Canada is going through another round of negotiating for health care dollars while never looking at the issues. The Provinces are demanding more money to keep the levels of service they currently don’t provide. The Federal Government is saying that the trough is starting to dry up and they have to put a cap on what they can spend. No one ever meets in the middle and the Canadian populace keeps geeting the dull end of the used needle.
Lets face facts. Money is not the issue. Canadians have piled billions in the system with the promise that things will get better. All of that money has simply been swallowed up in the morass that is the Canadian Health Care system. If money is not the issue than what is? There are many things wrong and they are all structural. Lets take that premise of universal health care or “free” health care as some like to call it. At its roots, the system put forth by Tommy Douglas many years ago recognised the problems we have now. It wasn’t supposed to be “free”. Mr. Douglas realized that people needed to have a buy in to the system and as a result he promoted a co-pay system. The “free” part came in when you suffered catastrophic medical care bills that you could not afford. That is when the system took care of you and did not deny service. A “free” system is always going to suffer abuse. Suffering from a cold or the flu, Canadians could stay at home, rest and drink plenty of fluids. Instead Canadians go to their doctor, where they are told to stay at home, rest and drink plenty of fluids. The doctor may also throw in blood work and a perscription to ease Mr. or Ms. Canuk’s mind. Canadians go to the doctor for things today that a generation ago would have been considered a passing annoyance. Why? Because it doesn’t cost anything and you can where it with pride.
“Where were you? ”
“Oh, I HAD to go to the DOCTOR.”
I once heard a hockey Mom tell her overly dramatic son to “suck it up Princess!” Sounds like a good perscription for Canadians as a whole. Tommy Douglas’ co-pay idea would definitely cut down on abuse of the system.
Family doctors are also to blame. It used to be that your GP was the one who diagnosed and treated your problems. Only the most serious, or confusing issues were referred to a specialist. Now your family doctor is at most times a turnstile that routes you to other areas, tests and specialties. We don’t need to be paying big bucks for that service. A well constructed computer program can do the same thing.
One health care consultant was promoting a funding system that was based on meaningful and measurable outcomes. I am not sure what that means, except to say that I am sure that it entails the hiring of a lot more administrators to develop and measure these meaningful outcomes. The Canadian health care system is administered to death. In fact there is a direct correlation between the rapid increase in health care funding and the increase in administrators. It is a bureaucracy that is now well entrenched and setting the direction of the health care system. As far as patient outcomes, why don’t we give doctors a kick in the butt and tell them to get back on the job. They are the ones that swear an oath to help and protect their patients. Shouldn’t they be the ones that are pushing for meaningful and successful outcomes for their patients, instead of using the excuse that the administrators are the ones holding back resources? Doctors are supposed to be at the top of the heap (they get paid enough), they should be the ones determining what is best for their patients, not administrators. They should be the ones complaining of long wait times and lack of access to services. Yet, they quietly stand aside and let the “system” take all the hard knocks. Straighten up guys and do your job. I still can’t believe that we have patients dying of C. Difficile and contracting Norwalk virus and MRSA in hospitals. That is simply a cleanliness issue, yet you do not hear of physicians, or nurses I might add, putting their foot down and saying they are not going to stand for unclean rooms and facilities for their patients.
A generation ago, you walked into a hospital and there were rooms with beds in them with patients being treated. Now those rooms have been converted to offices and meeting rooms and are filled with catered lunch trays for the latest get together to discuss an issue that should have been acted on eight months ago. That lack of accountability is staggering. Huge wastes of money occurr and yet no one is responsible since it was all decided at “committee”. Committees are the ones who spend millions of dollars on studies, when they could get a better answer from polling the workers doing the job. Most health districts spend money on marketing and promotion. Yup, markeing a service that you have to use. Why? I guess it is to make us feel good that they are doing something with all those billions. I think they should cut out the billboards and give someone a hip sooner.
The system as it stands is broken. Yet, there is still this belief that Canadians need to throw more money at it. Its like pouring water into a broken glass and wondering why you are always thirsty. Canada needs to do a major overhaul of its system. The simplest is to ditch what exists and put the running of hospitals out to tender. The government would still be the single payer, and the hospitals would have to make a business case for survival. If they couldn’t then they would be replaced by an organization that could.
None of this will take place, because Canadians are too chicken to mess with their much ballyhooed “Universal Health Care System”. Well the system is a mess and when Canadians get to the point where they really need it, the realization that it is not all they thought it would be will be too late.
Until then I remain,
A Sour Kraut