What's Wrong with Healthcare?

Thinking inside and outside of the healthcare box. After 41 years of family practice, what's happened to Canada's healthcare system?

Saturday, August 26, 2006

Emergency Department Services in Calgary.

So the Board of the Calgary Health Region is bringing in the Health Quality Council of Alberta to examine, assess, consult, mull over, deliberate, and generally pontificate, over Calgary’s Emergency Department problems. Great; a government appointed Board is asking another government group to look at (aka rubber stamp) what is being done at present and make the usual recommendations to solve (see Jim Dinning’s suggestions: innovate, explore, more of the same) our emergency health care crunch. Sounds like a make work project to me!
Keep in mind that it wasn’t that many years ago that a costly and quite extensive consultation process took place to look at the health care provision in the Calgary Region. Come to think of it, this may have occurred shortly after Jim Dinning and Jack Davis were sent from Edmonton to get things in order down here. The word on the street at the time was that Calgary didn’t have a health care provider problem; there was simply an erroneous “perception” that there was a problem. Well, during Mr. Dinning’s two and one-half years as the Calgary Board’s Chairman, costs escalated, as did waiting times in all areas. I suspect even at that time Mr. Dinning realized that the present monopolistic public system was unsustainable. Could this be why he left the post after only two and one-half years (before the present crunch) with nothing gained functionally? On the other hand, as an ambitious politician, he could leave early and still, using the universal health care mantra as the universal “get elected” tool, present himself as the savior of our universal public health care system.
At the same time, as the government (through the Calgary Regional Board), is dishing out more money to get another government body to give an opinion on ongoing and long-time problems, we find out there has been a million dollars spent on ads, booklet design, consultations, etc, on what they had previously termed the “third way”. Now the opposition parties call this propaganda, and squashed that process through the help of the MSNM and Medicare lobby groups. Personally, if some of my tax money went to putting this together, I would like to see it. One of the strident cries of the advocates of Medicare, against the “third way”, was that no one knew what it entailed. So let’s have a look at it. Seems to be a bit of indirect censorship going on; on one hand they are saying no-one knows what the government is talking about regarding the “third way”, and on the other hand they say the public shouldn’t see what was put together and the money was wasted. Maybe, just maybe, there is and was some information in that million dollar expenditure that is credible.
The facts are simple: in spite of annual funding to the Calgary Region from the government (since the beginning of Mr. Dinning tenure as Chairman), surpassing the annual combined inflation rate and population growth, there has been an increase in waiting (risk) in both our emergency departments, access to procedures, hospital beds, and diagnostic tools. In spite of this and an ever increase in government’s budget going to health care, the policy makers, opposition parties, and “would be” premiers, refuse to even discuss alternatives. One of the truly stupid comments that I have heard regarding the non-sustainability issue is “More money isn’t the answer”. Of course it is! If money didn’t provide better access to health care, why all the paranoia about the wealthy getting better access if there were a private system? Why do many high profile people get opinions and service south of the border and from private sources in other provinces?
A common comment made now in Alberta is: “With all our surpluses, why isn’t the Alberta Government putting more money into Health Care? Here are some of the answers:
1) At present there is a shortage of doctors, nurses, technicians, etc. Alberta could probably afford to give them all a fifty percent raise. I guarantee this would do several things. a) Bring in a good supply of these people from other provinces, b) Create a worse shortage of these people in other provinces, c) Create significant hostility in the people and administrations of nine Canadian provinces, and d) bring about federal taxation policies that would take away Alberta’s ability to lure workers from other provinces. This can be already seen to some degree with our “bribing” of construction and oil field related workers from B.C. and Ontario.
2) If workers in the health care field were to get a fifty percent increase in their income, what do you suppose workers in education and other public services would want? Suddenly there would be a huge inflationary effect on salaries throughout Alberta.
3) Keeping in mind the above scenario, what would happen, if, in the aftermath of this, Alberta’s revenues from non renewable resources were to drop or a change in federal taxation evened the playing field between provinces? I doubt very much we would be happy with a deficit budget or a fifty percent decrease in salaries.
Realistically, Alberta has to use its resources revenues in such a way as to not significantly disadvantage Canada’s other nine provinces. We could though, do some health care provision that is costly (may mean we don’t get federal funding), but truly innovative. With careful monitoring of process, outcomes and cost effectiveness, we may be able to show the way to true health care reform that would benefit all Canadians.


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