Why can't politicans talk about serious healthcare fixes?

[wyly]

MDs do run hospitals now, and that makes no sense to me. They should provide input to people who can organize services. I have worked with MDs, and even celebrated ones, and it's not the same mindset that can be focused on organization.

The system needs to be reorganized. I'm not sure where the expertise would come from, but an understanding of information management concepts would be essential.

MD's can only do the job if they're given the resources/finances to work with...if the political overlords(lackeys) decide to starve the system of cash or divert it for other purposes the MDs have no recourse, closing hospital beds or cutting funding for training and hiring are political decisions not medical decisions of MD's...here's the Alberta Health Services board ten members only one is a MD, significantly the board chair's background is private insurance, wanna guess what he thinks about public health insurance...it's the goal of conservative governments to destroy public healthcare by internal sabotage and underfunding...destroying the publics confidence to allow private healthcare and insurance in the backdoor...

[Michael Hardner]

MD's can only do the job if they're given the resources/finances to work with...if the political overlords(lackeys) decide to starve the system of cash or divert it for other purposes the MDs have no recourse, closing hospital beds or cutting funding for training and hiring are political decisions not medical decisions of MD's...here's the Alberta Health Services board ten members only one is a MD, significantly the board chair's background is private insurance, wanna guess what he thinks about public health insurance...it's the goal of conservative governments to destroy public healthcare by internal sabotage and underfunding...destroying the publics confidence to allow private healthcare and insurance in the backdoor...

Sorry, I meant that hospitals are headed up by actual doctors.

[bush_cheney2004]

...it's the goal of conservative governments to destroy public healthcare by internal sabotage and underfunding...destroying the publics confidence to allow private healthcare and insurance in the backdoor...

Better add the Supreme Court of Canada to your list...see Chaoulli v. Quebec.

[wyly]

Sorry, I meant that hospitals are headed up by actual doctors.

but they don't control funding,if there aren't enough funds to hire nurses to keep beds open or th ERs treating people quickly the MDs can do nothing about it...

we've had the government fund new additions for hospitals but allow no funding for actual beds or staff, what can the hospital administration do about that?...

then there was a situation where the political lackeys made a big announcement that they funded a number of new specialty MD positions...wow...what they omitted to announce was they didn't supply any funding for support staff or actual offices/clinics for them to operate out of, so no one was hired...needless to say the MDs are very frustrated by these idiotic political games intended to kill public healthcare...

[fellowtraveller]

Otherwise, I don't think that these points, most of them valid, are necessarily an argument for privatization or even a two-tier system. Costs will rise but they will have to be paid by us somehow.

'Somehow' won't cut it. The money won't be there, simply because the number of people paying into nthe system will not come anywhwere near the money required by the huge bubble of aging, nonproductive and non tax paying boomers needing the care.

It's a Ponzi sheme, and it will collapse unless costs are seriously cut. And I do mean seriously.

What specifically is your objection to private provision of services? The vast majority of doctors right now are private sector.

[fellowtraveller]

here's the Alberta Health Services blah blah blah

This kind of errant nonsense is an illustration of the inability to have an actual discussion on the future of health care. He conveniently overlooks that Alberta spends more per capita than other provinces on publicly funded health care services. Not only that, every year they kick in billions so other provinces can provide services.

They are horrible people.

[bloodyminded]

'Somehow' won't cut it. The money won't be there, simply because the number of people paying into nthe system will not come anywhwere near the money required by the huge bubble of aging, nonproductive and non tax paying boomers needing the care.

It's a Ponzi sheme, and it will collapse unless costs are seriously cut. And I do mean seriously.

What specifically is your objection to private provision of services? The vast majority of doctors right now are private sector.

I have no objection to it all...providing guaranteed universal healthcare overrides private profits.

[Michael Hardner]

but they don't control funding,if there aren't enough funds to hire nurses to keep beds open or th ERs treating people quickly the MDs can do nothing about it...

we've had the government fund new additions for hospitals but allow no funding for actual beds or staff, what can the hospital administration do about that?...

then there was a situation where the political lackeys made a big announcement that they funded a number of new specialty MD positions...wow...what they omitted to announce was they didn't supply any funding for support staff or actual offices/clinics for them to operate out of, so no one was hired...needless to say the MDs are very frustrated by these idiotic political games intended to kill public healthcare...

If there aren't enough funds, then that means the cost increases we've been experiencing should be higher.

Of course the MDs are frustrated, so are the citizens and politicians.

[wyly]

This kind of errant nonsense is an illustration of the inability to have an actual discussion on the future of health care. He conveniently overlooks that Alberta spends more per capita than other provinces on publicly funded health care services. Not only that, every year they kick in billions so other provinces can provide services.

They are horrible people.

blah, blah, blah....what do I think of your flippant condescension...fuck u!... Edited December 9, 2010 by wyly

[wyly]

If there aren't enough funds, then that means the cost increases we've been experiencing should be higher.

Of course the MDs are frustrated, so are the citizens and politicians.

MD's are frustrated because they are asked to do a job without the resources, citizens being the greedy bastards that we are expect everything for nothing but good healthcare comes with a price(taxation)...politicians are nearsighted ideology driven bastards who put their own goals before that of the greater good...

without good health what do you have?...what is more important than the your personal health and that of your family? nothing...if you were offered all the wealth in the world in exchange for the your or a family members life it's a safe assumption you would turn it down...if saving the life of your child required giving up all your wealth would you hesitate for a even a second?... if taxes must go up to cover this then so be it...

[Michael Hardner]

MD's are frustrated because they are asked to do a job without the resources, citizens being the greedy bastards that we are expect everything for nothing but good healthcare comes with a price(taxation)...politicians are nearsighted ideology driven bastards who put their own goals before that of the greater good...

The costs keep going up, and because we don't have a good system of dialogue in order to prioritize things, and especially to manage change, a slash-and-cut mentality comes in.

without good health what do you have?...what is more important than the your personal health and that of your family? nothing...if you were offered all the wealth in the world in exchange for the your or a family members life it's a safe assumption you would turn it down...if saving the life of your child required giving up all your wealth would you hesitate for a even a second?... if taxes must go up to cover this then so be it...

Right, except that there are limited resources to everything. We could conceivably say "we don't care what it costs, tell us what you need and we'll give it to you" but that would result in double digit increases in costs.

The middle ground is for the system to be managed better. If we don't change how the system is organized, then there will be continual fighting along side shortfalls and failures.

[Evening Star]

'Somehow' won't cut it. The money won't be there, simply because the number of people paying into nthe system will not come anywhwere near the money required by the huge bubble of aging, nonproductive and non tax paying boomers needing the care.

It's a Ponzi sheme, and it will collapse unless costs are seriously cut. And I do mean seriously.

What specifically is your objection to private provision of services? The vast majority of doctors right now are private sector.

What I meant was that whether health coverage is public or private, Canadians are going to have to pay for it. Either we'll pay via taxes or affected families/individuals will pay themselves via premiums and fees. So there's no guarantee that privatized coverage (which is what I was talking about - not private provision of services) will actually reduce the cost of health care.

[jbg]

'Somehow' won't cut it. The money won't be there, simply because the number of people paying into nthe system will not come anywhwere near the money required by the huge bubble of aging, nonproductive and non tax paying boomers needing the care.

It's a Ponzi sheme, and it will collapse unless costs are seriously cut. And I do mean seriously.

I was born in 1957 and hence am such a "baby boomer". I also know d*** well that I won't retire until well into my 80's if not later. I know and expect that most social benefit plans are going to implode long before then.

[fellowtraveller]

I was born in 1957 and hence am such a "baby boomer". I also know d*** well that I won't retire until well into my 80's if not later. I know and expect that most social benefit plans are going to implode long before then.

There is no reason that we cannot have universal access to some kind of universal health care, but it simply cannot be as extensive as it is now, no matter what. The numbers of boomers are too high, the numbers of their children are too low.

Most likely, universal health care will be greatly reduced in scope to cover only the most critical of care, and many services will be up to the citizen to buy on the open market. This situations already exists to some degree in several areas like chiropractic, eye care, dental care, drugs, etc. It will get worse, it has to.

[fellowtraveller]

blah, blah, blah....what do I think of your flippant condescension...fuck u!...

Thank you for your valuable contribution.

[wyly]

The costs keep going up, and because we don't have a good system of dialogue in order to prioritize things, and especially to manage change, a slash-and-cut mentality comes in.

a big part of that rise in cost is more expensive procedures that why we live to an average 80+ when I was kid it was 60 something...another cause is demographics boomers need a lot of healthcare and it's going to get worse, there are a lot of us boomers and a lot of them are MDs...

Right, except that there are limited resources to everything. We could conceivably say "we don't care what it costs, tell us what you need and we'll give it to you" but that would result in double digit increases in costs.

are you suggesting that at some point we have to decide when we stop treatment and let people die? stop research into new treatments because they cost to much? that we should reverse our increasing average lifespan to 65 in order to save money?...

The middle ground is for the system to be managed better. If we don't change how the system is organized, then there will be continual fighting along side shortfalls and failures.

absolutely no doubt there is waste and poor management but for the most part the system is very efficient, it works as long as it's not starved of funds...it doesn't help when we have conservative governments deliberately undermining the system to destroy it...

maybe you heard of the "cookie incident" where the top alberta health employee was fired for a stupid remark to reporters...here was guy who was hired to clean up previous nightmare management, he managed to trim some 700mil off the budget...so why was he fired? a stupid comment? nope, he was a scapegoat deflecting heated criticism of the conservative government's health performance from one of it's own MLAs...ideology trumps healthcare...

[wyly]

Thank you for your valuable contribution.

if you expect civility then show some...

[Shwa]

There is no reason that we cannot have universal access to some kind of universal health care, but it simply cannot be as extensive as it is now, no matter what. The numbers of boomers are too high, the numbers of their children are too low.

Sure it can. You are looking at a worse case scenario and I highly doubt it will come to that. There is more than enough wealth to go around, and health is one of those key aspects of society that is worth protecting. I see quite a bit of the health industry pointing towards prevention and healthy lifestyle and those changes alone will modify the overall system to the better.

Most likely, universal health care will be greatly reduced in scope to cover only the most critical of care, and many services will be up to the citizen to buy on the open market. This situations already exists to some degree in several areas like chiropractic, eye care, dental care, drugs, etc. It will get worse, it has to.

No it doesn't have to get worse and it likley won't. In fact, universal health care will likely expand in scope and we'll make great knowledge gains in the areas of aged health and geriatrics with the boomers. Otherwise, we are in fine shape, most people want universal health care and there ya go.

[Michael Hardner]

a big part of that rise in cost is more expensive procedures that why we live to an average 80+ when I was kid it was 60 something...another cause is demographics boomers need a lot of healthcare and it's going to get worse, there are a lot of us boomers and a lot of them are MDs...

Do you have a source for that ?

are you suggesting that at some point we have to decide when we stop treatment and let people die? stop research into new treatments because they cost to much? that we should reverse our increasing average lifespan to 65 in order to save money?...

No. Not everything we do in healthcare involves saving lives. In any case, that's an odd reaction to my statement of reality.

absolutely no doubt there is waste and poor management but for the most part the system is very efficient, it works as long as it's not starved of funds...it doesn't help when we have conservative governments deliberately undermining the system to destroy it...

You have no idea if it's very efficient, because the monolithic entity that provides services also doesn't report performance well if at all.

And again, you're turning this into a dig against conservatives. The current liberal government in Ontario hasn't done very well either. You're politicizing the thing right off the bat, which proves my point.

People start arguing patriotism, and Canadian values over these things - the shouting starts and nothing gets done.

maybe you heard of the "cookie incident" where the top alberta health employee was fired for a stupid remark to reporters...here was guy who was hired to clean up previous nightmare management, he managed to trim some 700mil off the budget...so why was he fired? a stupid comment? nope, he was a scapegoat deflecting heated criticism of the conservative government's health performance from one of it's own MLAs...ideology trumps healthcare...

No, hadn't heart of that but that's another example of why politicians need to step away from this business.

[Evening Star]

I see quite a bit of the health industry pointing towards prevention and healthy lifestyle and those changes alone will modify the overall system to the better.

What do you think of the idea that tackling poverty and social inequalities could end up reducing demands on the health care system?

I have no problem with Michael's suggestions for better oversight and reporting on performance in the system.

[Sir Bandelot]

Part of the reason the health care system is so expensive has nothing to do with the health care system itself. Liability is one of the most significant factors. Even when it comes to things like equipment acquisition, liability plays a major part in raising the cost. Equipment manufacturers need to do rigorous testing to meet safety standards and get approval from organizations like Health Canada and the FDA in United States. The potential for litigation and lawsuits have driven up the cost of goods and also the cost for insurance. Professional medical associations must charge higher membership fees in order to offset potential legal costs. This in turn forces medical staff to demand a higher salary. It is one reason why hospitals today are actually corporations, with board of directors and a legal advisory team that plays an important role. All information is carefully examined and vetted before it goes out through the public relations department. All of this is done to avoid the implication of liability.

It's part of the nasty game we play in our society, and I believe it's the same problem whether there is a national health system or not.

[Bonam]

Part of the reason the health care system is so expensive has nothing to do with the health care system itself. Liability is one of the most significant factors. Even when it comes to things like equipment acquisition, liability plays a major part in raising the cost. Equipment manufacturers need to do rigorous testing to meet safety standards and get approval from organizations like Health Canada and the FDA in United States. The potential for litigation and lawsuits have driven up the cost of goods and also the cost for insurance. Professional medical associations must charge higher membership fees in order to offset potential legal costs. This in turn forces medical staff to demand a higher salary. It is one reason why hospitals today are actually corporations, with board of directors and a legal advisory team that plays an important role. All information is carefully examined and vetted before it goes out through the public relations department. All of this is done to avoid the implication of liability.

It's part of the nasty game we play in our society, and I believe it's the same problem whether there is a national health system or not.

But what could be done differently? Without the chance of being held to account and punished in cases of negligence, malpractice, faulty equipment, etc, these incidents would quite likely be more frequent. And, just as importantly, people have every reason to demand and deserve compensation in such cases. Thus, legal and financial liability is inherent to modern medical practice. Certainly, it raises the cost, but would the alternative, where a doctor could negligently cause death to a patient or a manufacturer could sell a poorly designed and poorly tested piece of equipment to a hospital and not be held to account, be any better?

[William Ashley]

Some are talking but the fact is that people don't want to fix the system they want to control it for their benefit, yet another reason why partisan over social policies fails the public interest.

Unfortunately that is the political landscape.. politiicians who don't vote on public benefit but vote on personal interest. People who represent party interests instead of a social consensus.

Just think what would happen if there was only a vote by a representative if all their constituents were in agreement.

Fact is these people don't care about the public interest, their view is biased and not whole. It is one that changes based upon political benefits and the overall game of what they are trying to acheive.

If healthcare were as simple as providing healthcare we would have it as a private industry receiving public tax dollars.

Sadly healthcare is broken in Canada and serves the police state - we have peace officers in hospitals and provinces making laws to remove citizens federal rights.. we have court diversions to sidestep judicial process and assault and infringe people extrajudicially.

we have major pharma companies reaping profits at the cost of the tax dollar, it is business first healthcare second.. otherwise the health industry would actually be nationalized instead of funded on tax payer dollars.. for a few select products and procedures.

The only way the politics will be removed and the public interest maintained is by removing public funding to private companies and corporations.

Fact is though... old poor health people don't want that because their poor health styles and age are catching up with them, cancer is an ongoing issue, and people can't afford the rates as individuals.

My NHIP plan is one that provides health insurance set at a rate of the cost paid by the tax payer, or the health industry is on the hook for funds left.. we can just see overprescription and high cost equipment scrapped when it isn't required to service the public need.

It is just a bunch of waste for limited effect. There are more pressing issues, but the old people are going to want it because they want to waste millions of tax payer dollars to extend their biological life.

Of course its not all old people.

Paranoia and non self reliance is rampant and that is the major issue with health care, that and centralization of health resources and knowledge. If we want a working public health care process it has to be whole..

We need people educated to help themselves, we need essential treatments...

even though it could be me or you, we have to accept death if a doctor wants a lifetime income of someone to save their life... the economic benefit only goes one way. Fact is the costs are hyper inflated.. it is political economy, it likely won't change but the only way to fix it is to restructure it - remove the power from doctors to override law and to choose expensive procedures or medication when it is a just a bandaid that has side effects...

people need to take responsiblity for their own health, not rely on doctors to save them and prevention is essential.

Either that or just tax the medical industry at a higher rate to balance things out but they will just move perhaps.. that is maybe part of the solution too.

Doctors are expensive, why can't we make the major leading health issues and leave them to speacialists in those areas.. rather than take up a general practitioners time, or a medical practitioners time....

and hows this why not get old people to do pathology and primary care... have them earn their free pensions.. oh but no that wont happen will it...

[Michael Hardner]

Part of the reason the health care system is so expensive has nothing to do with the health care system itself. Liability is one of the most significant factors. Even when it comes to things like equipment acquisition, liability plays a major part in raising the cost. Equipment manufacturers need to do rigorous testing to meet safety standards and get approval from organizations like Health Canada and the FDA in United States. The potential for litigation and lawsuits have driven up the cost of goods and also the cost for insurance. Professional medical associations must charge higher membership fees in order to offset potential legal costs. This in turn forces medical staff to demand a higher salary. It is one reason why hospitals today are actually corporations, with board of directors and a legal advisory team that plays an important role. All information is carefully examined and vetted before it goes out through the public relations department. All of this is done to avoid the implication of liability.

It's part of the nasty game we play in our society, and I believe it's the same problem whether there is a national health system or not.

How much of the reason ? If there were a definitive authority that could explain these kinds of costs then that would be helpful, but there isn't one.

[wyly]

Do you have a source for that ?

which part??? living to 80? average was about 69-72 in the 60's, now it's 80.7...all because of better healthcare, treatment and screening which all costs more...Boomers? that's quite common knowledge...boomers that are MD's? reflects the population demographics...

No. Not everything we do in healthcare involves saving lives. In any case, that's an odd reaction to my statement of reality.

I didn't think you did but your response was odd, all healthcare ultimately is about saving lives...preventing small issues becoming life threatening issues...

You have no idea if it's very efficient, because the monolithic entity that provides services also doesn't report performance well if at all.

you know this how? when was the last time a government opened the books to show how it was doing?...hospitals,MDs chart everything

And again, you're turning this into a dig against conservatives. The current liberal government in Ontario hasn't done very well either. You're politicizing the thing right off the bat, which proves my point.

fair enough I don't know your situation in ontario but public(socialist) healthcare to a conservative is like holy water to a vampire...I've personally known enough hardline conservatives who see public healthcare as nothing more than communism...I'm not speaking of your garden variety moderate conservative but the hardline loons, we have a lot of those in alberta(wildrose party)

People start arguing patriotism, and Canadian values over these things - the shouting starts and nothing gets done.

disagree...the neo-cons back off, as much as they hate it they can't openly attack it...they constantly push the envelope to see how far they can go...

I'm quite content to shout as loud as I can to keep them under their rocks...and patriotism has nothing to do with it nor do canadian values, it's human values...

No, hadn't heart of that but that's another example of why politicians need to step away from this business.

agree a buffer has to put between politicians and healthcare, those managing the services need to be free of political bias and judged solely by the performance of the healthcare system under their guidance...that means not hiring ex MLAs /affiliated political stooges and people with a vested interest in seeing the system fail...actual medical experts in administration and MDs, not insurance brokers and lawyers... Edited December 10, 2010 by wyly