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, November 18, 2006

Mr. Mark Norris, The Healthcare Micro-manager.

Mr. Mark Norris likes to preface many subjects with “this is a very complex subject”. It is little surprise then, for him to introduce the issue of “health and wellness” with the statement: “Over the years the system has evolved, become complex, expensive, and difficult to understand. He goes on to admit there has been a significant increase in cost per capita, but from what I can decipher, his answer is primarily an increase in micromanagement. Isn’t this just putting money into administration, and taking it away from the frontline caregivers? But let us see where he is going with this, in more detail.
1) Ensure the partners in the health-care system are accountable for health and financial outcomes. a) Review management systems (does this mean we will have managers of managers? I think we have lots of that already).
2) Ensure health-care delivery standards will be set, measured, and met (sorry, this should have been done many years ago before the standards had slipped to their present level). He recommends more a) discussion (fifteen years of it isn’t enough?) b) review of the electronic system as per patient confidentiality (that will certainly help sustainability). c) Establish a peer review process for new technology and drugs as to what is cost effective (I would suggest that this has been going on continually already, but behind closed doors; now if he had said a professional body should be structured to do this, with public overview and accountability----------). d) Set up a “group purchasing” model to improve the purchasing power of the entire system (this has already been done in a major way by the establishment of large health regions. The most significant area that would benefit would be in the area of pharmaceuticals, and this would be best done on a national basis. Unfortunately, the federal government is not likely to take on the area of medicine with the sharpest rising costs).
3) Ensure access to health care is maintained for all Albertans a) Further extend the diagnostic and treatment centre clinic model that is working effectively in other areas (is this the same model that practitioners had before cut backs in the 1990s that provided comprehensive care without subsidization from the Regional Health Authorities, or the models that are now being run by the same Authorities, providing the same services, but are being heavily subsidized by the Region?). b) Consider locating medi-centers near major emergency wards (and where will the doctors come from to staff the place. I think improving the care in the communities, rather than taking doctors out of the communities, serves the needs of patients better). c) Review the 3.5 billion capital plan for health care to ensure the right facility is being built in the right place (Mark, this should have been done ten to fifteen years ago. The problem now is to provide people/power for the facilities that are being planned, and not one of your proposals addresses this dilemma. Almost any physical structure that will accommodate patients and health care personnel would be welcome at this point in time).
So that’s it folks. Our premier-in-waiting, Mr. Mark Norris, will review, analyze, study, supervise, and in general, manage the managers better, with a view to improving the efficiencies of our system. Nice try, but no cigar.

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