Grim Assessment of McGuinty Gov't Health Care

[scribblet]

Wii's and Emergency Healthy Care waiting lines and questionable expenses exposed, where are the gov't priorities, other than grabbing more of our tax dollars to waste.

http://fullcomment.nationalpost.com/2010/12/08/national-post-editorial-board-a-grim-assessment-of-mcguinty%E2%80%99s-government/

Focusing on health care and public protection, Mr. McCarter’s review presents a picture of government mismanagement and bureaucratic unaccountability. While tax dollars fly ever faster out the door, Ontarians wait longer to see a doctor, haven’t benefitted from promised job creation and find their properties improperly assessed. State spending is ineffective, poorly tracked or downright detrimental, leaving taxpayers wondering what value they are getting for their money.

Consuming 40% of the provincial budget, the health-care system proved to be the worst offender

but get this, something we've always suspected

On the home front, the AG found that the province’s Municipal Property Assessment Corp (MPAC), which assesses all properties for tax purposes, incorrectly values one in eight homes in the province by up to 20% above or below market price. When presented with the AG’s evidence, gleaned by comparing evaluations with actual sale prices of houses, MPAC refused to investigate or make any adjustments.

Bring on the elec

[Michael Hardner]

The province should consider setting up a brand new approach in a designated area, restructuring the system from top to bottom and run it as a 5 year trial. The changes could be rolled out to the rest of the province after that.

[charter.rights]

The province should consider setting up a brand new approach in a designated area, restructuring the system from top to bottom and run it as a 5 year trial. The changes could be rolled out to the rest of the province after that.

The province should....

"We can't solve problems by using the same kind of thinking we used when we created them." Albert Einstein.

The result would be more of the same because the problem lies in bureaucratic entitlement.

Rather a completely new system would have to be created by non-bureaucrats with a mind to preventing this kind of bureaucracy in the first place. Anything else will merely be an image of what it is now.

Just look at E-Health as an example of that.

[charter.rights]

I want to add that the MPAC corruption is not new to me. I caught them about 8 years ago when my home was reassessed using their own appraisals as comparables for my assessment. I challenged them when I provided neighbourhood comparables that demonstrate the market values of their appraised homes were far less than what they had estimated. Apparently they had been doing this from the beginning.

In the end it resulted in about a $40,000 reduction on a $22k house - a substantial amount.

[Oleg Bach]

McGinty is a lot like Obama. They do not care what party they supposedly represent...be it communists - liberals - high arcy conservative finacial types - left or right or centre - it does not matter - These attention seeking ego maniacs will to anything to sit in the big chair..which in the long run makes them utterly useless when it comes to public service - because they do not serve the public - they serve their quiet masters and themselves.

[Michael Hardner]

The province should....

"We can't solve problems by using the same kind of thinking we used when we created them." Albert Einstein.

The result would be more of the same because the problem lies in bureaucratic entitlement.

Rather a completely new system would have to be created by non-bureaucrats with a mind to preventing this kind of bureaucracy in the first place. Anything else will merely be an image of what it is now.

Just look at E-Health as an example of that.

Very good, but the province has to lead because the people aren't going to. They could set something up and then get out of the way.

[charter.rights]

Very good, but the province has to lead because the people aren't going to. They could set something up and then get out of the way.

Com'mon....You know very well that the province would control it through the terms of reference, limiting funding and controlling who would be on the board. Any contact with the MPPs or the bureaucracy would lead to failure by design. Why would any bureaucrat willing help the demise of his job? Or why would MPPs allow reduction in their power and control?

No. The only way something could work is if it was done outside of any government, by citizens running parallel to the current system and then having some legal authority to replace the existing government. Not likely that will happen but there would be no other way of achieving success.

[Michael Hardner]

No. The only way something could work is if it was done outside of any government, by citizens running parallel to the current system and then having some legal authority to replace the existing government. Not likely that will happen but there would be no other way of achieving success.

Well, that sounds good too - but legal authority means the government would set it up, no ?

Unless, it's some kind of court challenge... I don't know...

A tripartite governance system, with citizens, medical professionals and workers, and the funding/management agency could be set up with a geographic region and the instructions to start from zero. Set up the parameters for dialogue, and have them work in collaboration to structure the system, set goals, and measure how well they're achieved.

[Shwa]

Rather a completely new system would have to be created by non-bureaucrats with a mind to preventing this kind of bureaucracy in the first place. Anything else will merely be an image of what it is now.

In other words, it can't be done. Show me any complex organization in the western world without an equally complex bureacracy. Heck, even the lowly office clerk working at Joe's Garage has rules to go by.

[Shwa]

A tripartite governance system, with citizens, medical professionals and workers, and the funding/management agency could be set up with a geographic region and the instructions to start from zero. Set up the parameters for dialogue, and have them work in collaboration to structure the system, set goals, and measure how well they're achieved.

In other words, Health Care by committee. No thanks. I'll stick with what we got.

[madmax]

Wii's and Emergency Healthy Care waiting lines and questionable expenses exposed, where are the gov't priorities, other than grabbing more of our tax dollars to waste.

http://fullcomment.nationalpost.com/2010/12/08/national-post-editorial-board-a-grim-assessment-of-mcguinty%E2%80%99s-government/

but get this, something we've always suspected

Bring on the elec

Be serious!

Its a fixed election date. Bang the drum LOL. Care to go back to the thread on Hudaks Position on PCs taking Political donations from Public Utilities?

I enjoy you posting flaws in the current McGuinty Government.

Regardless the Official Opposition has no clothes.

Edited December 9, 2010 by madmax

[Michael Hardner]

In other words, Health Care by committee. No thanks. I'll stick with what we got.

Incorrect. We have committees now, but they don't talk to each other and there's no good framework for dialogue. The idea would be to set up a streamlined organization to represent the major stakeholders in healthcare, and set a solid foundation for managing the organization and especially for managing change.

[scribblet]

Be serious!

Where did I say it wasn't a fixed election date, you get serious, your posting flaws are, shall we say, laughable. LOL

[scribblet]

I want to add that the MPAC corruption is not new to me. I caught them about 8 years ago when my home was reassessed using their own appraisals as comparables for my assessment. I challenged them when I provided neighbourhood comparables that demonstrate the market values of their appraised homes were far less than what they had estimated. Apparently they had been doing this from the beginning.

In the end it resulted in about a $40,000 reduction on a $22k house - a substantial amount.

Agree about MPAC, but the gov't isn't interested in correcting this. I went in to my MPPs office a while ago (Liberal) to complain about MPAC - bottom line is they are holding the status quo.

As far as health care goes McGuinty even the Star isn't happy.

Health care costs are the elephant in the room as they continually grow but no one wants to take the lead to seriously discuss reform.

http://www.thestar.com/opinion/editorialopinion/article/861768--hepburn-time-for-mcguinty-to-fix-health-care-mess

[charter.rights]

In other words, it can't be done. Show me any complex organization in the western world without an equally complex bureacracy. Heck, even the lowly office clerk working at Joe's Garage has rules to go by.

Exactly...at least without a revolution by "The People". And why would we change it? Any tinkering (as we saw from Harris' term) just makes things worse.

I have generally not had much problems with the Health system (well I take that back...once I met Nurse Indifference in a big hospital emergency ward and I ended up going somewhere else). While I understand there are wait times, when I actually had an emergency there really was no waiting.

The problem as I see it is an overuse by zealous mothers and fathers who refuse take responsibility for themselves or their children. A fever is not generally an emergency and can be controlled at home using basic home care. Yet how many end up in emergency or urgent care clinics demanding the doctor look at their child and then complain when they have to wait for 3 or 4 hours. Self care is the first priority in Health Care and if families can't do that, then they deserve to wait.

[Shwa]

Incorrect. We have committees now, but they don't talk to each other and there's no good framework for dialogue. The idea would be to set up a streamlined organization to represent the major stakeholders in healthcare, and set a solid foundation for managing the organization and especially for managing change.

In other words, another layer of bureaucracy! And if it isn't too bureaucracy-like at first, give it time. However, I would agree that some of the processes require acute and regualr review from time to time. They could hire management consultants to do that.

[Michael Hardner]

In other words, another layer of bureaucracy! And if it isn't too bureaucracy-like at first, give it time. However, I would agree that some of the processes require acute and regualr review from time to time. They could hire management consultants to do that.

To someone who is very close to the bureaucracy, it seems that the problems are not solvable. But they are. Information design and change management need to be brought in at the beginning of a redesign.

Interestingly, you talked about 'giving it time'. That's the main problem, from what I can see, with the current system: it's not flexible enough to withstand the amount of change we've seen. The systems worked well until that damn change started happening...

[Shwa]

To someone who is very close to the bureaucracy, it seems that the problems are not solvable. But they are. Information design and change management need to be brought in at the beginning of a redesign.

Interestingly, you talked about 'giving it time'. That's the main problem, from what I can see, with the current system: it's not flexible enough to withstand the amount of change we've seen. The systems worked well until that damn change started happening...

What I mean is that any streamlined process will, over time, develop a bureaucracy. All you need to do is take a look at history to verify this phenomenon. Can you name one complex western institution that did not have a bureaucracy in support of it? What you are talking about is de-institutionalizing health care. Ain't gonna happen. Ever.

That has nothing to do with my proximinty to "the bureaucracy."

[Oleg Bach]

"Grim assessment of McGinty" PERIOD..put the health care issue aside - what keeps our hospitals going in the long run are private donations..in effect our system is privatized and supported publically. I really don't think people understand the amount of benevolent giving that takes place...For instance over at St. Michaels Hospital - I commented on what a "nice" hospital it was. One administrator put it plainly - She did not say it was because of the government that the place was "nice" but as she put it "we get a lot of donations"...

As for the grim assessment of McGinty as a supposed leader and a person - trust your eyes - He looks and acts like a highly energized weasil because he is a weasil - so what's the surprise in the fact that he is incapable of telling the truth?

[Michael Hardner]

What I mean is that any streamlined process will, over time, develop a bureaucracy.

Not exactly. It will/should have bureaucracy from the outset. This is also known as administration or management. It's necessary, but it doesn't mushroom in every industry.

All you need to do is take a look at history to verify this phenomenon. Can you name one complex western institution that did not have a bureaucracy in support of it? What you are talking about is de-institutionalizing health care. Ain't gonna happen. Ever.

Bureaucracy as I described it is necessary, but it can be efficient, and it can be good at managing change.

That has nothing to do with my proximinty to "the bureaucracy."

It may be germane for you to indicate what environment you work in. I have worked in many different environments myself. Let's compare.

[pfezziwig]

A little competition should straighten these wastful spending practices out.

Let the private sector into the healthcare sector and fund the public sector to your hearts content (ie. steal from the future). Then wait for the embarrassing stories of the private sector delivering the same services at a fraction of the cost of the public sector, watch them get off their butts then.

What incentive do healthcare bearucrats have now to save money, there's probably more of a dis-incentive, what manager wants to save a department millions of dollars, they'll just receive less in their budget next year and the manager will be blamed for that?

[madmax]

A little competition should straighten these wastful spending practices out.

LOL,

Let the private sector into the healthcare sector and fund the public sector to your hearts content (ie. steal from the future). Then wait for the embarrassing stories of the private sector delivering the same services at a fraction of the cost of the public sector, watch them get off their butts then.

Good luck with that thought.

[dre]

Not exactly. It will/should have bureaucracy from the outset. This is also known as administration or management. It's necessary, but it doesn't mushroom in every industry.

Bureaucracy as I described it is necessary, but it can be efficient, and it can be good at managing change.

It may be germane for you to indicate what environment you work in. I have worked in many different environments myself. Let's compare.

I know Im a broken record. But the problem with the admittedly intelligent and reasonable way youre trying to approach this is that youre assuming that how the system is "designed" is the problem, and that reorganizing it will fix it.

In this case thats not true. Healthcare costs are increasing in every western system regardless of how its organized, how public it is, how private it is, etc. The fundamental problem is how health services are procured by healthcare authorities in the west. They dont value shop, there isnt an open bidding process and the purchasers are too close to the suppliers.

[Michael Hardner]

I know Im a broken record. But the problem with the admittedly intelligent and reasonable way youre trying to approach this is that youre assuming that how the system is "designed" is the problem, and that reorganizing it will fix it.

Yes, that is my assumption.

When I look at eHealth, and the CIHI reports I can't come to any other conclusion.

In this case thats not true. Healthcare costs are increasing in every western system regardless of how its organized, how public it is, how private it is, etc. The fundamental problem is how health services are procured by healthcare authorities in the west. They dont value shop, there isnt an open bidding process and the purchasers are too close to the suppliers.

I Haven't heard this. Are they increasing at the same rates ? Are they increasing in a way related to demographics ?

[dre]

Yes, that is my assumption.

When I look at eHealth, and the CIHI reports I can't come to any other conclusion.

I Haven't heard this. Are they increasing at the same rates ? Are they increasing in a way related to demographics ?

They are increasing at very similar rates yes, although the US has increased faster than Canada, Germany, Switzerland, or the UK.

http://upload.wikimedia.org/wikipedia/commons/5/55/Health_care_cost_rise.PNG

Thats shows Canada following roughly the same increase as switzerland, austria, germany, the uk, etc.