Reporting on Ontario Healthcare

[Shwa]

I'm not that impressed with those numbers, the one marked as Percent of population that rates medical care received as very good or excellent (2007) is at 75%, for those who have a regular doctor.

Will you answer my question next ?

- Why are you not upset at the results of these reports ?

- At what levels will you become upset ?

I am not "upset" at the results of these reports - the example I have given - because a 75%-84% satisfaction level is pretty good considering that the services that many of the respondents had likely involved pain of some sort. Those percentages could be higher, and that means there is room for improvement, like any human endeavour. My old uncle was in the hospital a few years ago after falling and breaking his hip. He complained about the food and the "art" that was in the lobby, but loved his nurses. How do we measure his "upsetedness?"

I will become "upset" at the level in which the health of the general population is actually threatened or my confidence going into an Ontario hosptial is low. No one wants to face pain with fear and dread. Would that mean a satisfaction rate of less than 50%? Less that 75%? Only time will tell.

In the meantime, here is an interesting editorial from today's Star:

Bed blockers still there

The idea that aging baby boomers are unnecessarily taking hospital beds away because of lack of beds in nursing homes isn't going to get any better for another generation. And if you are as old as I am - which I think you are if you have been involved in politics for four decades - then we have met the enemy and the enemy is us.

[Michael Hardner]

I am not "upset" at the results of these reports - the example I have given - because a 75%-84% satisfaction level is pretty good considering that the services that many of the respondents had likely involved pain of some sort. Those percentages could be higher, and that means there is room for improvement, like any human endeavour. My old uncle was in the hospital a few years ago after falling and breaking his hip. He complained about the food and the "art" that was in the lobby, but loved his nurses. How do we measure his "upsetedness?"

I will become "upset" at the level in which the health of the general population is actually threatened or my confidence going into an Ontario hosptial is low. No one wants to face pain with fear and dread. Would that mean a satisfaction rate of less than 50%? Less that 75%? Only time will tell.

That's a non-answer. If it falls to 50% you'll wait to see how you feel about it then ?

That's lame. If the trend is towards declining services and increasing costs, why wait to address it ? Certainly if the latest initiative we're looking at on this thread doesn't change the direction of those lines then the time will come for radical - yes, radical - change.

If you don't take control of the situation, then it will control you and privatization will be the only option.

How do you feel about privatization by the way ?

In the meantime, here is an interesting editorial from today's Star:

Bed blockers still there

The idea that aging baby boomers are unnecessarily taking hospital beds away because of lack of beds in nursing homes isn't going to get any better for another generation. And if you are as old as I am - which I think you are if you have been involved in politics for four decades - then we have met the enemy and the enemy is us.

I was involved in politics in my early teens... and the late 70s... - wait that is 5 decades !

The enemy is us, I agree, and the solution is us. I have seen too many people put trust in government where it wasn't warranted, or maybe this long time LOC voter has been brainwashed by Pliny.

[Shwa]

That's a non-answer. If it falls to 50% you'll wait to see how you feel about it then ?

Is that what I wrote?

That's lame. If the trend is towards declining services and increasing costs, why wait to address it ? Certainly if the latest initiative we're looking at on this thread doesn't change the direction of those lines then the time will come for radical - yes, radical - change.

Initiative?? Is is an Act that has passed through the House and is on its way to coming into force. Now, do you have some legitimate report or study that foretells the implementation of modern management practices will result in declining services coupled with increasing costs or are you simply guessing?

If you don't take control of the situation, then it will control you and privatization will be the only option.

So during the life of the process to get the Excellent Care for All Act passed, can you show me some severe and withering criticism offered by the opposition parties? News stories of wide reaching protests or some other indicator that this Act will increase the shortcomings of the present health care system in Ontario? Seriously, I am looking for some reports, studies, protests, editorials and such that provide a definitive that what the sitting government is doing actually amounts to nothing or worse, a hindrance.

How do you feel about privatization by the way ?

There are some advantages and some disadvantages. But I prefer things as they are. I can always go to Buffalo for an MRI if I really want.

The enemy is us, I agree, and the solution is us. I have seen too many people put trust in government where it wasn't warranted, or maybe this long time LOC voter has been brainwashed by Pliny.

Pliny and the like want radical change and that will never happen with our present society. That doesn't mean the radical argument is invalid, in fact those sorts of arguments are often used as modifiers or input into localized initiatives. There will be changes overall, but careful, incremental ones. Innovative. But never comprehensive to any degree so long as we move toward modern management practices.

[Michael Hardner]

Is that what I wrote?

It's a question. You said something about 50% though... It seems from your answer that you're just going to defend the system, even if it continues to decline. That's my take on it.

Initiative?? Is is an Act that has passed through the House and is on its way to coming into force. Now, do you have some legitimate report or study that foretells the implementation of modern management practices will result in declining services coupled with increasing costs or are you simply guessing?

Yes - an Act can be called an initative, I think.

Modern management practices tend to result in improvements, that's why they've been adopted. Engineering management, project management, service and customer management. It's all good.

So during the life of the process to get the Excellent Care for All Act passed, can you show me some severe and withering criticism offered by the opposition parties? News stories of wide reaching protests or some other indicator that this Act will increase the shortcomings of the present health care system in Ontario? Seriously, I am looking for some reports, studies, protests, editorials and such that provide a definitive that what the sitting government is doing actually amounts to nothing or worse, a hindrance.

I could quote you items from question period - is that what you're looking for ?

And... why ?

There are some advantages and some disadvantages. But I prefer things as they are. I can always go to Buffalo for an MRI if I really want.

Soon you'll be able to go to Toronto, it seems.

Pliny and the like want radical change and that will never happen with our present society. That doesn't mean the radical argument is invalid, in fact those sorts of arguments are often used as modifiers or input into localized initiatives. There will be changes overall, but careful, incremental ones. Innovative. But never comprehensive to any degree so long as we move toward modern management practices.

Decline needs to be reversed, though, or revolution and chaos ensues as history shows us.

Incremental changes are fine, especially if they're changes that are being field tested for the long haul.

You have a reasonable take and a good perspective on all of this, likely the best of anybody who has come in on this topic (still makes me think you have inside knowledge from somewhere btw, not that there is anything wrong with that) and I appreciate your posting on this thread with me.

I do wish you were more upset with things though. I feel that more openness could reverse our march towards privatization and that the internet may provide for changes in market information that make Adam Smith less relevant.

[Shwa]

I do wish you were more upset with things though. I feel that more openness could reverse our march towards privatization and that the internet may provide for changes in market information that make Adam Smith less relevant.

The thing is that I don't see a march towards privatization at all outside that of outsourcing some functions of the system where that outsourcing makes sense, like some material supply, service contracts for technology, etc. Even at that, the sum total of management knowledge has learned that outsourcing is not a silver bullet solution to anything. Besides, what people never seem to pay attention to is that we have lots of private interests presently in clinics, some hospitals, hospices and other health related enterprises, nevermind material and equipment supply.

What I see happening is the that the public sector is going through a management process makeover and you don't need to be an insider to see this phenomenon. It might not be 100% Gov 2.0, but the information is out there. Now one can say that the public sector has always followed along the same path as the private sector practices and that might be partially true to the point where the bureaucracy sees themselves as having a fundamentally different bottom line. But there is an adoption of principles that are equally true for both private and public sector functions. However, when we see a private corporation issue wide-sweeping edicts about practices, processes or products, similiar edicts in the public sector are problematic, even if pushed through as a policy of one institution or another.

And I don't think even the most ardent privateer wants the government to generally rush through anything as it concerns health care. I mean, sure, specific instances must be addressed, but lets use legislation for the big picture.

[Michael Hardner]

The thing is that I don't see a march towards privatization at all outside that of outsourcing some functions of the system where that outsourcing makes sense, like some material supply, service contracts for technology, etc. Even at that, the sum total of management knowledge has learned that outsourcing is not a silver bullet solution to anything. Besides, what people never seem to pay attention to is that we have lots of private interests presently in clinics, some hospitals, hospices and other health related enterprises, nevermind material and equipment supply.

Sure.

What I see happening is the that the public sector is going through a management process makeover and you don't need to be an insider to see this phenomenon. It might not be 100% Gov 2.0, but the information is out there. Now one can say that the public sector has always followed along the same path as the private sector practices and that might be partially true to the point where the bureaucracy sees themselves as having a fundamentally different bottom line. But there is an adoption of principles that are equally true for both private and public sector functions. However, when we see a private corporation issue wide-sweeping edicts about practices, processes or products, similiar edicts in the public sector are problematic, even if pushed through as a policy of one institution or another.

I'm somewhat reassured by your assertion here.

I am also getting a little impatient, when my doctor has to constantly FAX information hither and to.

And I don't think even the most ardent privateer wants the government to generally rush through anything as it concerns health care. I mean, sure, specific instances must be addressed, but lets use legislation for the big picture.

Hmmmm....

Well....

I still think that open reporting would be good, especially as these new best practices are adopted.

Ok.... moderatedly reassured, am I.

[Michael Hardner]

Moderately...

In McGuinty's first budget, they spent money to reduce waiting times for cancer treatment:

http://wapedia.mobi/en/Dalton_McGuinty

[dre]

Extend medicare to cover operations in foreign countries, and give patients cash incentives to become medical tourists. That will reduce pressure on the system and put downward pressure on costs.

Any operation that has a waiting list here is a business opportunity and a market for somebody else. Countries like India or the nearly 50 other countries that list medical tourism as a national industry will gladly provide these services promptly and for much much less, and with comparable patient outcomes and in high tech modern facilities.

[Michael Hardner]

Extend medicare to cover operations in foreign countries, and give patients cash incentives to become medical tourists. That will reduce pressure on the system and put downward pressure on costs.

Any operation that has a waiting list here is a business opportunity and a market for somebody else. Countries like India or the nearly 50 other countries that list medical tourism as a national industry will gladly provide these services promptly and for much much less, and with comparable patient outcomes and in high tech modern facilities.

Why not import foreign doctors here on special visas and build temporary facilities to handle overflows from time to time ?

[Smallc]

Why not import foreign doctors here on special visas and build temporary facilities to handle overflows from time to time ?

Temporary facilities would cost a significant amount to maintain. It isn't as if you can just shut the doors, forget about it, and use it again in 2 years.

[dre]

Why not import foreign doctors here on special visas and build temporary facilities to handle overflows from time to time ?

Love the idea and Iv brought that up before. Id flood the country with cheap doctors. Theres thousands of good doctors around the world that would gladly come here and work for a fraction of what doctors here charge.

The reason why thats hard is that various medical associations in the US have successfully lobbied for very ownerous certification criteria, and all kinds of region certification requirements. There would be a long hard battle with doctors here over EITHER the idea of moving the patients to the good deals, or moving the good deals to here, but I certainly think both ideas are worth trying.

These are tried and true means of addressing demand while bringing down prices that have worked in various other industries.

[Michael Hardner]

Temporary facilities would cost a significant amount to maintain. It isn't as if you can just shut the doors, forget about it, and use it again in 2 years.

No - you could keep them open. The big costs, though, are for medical professionals which we could outsource.

[Smallc]

No - you could keep them open. The big costs, though, are for medical professionals which we could outsource.

If they're temporary, and you keep them open, they aren't temporary anymore.

[Oleg Bach]

Investment bankers sit on the board of most big Canadian hospitals. All they want to do is quietly privatize the system.

[Michael Hardner]

If they're temporary, and you keep them open, they aren't temporary anymore.

Temporarily.. permanent ?