Thursday, 21 November 2019

Mass Immigration Will End Canada's Public Health Care System.

Canadians list healthcare as one of the key characteristics that define the nation yet I fear mass immigration will put an end to it.  This is because mass immigration is adding undue stress to the system.  This will, in time, force us to adopt a privatized system because it will no longer be affordable as a public expenditure.  There may be a semblance of of a public option but it will be a shell of its former self being so underfunded and inadequate that most will avoid it if they can.

How can I say this?

Getting objective data on the standard of Canada's health care system is hard to come by since many studies have an agenda to push and use specious methodology.  You can also find conflicting reports.  For instance in this ranking of national health care services the U.K. tops the list whereas in this ranking the U.K. ranks 19th.  Incidentally Canada ranks ninth out of eleven nations in the former yet doesn't even make the list in the latter.

The WHO purports to be an apolitical organization so we'll use its data since it's safe to assume it will be the most objective in its methodology.  According to the WHO Canada ranks 30th out of 191 nations in health care efficiency.  Topping the list is France which should raise some skepticism of rankings in general since the rankings mentioned earlier placed France 10th in one (and just below Canada) and 18th in the other.  For the sake of interest the U.S. placed 37th.  Nations of note that ranked higher than Canada are Malta (5), Oman (8), Colombia (22), Saudi Arabia (26), United Arab Emirates (27), and Morocco (29).

Bear in mind a low ranking doesn't necessarily mean terrible.  When the world's ten fastest runners compete in a race someone is going to come in tenth place even if the difference in placings is in nanoseconds.

So what do we have to go by?  Let's look at wait-times.  According to a Frasier Institute study "Canada's wait-times hit new record high, again" with Canadians expecting to wait an average of 20 weeks to see treatment by a specialist after referral.  According to the CBC Canadians' wait-time to see a doctor is longer than the international average (but the CBC assures us we're okay with that since we're still satisfied with the quality).  Furthermore emergency room wait-times in Canada continue to rise.  And another ranking by a group called The Commonwealth Fund cites wait-times as a deciding factor why it ranked Canada's health-care system dead last among a grouping of eleven nations.  Bear in mind wait-times are prioritized.  If you need urgent care you're going to get it but the less urgent your health-care needs are deemed by a professional the longer you're going to wait and the more there are in the queue the longer you're going to wait.

This is where mass immigration is taxing the system.  Canada's two most immigrant destined provinces, B.C. and Ontario, are two of the worst places in the country to be stuck in an ER.  B.C. reported an average wait-time of up to 8 hours in the ER whereas Ontarians were waiting an average of 16.8 hours in the ER.  For Canada, "hallway medicine" in now a thing.

Immigrants also add marginal costs to the system.  One such cost is the need for translation services on not only translators but a lot of paper and ink is wasted publishing healthcare information in a myriad of languages that all say the same thing.  This waste can be avoided if a working knowledge of an official language was requisite prior to arrival but the government has signaled it's not interested in instituting that as a requirement.

Another is pressuring the government to allow the importation of their elderly and sickly relatives into the country.

The solution to these problems is always to throw money at it but we throw a lot of money at it already.

Healthcare as a percentage of the national GDP has been following an increasing trend over the decades currently representing 11.6% of it making Canada one of the highest spenders on healthcare in the OECD.  This can be due to the ageing of the Canadian society as Canada's boomer generation enters its winter years but we've also been growing the population at the same time with mass immigration further compounding demand.

Healthcare spending is handled at the provincial level and is the single largest item on all provincial budgets consuming a national average of 38% of public spending.  In Quebec, healthcare consumes 34.3% of public spending and a whopping 42.3% of public spending in Ontario.  As healthcare expenses rise so too does its demand on provincial budgets consequently leaving less public money available to be spent elsewhere; that is, if the government wants to maintain the level of care the public is accustomed to while keeping spending under control.  That means cuts to some social programs and public sector initiatives or the government can run deficits and kick the problem down the road and let someone else worry about it.  Of course, the government can always raise taxes.

Another option is to delist previously funded procedures.  Canada doesn't have a totally universal healthcare system.  We do pay for certain things out of pocket or via an insurance scheme such as dental, optical, and pharmaceutical.  Some 30% of healthcare spending in the country is done in the private sector.  Delisting healthcare services allows the government to keep public spending under control without having to cut costs elsewhere, run deficits, or raise taxes.  But this is just offloading the cost of healthcare services onto the public that they previously paid for with their taxes which, in a sense, is a tax increase in a roundabout way.  It's also the death of the public healthcare system by a thousand delistings.

How many services can the government delist until it can't any longer?  Will it then move towards a public/private system with the government agreeing to pick up a portion of the tab of all services with the other funded by private means?  How is that not effectively a privatized system?  Continuously delisting services to address rising healthcare costs is a pathway to privatization and mass immigration is making that happen.

Rising healthcare costs as a portion of public spending isn't because healthcare services have become more expensive.  It's because of increasing demand made by the importation of masses of underperfoming immigrant cohorts who consume more in taxes than they contribute.  Mass immigration isn't the economic stimulant it's being made out to be.  Immigrants are attracted to prosperous societies, they don't prosper societies.  Well, they haven't prospered Ontario anyway; the province that sees most immigrant settlement.  More than half the residents of an immigrant heavy region of the province is considered "low income" by the United Way.  A study by an economist from the University of Calgary calculates the annual GDP per capita of the province is just USD$48,000 which is $1000 better than Kentucky and 12% better than West Virginia.

My solution to preserving Canada's public healthcare system is to severely cut immigration, make it more selective and restrictive, and ride out the "grey wave".  We should cut immigration by at least half; select for health, language skills and job skills; favouring applicants that are unmarried and be denied the prospect of importing extended family members.  Economic migration works but only 20% of immigrants enter Canada as economic migrants.  That means of 350,000 immigrants that are allowed to settle here only 70,000 were assessed by Canada's points based system.  The rest are either immediate family members, sponsored family members, and refugees.  This is where the public spending burden is coming from.  In short, we need to cut demand. 

It's worth noting Canada has seen the doctor per capita ratio reach a record high.  This is good news and may make a dent in wait-times but how was that ratio achieved?  Did we import these doctors?  If so that means another society is going without them and if they come from physician deprived parts of the world where their skills are in greater need than here how is encouraging their migration to Canada ethical?  We are guilty of poaching and the immigrant doctor, if from the developing world, should reassess why (s)he went into medicine in the first place.  Regardless, mass immigration can eat away at that ratio.  Cutting immigration and burdening the "grey wave" would not only greatly improve that ratio further in time but it would reduce wait-times and decrease demand (and therefore expenses) on the system.  Doctors will make less money but if money is why they chose medicine in the first place than they're in the wrong profession.

Famed economist Milton Friedman is quoted as saying "It's just so obvious you can't have free immigration and a welfare state" and he's right but this wasn't said in defense of the welfare state.  He was rabidly opposed to it and advocated for open borders migration.  Same can be said of a public healthcare system.  You can't have open borders and a public healthcare system because mass immigration will bankrupt it.  As Canadians it is our obligation to future generations to preserve and build upon what we inherited and we're failing to do that on many fronts and healthcare is one of them.  We are leaving them a worse future so that we can live in fleeting comfort in the present as a generation of spoiled, entitled Canadians give our country away, who have no right to do so, to a people who don't deserve it.

If you're still not convinced mass immigration is a threat to our public healthcare system I present exhibit B: the U.K.'s NHS.

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