Thursday, December 1, 2011

Medicare fault is a terribly misunderstood idea in Canada

For the most part, each province and territory runs things in their own way, with the federal government contributing money. Currently, the provinces and territories are renegotiating

We are at a crossroads, with a Prime Minister PM, who is determined to thrust legislation through parliament, despite many objecting to, for example, the new Crime Bill. Crime is down, legislation up. It's all optics, rhetoric, and 20-somethings in the PMO who drive the agenda.

The same is true with healthcare. Many claim that our system is broken. It captures headlines, yet doesn't reveal the truth. As in the USA, provinces and territories run their healthcare systems differently. To make these gross claims is just plain wrong. There are system deformities, for example, in a country where abortion is legal, provincial control ensures that women in PEI cannot access an abortion in their province. For those without the financial and emotional resources to go out-of-province, this is a huge barrier to care.

Examining Canadian healthcare truly must be undertaken on a province-by-province, and territorial basis. With the philosophy of universal healthcare in Canada, Concierge Healthcare in Calgary, Harper's former stomping grounds, is a shameful way to deliver two-tier, private care.

I have read a financial, economists point of view of healthcare, which misses what is going on in some parts of Canada. The healthcare accord between Canada and the provinces and territories comes up in 2014. Many of us are afraid of what PM Harper will do.
In the meantime, many lobby, subtly, for privatisation of healthcare, through claims that the healthcare system is broken. Other economists (truly!), are analysing what works, what needs changing.
CHAP  - Cardiovascular Health Awareness Program

How would Apple run medicare?
November 22, 2011-by William Watson, Ottawa Citizen.
What would the system would look like if it were run by Apple? Or Virgin? Or Amazon? Or any other...

This is a reiteration of one author's summaries by William Watson, Ottawa Citizen.
He regurgitates Don Drummond's C.D. Howe Institute Benefactors Lecture for 2011, which he delivered last week in Toronto on the subject: "Therapy or Surgery: A Prescription for Canada's Health System." For the full report (PDF)

Drummond believes that:

  1. Primary care physicians should band together
  2. Chronic-care patients (ALC) should be taken out of hospitals 
  3. The system needs to re-orient from care to prevention
  4. Paying doctors per service encourages them to perform too many services while paying a salary (see Concierge Healthcare out west) discourages efficiency. Drummond favours a 70% salary; 30% fee for services.
I find it interesting reading about such ideas, as if they are new...

Read labels: 'per1/6 tray' of cookies
  1. Family health teams (FHT) abound in Ontario (200 to date). 
  2. Long-term care is filled with those who can pay for the services, they are full, with waiting lists, unless you can afford a private room. In that case, ALCs get into retirement homes, or buy private services for better Home Care. Private transfer payment agencies draw nurses from public administration. 
  3. The beauty of Nurse Practitioners, and the FHT, means that dietitians, RNs, social workers, and nurse practitioners can support the patient, give advice, provide workshops to those seeking to change their eating habits, monitor blood pressure, modify lifestyles. One of the best programs was CHAP, where you can learn about heart health and monitor your own health. But we all know how difficult it is to change. When I ran blood pressure clinics in Central Ontario, I found that many had learned about heart health. This was a terrific program that demonstrated much success.
  4. I think that the fault in our system revolves around physicians who do not understand geriatrics, who cherry pick patients, who do not ascribe to new notions about palliative pain management  vs. chronic pain (see Self-governing body CPSO Pretty Lax; What is your physicians medical batting average?; Who is protecting patients?; WCBA -Before You Fire Your MD - Have a Chat -  The Role of Doctors in Opiod Use).

Health care's future on ministers' agenda
Canada's provincial and territorial health ministers meet with federal counterpart Leona Aglukkaq on Friday in Halifax to discuss the future of health care. more »

1 comment:

jaylen watkins said...

This facts are quite shocking. Why every time Medicare is to be blamed.

Medicare America