To Heather,
Alright where were we?
1) Med School Enrollment increase – Looks like a point of agreement. Again, my fundamental problem with measuring Canadian “system” results is I believe it’s very hard to measure any system if it’s chronically understaffed. It would be like measuring a hockey team who only played 4 players (sorry, couldn’t resist using the hockey analogy in a U.S. forum 
). Of note, for Richard your comment re: the Canadian System I think falls into this category. It’s not “designed” to cause difficulty to transition to specialist care. There are difficulties because it’s understaffed.
RE: Canadian-Trained Healthcare providers moving to the United States for higher salaries – First, I think with the revaluation of the $CAD vs $USD, I do not see that trend occurring nearly as much as we did in the 80′s when it was a significant problem. That being said, I think there’s an easy solution to that. As most Americans may not know, Canada heavily subsidized post-secondary education, and most heavily medical field training. Under the current system, those individuals are allowed to take that subsidized training (which should be accounted for in our healthcare costs) and relocate anywhere in the world without restriction making the Canadian taxpayer investment ROI equal to exactly zero. If we are going to continue a medical training subsidy, the structure needs to modified so that students are billed at full rates during their training and then are granted loan forgiveness over a period of 10-years or so. The end result is to create a barrier to bolting to other jurisdictions after receiving upwards of $200,000 in educational subsidization from Canadian Taxpayers.
RE: What Canadian Med Schools teach: The other problem I have is of the graduates, we are generating far too many vanity-focused doctors and too few emergency specialists. Our $200,000, and most importantly that key medical school spot is going to train someone who is going to open something akin to a high-end spa providing cosmetic enhancements such as botox, breast enhancements, skin peels, etc. I have no problem if doctors choose to go this route, however such specialization should not be subsidized as it’s not part of what we really need.
RE: Alberta specifically – I don’t what to say on this issue. I have two sets of uncles and aunts and five cousins in Alberta and they say things very similar to you. That being said I think it’s primarily a mismanagement issue as opposed to anything else and I put most of that Klein and now Stelmach. I used to sell custom software into the oilsands projects and in 2005 flew out to Fort McMurray and received facilities tours of both Syncrude and Suncor. I was absolutely baffled by the lack of forward planning across-the-board considering the long-term planning timelines surrounding oil sands development. The fact Klein hadn’t put money to expand the 2-lane highway from Alberta which regularly resulted in unnecessary traffic accident deaths, as well as the urban planning mismanagement within Fort McMurray were mind-blowing. As a side note, the recent oil royalty review by Stelmach was another mindnumbing read. Bottom Line: I’m not there, but considering the fact your province is generating fiscal surpluses of billions per annum, I find your provincial government’s management of most folios….let’s call it confusing. My gut instinct is that if you put someone like Gwyn Morgan (former Encana CEO for those who don’t know) in charge and I think your provincial services could be 100% better in very short order. Good Lord, I’ve got Dalton in charge and as awful as he is, I wouldn’t trade you for Stelmach, and I’d trade Dalton for a ripe turnip.
Matthew.
P.S. Just for some additional background information, my grandmother needed an emergency hip replacement after a fall and she received that within 48-hours of that fall. She subsequently received comprehensive physiotherapy to heal all of which costs $0.00 out of pocket. She now lives in an assisted living nursing home that is subsized by the provincial government. I flag this because nursing home subsidies constitute an ever-larger portion of healthcare spending but its inclusion is often omitted from the debate. In the last year, I have a female friend who is a hotel sales rep in Niagara Falls whose mom was diagnosed with breast cancer and she was in chemo within 2-weeks and I talked to her just about every day during the treatments and the service was apparently outstanding. The biggest problem that exists in Ontario remains Emergency Room wait times and again that has to do with understaffing. Fix the understaffing and suddenly things aren’t too bad. Sadly I don’t expect Dalton to do anything smart in this respect but it’s important to recognize that “the system” cannot really be separated from the provincial leadership and management.
