Winnipeg Free Press

Winnipeg Free Press (Newspaper) - July 10, 1987, Winnipeg, Manitoba Winnipeg free press july i cares rising costs Are debated pollsters Tell us 95 per cent of canadians love on the other the bolder medicare Bureau economists though nary a politician Tell us they would not run a Corner grocery store the Way Canada runs its billion medi care they have been saying that sort of thing for canadians seek medical Atten doctors and hospitals Supply the government pays the but the government does not get to ask questions about the nature of this service about whether canadians Are getting value for their medical care Dollar and the medical professionals who dispense it do not really have for the the doctor is the entry Point into the whole medical care system the testing the Hospital with All its services and but the while commanding these does not have to calculate what these services they Are paid for out of other and ultimately out of Public the hospitals Are the focal Point of the because governments put them there and pay for their there Are cheaper ways provide but in the system we have questions such As that seem to have been largely what a Miracle it is that the whole thing seems to work and that canadians spend less of their National wealth on their medical care system than do Many Industrial including the yet simple Anth Metic makes it Clear this cannot go on much for a Quarter of a Century the costs of medical care have been growing at an average annual rate of per just about every Canadian government is struggling with High deficits and there is no Loose Cash around to pump into make it count very the Cash for new or enhanced services will have to be found within existing medical More and every Dol Lar spent will have to there was a noticeable Lack of crisis atmosphere As Canadian medical care prac toners and others gathered in Hali fax this week for a financial Post conference on health care in Cana can we afford unlimited Access was the question framed by Confer ence but it was virtually it was agreed the system would have to get More bang for its Bucks and that whether it be through better management or Rad ical new ways of offering patient care there were opportunities on All sides for getting this should Surprise no economist Greg a Mcmaster University professor and health care adviser to assorted governments in Canada As Well As the world Bank and world health or reminded his audience that the problem has not been knowing what to the problem has been implementing what we Joan Cohen Ottawa editor he for that Canada continues to focus almost exclusively on a Feero service sys tem when there Are other methods of organizing health care delivery that Are capable of producing greater efficiencies for example in the health maintenance organi in the under which an individual pays a Lump sum fee for health care the system challenges medical professionals to treat patients in the most effective Way possible so that their own profits Are As Large As Stoddart in an interview that no ofte system is necessarily better and that this capita Tion system should not replace our Feero service system but exist Side by Side with but he told the meeting that can Ada lacks much of the information needed for better health care we do not have a break Down of expenditure according to the Type of service canadians or an under standing of what makes us seek health the effects of Vari Ous income defensive medi technological breakthroughs and other which Means the information is not there for tackling the utilization he suggested this Lack of information said something about Cana Das commitment to properly Man age our health resources within our Public health insurance we in this learning to see medical professionals As managers of the medical care and Reward ing them for managing it Stoddart said that the system is not going to be swamped by the medical needs of an aging Canad an As is widely because these would Rise slowly and an increase of one or two per cent in annual growth should cover the usage rising he added a caveat that those calculations Are based on the Assumption that current utilization by age level and would remain in fact they Are and for unexplained Rea sons utilization is rising for All age Stoddart argues that despite the growth of Canada probably still has some breathing space before reforms become is and he notes that there is Little Public dissatisfaction with existing spending a fact that is going to be a serious obstacle to any Reform one could not leave the con Ference without a sense that there Are breezes of change out there and they Are gaining the conference heard from two senior bureaucrats from the Atlan tic provinces and that message rising costs of health care Are a major concern As planners look to the came through the Ambrose a widely respect de Deputy minister of health from warned that there would be no new Money for medical care during the 1990s As govern ments the rising costs of servicing the Public but he said that existing studies show overwhelmingly there is enough Money in the system no the task is to use it More too Many hospitals have been he maintained and too doctors trained thanks to series of decisions that were made As our health care system was being the effect has been to focus spending on the resulting tight Structure of health with too Little funding put alternative forms of Hearn suggested he was not quite sure where the leadership would come from but that the hospitals and medical profession would have to come together in a new partnership to find ways of recreating the William new Bruns Wicks Deputy minister of the department of Board of told of the provinces extra mural Hospital which operates a sophisticated Home care the Doc tors fee schedule in the province allows for Bonus payments for tract toners giving acute patient care under the extramural Hospital Morrissey said this Bonus catered to the interests of and rewarded the medical thereby winning its support for the new he went on to underline the warnings of others that the medical profession exerted Mas Sive Power Over the system and that no changes could be made in the system until this fact was and if we Are going to restructure and become More Effi we Are going to have to face the fundamental problem of who controls those was the setting that Manitoba health minister Larry Desjardins walked into when he addressed the he was expecting to be a loner in Halifax not merely because he would Bede of Only two politicians in attendance the other was Nova Scotia Ronald a but also because he was coming to talk about a new alternative health delivery method that Manitoba is now working to get off the Desjardins does not not seem to regard himself As the courageous politician that Stoddart had referred but much to the minis ters the Advance text of his speech stirred up a fair bit of too Many doctors his speech referred to the surplus of physicians and Over Supply of institutional and it said that the balance of care must be shifted via a rapid and significant expansion of ambulatory As a major step in that Desjardins had signalled last april that he would be seeking support from health care cooperatives and Large Winnipeg clinics in setting up a demonstration Pilot project of the health maintenance organization where citizens would sign up for a health care proposed now under negotiation with the emphasizes none linked care As in the Calls for savings to be shared among Doc patients and the As Desjardins pointed out in his the mos Are credited with reducing annual Hospital use from 750 Hospital Days per population to roughly 350 in 930 bed Days Are consumed each year per popu in Desjardins says the project would build on the but be tailor made to meet Manitoba he maintains it will be important to try to convince the doctors that the proposal is not trying to foist the Burden of savings onto their As for the a they might be attracted to the program if some additional Ben such As were added to the the minister says he would like to try different models under the Pilot he sees the at some including the operation of Community clinics staffed by Sal Aried the discussions Are still in their Early Desjardins says he has discussed his plans with Feder Al health minister Jake Epp once a great enthusiast for alternative care the Manitoba minister says additional spend ing will be required during a transition period and he is hoping to obtain a Federal he the opposition tories in the legislature also keep their enthusiasms about the project to themselves and Pepper him with questions about Hospital bed let at wish him Eric Dowd in election Campaign gets dirty Toronto a level of personal nastiness not seen in Ontario politics in memory has begun to creep into the election Campaign that is although not yet officially rumours that progressive conservative opposition Leader Larry Grossman is having serious marital problems and a Liberal Cabinet min ister is homosexual have finally sur faced in the Rumor about the 19year marriage of Grossman and his has been circulating for Sev eral even if such a Rumor were it is of no consequence to the Public unless it is in some Way offensive or detracts from a politicians ability to do his Grossman has had to deny vigorously to reporters that it has any substance and said both he and his wife Are very some reporters said the first they knew of the Rumor was when they received Calls from assistants to Liberal ministers ask ing if it was in the Grossman trying to emphasize the problems of tenants asked Liberal Premier David Peterson if he knew the aver age Cost of renting a on bedroom apartment in Peterson replied is the member looking for a spot to move to has he been thrown out of his House in Forest Hill Grossman let the re Marks pass in the but later accused the Premier of trying to give More currency to the Rumor spread about the tory Leader said Petersons comments were in the gut Ter the kind of thing that has no place in Public life and the Premier should Peterson told reporters he was aware of the Rumor about Gross but his comments were in no Way related to he said he was sorry if the tory Leader Felt offend but would not because he had committed no the conservative retaliation if such it is came when the liberals tried to put through legislation aimed at avoiding conflict of interest among the proposed new Law would re quire maps to disclose their Finan Cial and those of their spouses As someone of the opposite sex the map is married to or lives with in1 a conjugal relationship out Side George conservative map Susan fish claimed attorney general Ian Scott told her privately he included the expanded definition of spouse specifically because she was living in a common Law rela fish now plans to move an Amend ment where an map lives with a sexual partner of the same the partner similarly should have to disclose his or her fish said she merely wants to ensure the sexual partner of a Homo sexual map is obliged to make the same disclosures As the partner of a heterosexual because of the Rumor a Liber Al minister is the amendment will be seen As an at tempt to focus attention on the ministers alleged this is also a because a ministers sexuality should not be any concern of the Public unless it impairs him in doing his there Are dangers such innuendoes will Hurt people without providing any Benefit to the Bourassa acts quickly to avoid hint of corruption Montreal like a Man flicking a Fly out of his soup with As Little splash As Quebec Premier Robert Bourassa deftly dumped one of his ministers last for the solicitor general Gerard Latulippe resigned until an apparent conflict of interest in his relations with his former Law firm is re but there is no doubt it was Bourassa himself who insisted on the Young ministers Quick departure from for one Latt Lippes conflict of inter est was not just it was for Bourassa has a mortal fear of scandal or impropriety touching his govern ment and was determined to Deal quickly and decisively with this first Public in discretion by a minister since he regained Power in Bourassaw fear flows from his earlier experience As Premier from 1970 to he had been rather careless then about integrity in his Cabinet and about his relationship with his wife wealthy Simard reports of favouritism and venality were largely but Bourassa let them get out of control until his government expired under a Cloud of perceived now Bourassa knows that in politics perceptions Are often As important As he wants his new government not Only to main Tain the highest possible standards of Interi but to be perceived As maintaining those Given the premiers views and the stiff guidelines he has set for his ministers Latulippe was a dead Duck when Bourassa James Stewart in Quebec Learned of his ministers Messy but not illegal dealings with his former Law part when Latulippe was elected and named to the Cabinet he signed a Severance contract with his former Law firm in Mcdougall under which he received a percentage of fees paid by former clients and was to help the firm retain such a relationship and such substantial payments Latulippe had been paid about in fees from his former firm while he was a minister were a Clear Viola Tion of the spirit of the the guidelines require ministers to end All commercial and business activities that might constitute a conflict of interest or prevent them from devoting All the time necessary to their Bourassa Learned some of this from Latu Lippe about but did nothing while Latulippe apparently tried to get out of his contract with his former who were pressuring him for More the Premier probably also preferred to do Noth ing until after the legislature had risen for the so there would be no embarrassing questions in the the Story finally broke when the premiers office Learned that the Montreal Gazette was about to publish an investigative detailing Latulippe Bourassa then quickly arranged a minor Cabinet adding one new shifting a few others around and almost As an that he had accepted the resignation of Latulippe to allow him Latulippe to conform to the rigorous rules concerning conflict of inter for a Short time a few observers thought Bourassa was being harsh on an inexperienced but Well meaning the Gazette revealed More damaging details about Latulippe failure to make a clean break with his aside from his direct contract with his former Law Latulippe As solicitor Gen eral had awarded at least two government contracts to a consulting firm owned by friends and former the minister had also awarded another contract to a firm which then passed on part of it to his lawyer these contracts and several As the Gazette and la Presse later had not been reported As required to the National Assembly standing the no reporting May have been Over sight or but Latulippe other misdemeanours seem More deliberate the awarding of contracts to friends the signing of a Severance contract that clearly Vio lated the spirit of ministerial guidelines his failure to report the Legal fees in the state ment of holdings and income All ministers Are suppose to Latulippe is gone and Bourassa handled his going with a great Deal of political but he has left a dirty Little Mark on the Bourassa the opposition wants an investigation into Latulippe Deal Ings and particularly into his failure to report departmental contracts in the Public just the kind of thing Robert was hoping to because its the kind of thing that can easily ruin the perception of clean doonesbury by Garry Trudeau a cd pacy is Imo a gkublin6 rubber Chicken taking 1nnuehpo about mob Woff Etwo la All Abott those Rumaks i ;