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?

Sunday, December 17, 2006

NDP/Friends of Medicare Celebrate Hancock as Health Minister

So Mr. Dave Hancock is Alberta’s new Healthcare Minister. That figures; he said twice as much about health care on his home page leading up to the leadership elections as all of the other candidates combined, and at the same time, said the least. Have you ever noticed that when people go on and on about a subject that they may be treading water. I wrote pages and pages in an exam in medical school and got a 67%. The professor stated that I either knew the material very well, but was unable to express myself, or, I had a very tenuous grasp of the subject matter. I think Mr. Dave Hancock, as a professional politician and lawyer, likely has no trouble expressing himself. His solution to everything is “healthy life styles” and innovation.
Let’s review the key innovative and preventive movements by the Alberta government, and in particular, the Calgary health Region in the past 17 years, so we can get an idea how things are going.
1) Increasing health care costs brought in the innovative idea of decreasing medical school enrolment (if there are fewer doctors, there will be fewer tests ordered and fewer people will be admitted to hospitals). Sick people don’t generate costs, doctors do. This attitude alienated thousands of Canadian doctors and was responsible for the significant loss of physicians to other countries.
2) Increase the training time for a nurse from three years to four years.
3) Hire an accounting firm to set healthcare on a “business model”. This resulted in two hospitals in Calgary being sold, and one blown up. We went from 3.3 acute treatment beds per thousand population in Calgary, to the present 1.7 beds per thousand population.
4) During this downsizing in the province thousands of nurses were let go. These were the recent graduates because the Nurses Union gave privilege to the oldest nurses. Now we have an acute shortage of nurses and an alarming average age (approaching retirement).
5) Walk in clinics were looked at as a way of relieving pressure on emergency departments, but few, if any, took on preventative ongoing care. Income for walk-in clinic docs is much better than traditional family care, so fewer new docs are doing traditional family practice, and fewer docs, overall, are practicing preventative medicine.
6) Private laboratory services were largely taken over by the Calgary Region and more than 50% of small laboratory outlets were closed. This practice continues and patients often wait an hour or more for a simple blood test.
7) As a result of (6.) many small X-Ray outlets also closed and many small medical clinics in Calgary followed suit. Now the government is trying to re-establish similar clinics (8th and 8th, etc) at twice the cost. Little if any preventative medicine is practiced by the physicians that work in these clinics.
8) The region brought in “hospitalists” (physicians who specifically look after hospital patients), and paid them more than the physicians received for looking after their own patients in hospital. This precipitated a flood of family doctors giving up their hospital privileges.
9) Doctors were left out of the decision making process because they were deemed to be a special interest group (I suppose they thought the doctors would only give advice that was self serving). We are told this attitude no longer exists, however it should be noted that our new premier, Mr. Stelmach did not appoint Dr. Oberg as Health Minister (nor did Ralph Klein). The suggestion was that he did not want someone that was “too close” to the medical profession. Interestingly enough, Mr. Knight was appointed as Energy Minister (his background in energy services is seen as an asset), and the fact that Mr. Groeneveld was a farmer seemed to be a plus for his appointment as Agriculture minister.
So much for trying to solicit the help of the medical profession. Could it possibly be that Mr. Stelmach simply needed the “tried and true” rhetoric of “we will save healthcare with innovation and prevention” (and Mr. Dave Hancock can sure preach that sermon), to get elected in the next provincial election. Every prime minister and premier for the last thirty years has been elected with the same song and dance, so why not Mr. Stelmach? And while they fiddle with their innovations and grandiose plans of addressing the “determinants of health”, people die while they wait in “risk” lines.
I note that the NDP are quite happy with the appointment of Mr. Hancock to the Healthcare portfolio, and why shouldn’t they be; he’s their man.
And lastly, the great innovative idea of a health system that is “cost effective” and “patient focused”. I have in previous entries talked of the many pit falls of our cost effective policies. In my next entry I will discuss the “patient focused” part. And if you wish to read more on our new Health Minister, I refer you to my entry “Dave Hancock, a Lawyer’s perspective on Healthcare.


Blogger michie said...

I'm not sure HOW the government intends to motivate people to participate in preventative health care. To me, a politician talking prevention without a strategy that has a high likelihood of success is like saying that anyone can get an elephant to balance on a beach ball. There is no basis in reality there. In fact, most research would indicate that getting people to make healthy choices is incredibly difficult even for the MOST motivated... and not only that but it's also highly labour and money intensive!!!

The government must have something pretty INNOVATIVE in mind to effect such a change in peoples' behaviours, considering that they're up against not only human nature (to move towards comfort), but an environment that enables and feeds the most unhealthy and destructive behaviours.

18/12/06 12:39 PM  
Blogger Al said...

Amen to that!

18/12/06 9:32 PM  

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