PASSPORTS TO HEALTH: ‘ALL SYSTEMS BROKEN’.

The phrase crops up across the entertainment business and on film — from Apollo 13 to a 1987 Donna Summer album to a Star Trek scene where a public announcement startles Mr. Spock: “All systems are go!”

Not in Ottawa.

On Tuesday, two events demonstrated how Canadians face increasing dysfunction in government management. At the Senate finance committee, Yves Giroux, the Parliamentary Budget Officer, described his experience dealing with the murky bureaucracies that lurk in the background while politicians publicly commit to new and bigger roles for government.

Commenting on the state of affairs surrounding passports and unemployment insurance, Giroux described “a system that is broken.” Cabinet ministers, he said, “are not very well equipped” to manage their portfolios. In his comments (quoted by Blacklock’s Reporter), Giroux described the process in which politicians announce “the government will ‘invest’ or will spend that many millions to do this and that. OK, but what will be the result?”

Pressed by senators, Giroux continued: “I think if you asked anybody who asked recently for a passport, Employment Insurance, Old Age Security and the list goes on, they are probably very well aware the level of service Canadians are getting is not what one could expect from a world-class public service.”

Giroux’s message: All systems are broken.

Change the scene on Tuesday over to another Ottawa event and a message on the functioning of Canada’s healthcare system. “Unfortunately, it hasn’t been living up to expectations,” the government admitted in a statement issued by the Prime Minister’s Office. “Emergency rooms overwhelmed or even closed. People are waiting for surgeries that are postponed or cancelled. The health-care system and the workers who uphold it are under enormous strain, a situation that was exacerbated by the pandemic, and needs immediate action to deliver better health care for Canadians.”

To improve this “all systems broken” scene, Ottawa offered the provinces — another wing of the Canadian state-controlled universal health-care system — new

“investments” of $46 billion in new funding on top of

$150 billion already planned over the next decade.

The $196 billion will be allocated here and there across the health-care system based on criteria and data that were not released and toward a long list of funding targets. The prime minister’s announcement said the money will go to emergency care, pediatric hospitals, emergency rooms, family health services, health workers, mental health, wage increases, medical travel, electronic health information systems, substance abuse, home care, long-term care, digital tools and more and better data.

Determining exactly how much money and resources Ottawa and the provinces should be allocating to each of these and thousands of other existing services and procedures remains one of the great problems of the centrally planned Canadian health-care system. What to fund, how to organize the system, how much to pay doctors and nurses, how many doctors are needed, which family physician regime should be adopted, how many operating rooms should be funded — the list is endless and under the “universal” Canadian system all such decisions are delivered top-down, often based on guess work or on studies and data manipulation by academics and bureaucrats who in many ways have no better handle on the operation of the health-care system than the bureaucrats overseeing Employment Insurance.

This “system broken” crisis is a classic manifestation of the core problem encased in central planning economic models. Centralized decision-makers decide everything, from hospital funding to the number of doctors allowed to graduate annually.

The failure of the model is the reason more and more Canadians seem ready to accept the concept of private provision and funding of health care.

Despite growing appreciation of the need for more private provision of health care, few experts are coming up with plans for a transition to more private care that could be based on the operation of private competition and market pricing — all of which are prohibited under the Canada Health Act.

As described by a 2002 Senate report, the Health Act “does not prevent” provinces and territories from allowing private for-profit and not-for-profit health-care providers to deliver provincially insured health services — “so long as extra-billing or user charges are not involved.” In other words, private markets for health care — from clinics to doctors to surgeries to hospitals — are mostly prohibited. The government sets the prices and controls the allocation of resources.

But if the system is broken, some radical re-thinking will be needed to un-break it. For that re-thinking to take place, however, the major intellectual machinery driving health care in Canada needs to be recalibrated, from the CBC through to the scores of medical groups, associations, professionals and think-tanks who routinely churn out reports against privatized health care and in favour of “pragmatic reform and innovation” by expanding the current central-planning model.

Jack Mintz, on this page yesterday, proposed an individual tax-credit system that would allow Canadians to control some of their own spending as recommended by a 2015 federal health-care advisory panel. That might help, but under the Canada Health Act such a plan would still leave overall control of the system and its pricing in the hands of politicians and bureaucrats.

The system is broken and the Canada Health Act is the reason.

CANADA NEEDS A NEW HEALTH ACT AND HEALTH-CARE MARKETS.