes in health care and objectively superior delivery for equal or lesser cost. Here’s one study that details it. https://cdhowe.org/publication/troubling-diagnosis-comparing-canadas-healthcare-with-international-peers/ I have many more.
2. Have you ever had a health care encounter with a peer nation to Canada either personally or with a close family member?
3. Have you considered the difference between public health care and public insurance? Your family doctor (if you have one - I don’t) is a private provider working within the public insurance system.
Appreciate the discussion. I think I know where this is headed but happy to play along. To answer your questions: 1. I think Canadas values are similar but not the same as the countries listed. Those countries have a much longer held class system entrenched in them and as result they are comfortable with massive disparities in educational and health care access. 2 Yes and Yes. Have worked in one of the countries listed and have had family receive care there. 3. Acutely aware of the difference. I work in health care.
Thanks for the response. Based on answers 2 and 3 I’d be interested to know your thoughts on Canada versus the other country in question as a point if comparison visa-vi quality of delivery.
As to question 1 I’ll say maybe to some… but not to most. Most of the OECD countries would be considered more “socialist” than Canada on the whole, excepting for their opinions Health Care delivery models apparently here it seems.
I agree most western european countries are more socialist for sure. Different taxation, different social supports. As it relates to the 3 countries you specifically listed education and health care have a very clear class based history that prevails today. If you are of even basic means in those countries you will almost certainly send your kids to private or boarding school (which differs markedly from here). The public schools are lesser. For health care, its more complicated than that. The public systems are well funded and functional but the delivery of care is a bit messy. They perform at a lower level (from my personal experiences and observations) than a typical Canadian hospital in general, and especially for emergencies and after hours care. They rely very heavily on a pool of international residents from poorer nations to staff the hospital, admit and care for patients, operate on them, etc. The consultants/faculty, in surgery in particular, are heavily motivated to serve their private practices at the expense of their public ones. You dont want to have an after hours emergent surgery there, you will NOT see the consultants/faculty, and they will not do your surgery..you will be cared for by residents or IMGs. The consultants view their public work as an obligation and act of good will in many respects.
The physician compensation is complicated there. They typically have a very flat pay scale for specialists there, compared to here, and the senior/established surgeons do absolutely as much private work as they possibly can for extra income.
Just because I can't help myself... his use to the term commodity is likely incorrect because the services aren't interchangeable between providers, but those examples you gave... they actually make Ms. Smith's point that Canadians should have more access to private health care, not be effectively barred from accessing it unless they're rich enough to travel for it.
Private police department? Yes, many people do. It's called private security and people can work in both.
Private legal system? Yes, some people use public defenders when accused of a crime, other people use high priced lawyers. And yes, lawyers can legally work in both.
Private fire department? Actually.. yes, some companies do have that when they need on-site immediate response and waiting for the fire department just isn't an option.
In none of the above cases do you lose access to the public system because you also use the private system.
Food inspection you have a point, but that's not parallel to doctors and providing health care to patients... that's parallel to the Canadian medical association and licensing bodies.
You're just arguing and being contrarian to amuse yourself. Your examples are completely bogus. Private security is not the same as policing (hmm think jails, arrests, think transnational or international policing, detective agencies, etc). Hiring your own counsel is not a 'private legal system' (maybe think courts, legislation, sentencing, judges, your expensive lawyer provides none of those). Private fire services are not the same as publicly provided fire departments. You cant hire one for your home in Mount Royal Calgary just because you are rich (your private fire company doesnt tie into public hydrants, scale high rises, respond to motor vehicle collisions). You're arguing in circles, have fun.
> You're just arguing and being contrarian to amuse yourself.
No, I'm really not.
Your examples just don't show what you want them to.
You brought up those examples, but food inspection aside, they all just prove the point that mixed public/private delivery including paying for better service works and doesn't destroy the public delivery.
They all have a mix of private and public with some people not using private security at all, while some people use private security a LOT. While the public police system provides basic security to all Canadians because we can all dial 911 and have the police show up, some people get more responsive and immediate security because they have private security and they pay for it.
Your original question was if someone paid for their own private police force. **Yes!!!** Some people DO pay for a private police force and as a result, they get better policing than I do.
Your "what about police & fire" is a good argument against privatizing the police and making all security a fee for service business because in that case you eliminate the basic public security. But no one is proposing that for health care. (Or for the police).
And it is on its current configuration economically unsustainable.
It is. Not equivalent to certain public services related to public order, national security and integrity of financial systems
I agree its massively expensive (& growing). But I disagree its 'unsustainable'. That's a philosophical position. If you think its too expensive to be paid for publicly, then you will favor it being paid for privately, and all that comes with that. Alternatively, if you think its a critical public service, then you will favor public dollars paying for it. There is no way around how incredibly expensive it is aside from looking for cost savings and efficiencies within how its administered and delivered. There is room for savings there for sure, but it likely wont massively turn the dial unfortunately.
The issue is the cost per capita we’re paying - which is among the highest in the OECD. 3rd highest actually. And growing at a rate outpacing our tax revenue. Here is another study which details the issues using OECD data. https://www.fraserinstitute.org/sites/default/files/2025-10/comparing-performance-of-universal-health-care-countries-2025.pdf
At the end of the day universal Public Health delivery has proven itself as a failed delivery model. The parochial and ideological view of Universal Public Health Care as this type of virtuous Canadian identity needs to end. At this point the data is overwhelming and completely damning. Yet we still have large segments of Canadians making arguments in its defense basically on feels.
The other argument I hear a lot in AB is that somehow this is a UCP or Danielle Smith problem. Well then what about BC’s disaster of a system? What about Manitoba’s? What of Ontario? If it’s not a government specific problem, and it’s not a funding problem (and empirically it’s quite obviously not), then it’s a problem with the system itself. Time to address reality. I have zero issues with the policy proposals being made by Danielle Smith and the UCP, and when it gets down to brass tax - a majority of Albertans won’t either. We’re modeling after what works elsewhere and acknowledging what we have doesn’t.
Understand your position. That doesnt make it fact however. We share different 'opinions' on this issue so no need to go back and forth about our opinions. You are incorrect however, that the 'data is overwhelming and completely damning', quite incorrect. There is considerable evidence that the introduction of private surgery increases, not decreases wait times, and the benefits are enjoyed by the wealthy (we have both Albertan, Australian, and Ontario data). Further, cross jurisdictional comparisons are challenging. Europe is not Canada. They have massively more providers per capita, massively more beds per capita, a totally different compensation system for physicians, a totally different taxation structure, a different social ethos, well entrenched (and in some places legislated and regulated) private health insurance (kind of like our Blue cross but different). You are not in position to speak for 'majority of Albertans', in fact, the 'data' shows most canadians are strongly in favor of preserving universal health care. And lastly, No, we are not 'modelling what works elsewhere'....literally none of the european countries are comparable to Smith's new found model, not in terms of staffing, not in terms of insurance, not in terms of their base levels of delivery, not in terms of funding. Given you like quoting sources I suspect you are well aware of the data/position papers/academic literature on this issue, and you are chosing to quote those which suite your bias. I am happy to do the same if you wish.
I’m happy to hear how sources such as the C.D Howe institute, and a study using OECD meta data are biased? It’s been these studies combined with my own anecdotal experience with Canadian Health care that has formed my opinion. Also Universal Health care should not be confused with Universal Public Health Delivery. This goes back to differentiating between insurance and delivery.
Why does Europe have massively more providers per capita? Id like to know? Why do they have massively more beds? They pay less per capita than us? My bet is that incentives are in place to create this environment. The market is allowed to play a part, and the most minimum of competitive friction has sharpened their delivery models. Canada has relied on central planning to provide health care exclusively, and now we have an overfunded and under performing system.
We also don’t acknowledge the inherent 2 tier system that already exists. Thousands of Canadians seek treatments and surgeries in the US alone, nevermind outside of that. That money leaves Canada and never comes back.
This idea as well of equality at all costs is also rediculous to me. An NHL player tearing an ACL is not the same as me doing it. The function of time is far more important and costly to them. And so we see ALL of them leave Canada for any surgery they ever receive. But sure, we get to pretend we’re all equal… Should Mark Carney be forced to wait in an ER room with a suspected heart attack, or should he be able to receive timely care because his health impacts far more people than mine does. Cold assessment maybe? But absolutely true.
At the end of the day, we also need to start openly acknowledging Canada has a major problem retaining our talent in this country. If we are going to ensure our best and brightest can’t as a matter of religious principle, have access to Health care delivery at least in the same league as what exists elsewhere (namely the US), we will continue to lose them. And this includes many of our Doctors, surgeons and nurses.
The universal public delivery proponents have had decades to right the ship in our system, all we have is continued in decline. And the only solution I’ve heard from them is to throw more money at it. What is Nenshi even saying for solutions beyond preaching platitudes in order to fix the public system? What is anyone saying? At this point I, and I’ve seen polling to suggest, most Canadians, are ready to move on and look for other solutions that do include more private delivery options. Otherwise I’m all for ears as to how we can fix an already highly funded system without throwing more good money after bad.
Yes, my insurer does contract with private fire fighters for my business and home to augment public fire services.
Yes, I hire security guards who perform security patrols to augment public police services.
Yes, foods I purchase have kosher and halal marks on them, private food inspection services.
Yes, I have utilized the services of private arbitration services and private lawyers.
Yes, I have also purchased the private services of doctors and nurses on numerous cases, non-covered services are private pay after all.
Only in "essential" health care is there a ban on doctors selling their services directly, and Canada is the only country where this is the case.
The left in Canada fight their proxy class wars in the hospitals which is weird.
> "Hey ChatGPT... Can British doctors work in private health care and public health care at the same time? Oh also... tell me about French doctors. Can they do the same thing? Oh and one last question... What about Canadian doctors? Can they work in private and public health care at the same time?
oh......uh... oh dear.
Thank you for this.
While I agree that the federal government has a role to play, Naheed Nenshi might do well to temper his instinctive desire to "make common cause" with more frequent resort to the sort of hard-nosed political realism that good politicians use to good effect when trolling for public support.
Ultimately, Nenshi and his party must put a compelling alternative vision on the table, one that puts to bed the inevitable UCP claims that all the NDP really wants to do is to increase taxes. In my view, many Albertans are as angry as Canadians in other provinces are about how successive provincial governments in Alberta have played politics with the medical care system, to the detriment of outcomes for patients.
I would be wary of any revamp that boosts the incomes of private insurers and doctors who want to be in a position to charge big fees direct to consumers for medically necessary procedures (knee operations are medically necessary, in my view).
Sounds like NN is the PP of the left
Mostly, I agree with you. But three things. One - the new availability does not break a promise as no Albertans have to pay, everyone can instead choose to wait until the system deigns to serve them.
Two - the NDP are missing opportunities to contribute. The NDP could lean on the union to allow test technicians to work on the weekend without claiming OT, and thereby be able to claim they contributed to reduced wait times.
The NDP could lean on the unions to get rid of the rule that overtime must be offered by seniority, thereby being able to claim they assisted in cost reductions that would release money to pay for more operations and also show up as decreased wait times. In addition, greater availability of OT for younger nurses could reduce the number of young nurses who leave the profession.
Three - Hear me out - the UCP are smart to support public health care by allowing public system dollars to pay for timely care here at home. Recently I have reliable information from several people paying $20,000 to $30,000 for timely out of province operations. A significant proportion of society can afford a one time bill of $30,000. It's possible that soon a large number of people will stop relying on the public system for operations, definitely leading to a reduction of support for public health care.
If the NDP truly wanted to support public health care they would recognize reality and either support the UCP's move, or lean on the union to allow job reductions in administration/ a more efficient public system, and spend the released money on reducing wait times for operations.
I disagree. I don’t think we need a fight exactly but it has been a common occurrence with Premier Smith and the UCP to observe their lack of knowledge about provincial authorities under the 1982 Constitution. (E.g., treaty rights, pardons for Coutts border protesters). Since Health is a shared jurisdiction I think it’s worthwhile for some clarification from the Federal Health Minister. Alberta has jurisdiction for service delivery within the Canada Health Act, not authority to alter the fundamental principles of public health.
The fight is Albertans against Smith and the ucp
The NDP nationally but especially in Alberta is owned by the public sector unions. Utterly beholden to them, especially teachers and nurses. It's sad to be honest.
The left in Alberta sees Ottawa as a "civilizing" force that brings law and order to the frontier. There is a reason why 98% of ND's are nationalists when you couldn't even get 98% of people to agree the world is round.
Two tier health care is the natural order of the world, just like there is two tier education or legal representation. There has always been a charity stream and a private stream. The left in Canada uniquely wants everyone to receive a universal handout so that everyone suffers equally and so that the poor aren't resentful.
It's just a wonder why doctors tolerate this arrangement. Lawyers would never tolerate banning private criminal defense for example. Imagine if lawyers had to work out of the Legal Aid system on the criminal side. (Justice is a right after all). The lawyers in Parliament would get rid of the CHA in a few days.
The biggest issue with Canadian health care are that Canadians fight our class wars proxy wars with health care policy. Like the Brits do with education and the French do with culture.
The NDP have an opportunity to get creative on this or any other issue, and appeal to voters with true innovation and leadership. As others have pointed out, there are lots of functional models in western countries to study and draw inspiration from. It is an odd choice to instead go tattling to Dad in Ottawa.
No,no,no Nenshi. No to the Olympics. No to a new Saddle Dome. No to new infrastructure. There wasn’t a good idea he didn’t like,because it wasn’t his.
I can’t think of many municipal politicians who succeeded or made great politicians at higher levels.
Although Doug Ford has been politically successful, I think he’d rather be the Mayor of Toronto than the Premier of Ontario.
As a Calgarian who watched Nenshi when he was our mayor, I'm scratching my head trying to figure out why as a provincial leader he just isn't leading.