Health Authorities

Quote: Originally Posted by L Gilbert

So, in their quest to cut healthcare costs, the various BC healthcare authorities have closed the hospital kitchens of the smaller areas in favor of having meals shipped in from wherever, closed wards, shut down ORs in smaller areas, laid off maintenance staff and cleaning staff and kitchen staff, etc. Yet they find the money to paint hospitals exteriors, give themselves bonuses, fly in emergency nurses from other provinces and even some states for two weeks while paying these workers overtime and all their expenses then fly them back, etc.
Is it me, or does anyone else find something wrong with this picture?

Quote: Originally Posted by L Gilbert

So, in their quest to cut healthcare costs, the various BC healthcare authorities have closed the hospital kitchens of the smaller areas in favor of having meals shipped in from wherever, closed wards, shut down ORs in smaller areas, laid off maintenance staff and cleaning staff and kitchen staff, etc. Yet they find the money to paint hospitals exteriors, give themselves bonuses, fly in emergency nurses from other provinces and even some states for two weeks while paying these workers overtime and all their expenses then fly them back, etc.
Is it me, or does anyone else find something wrong with this picture?

Quote: Originally Posted by L Gilbert

So, in their quest to cut healthcare costs, the various BC healthcare authorities have closed the hospital kitchens of the smaller areas in favor of having meals shipped in from wherever, closed wards, shut down ORs in smaller areas, laid off maintenance staff and cleaning staff and kitchen staff, etc. Yet they find the money to paint hospitals exteriors, give themselves bonuses, fly in emergency nurses from other provinces and even some states for two weeks while paying these workers overtime and all their expenses then fly them back, etc.
Is it me, or does anyone else find something wrong with this picture?

Quote: Originally Posted by Cobalt_Kid

Do you know how much money there is to be made off of illness and injury. The system is being designed to fail. When it does, the provincial government will claim private health care is the only solution.

Private health care already has it's foot in the door, the False Creek Clinic is a good example and the same corporation has another private clinic in Surrey. From what I understand, Campbell has made a backroom deal with the private providers to not enforce the federal health care act. We're probably going to be following the American model were as many as half the population there spends at least part of the year without coverage. Health care bills are the leading cause of personal bankruptcy in the U.S., so I guess we know what to expect to happen here in the future.

Quote: Originally Posted by snfu73

What's wrong is that next door alberta is swimming in cash, but the provinces don't know the meaning of the word share. There should be no have or have not provinces...one regions wealth should equate to national wealth. Hopefully that would help eleviate some of the issues in BC hospitals.

The other thing is...how to attract people to the health care industry...that's a nationwide issue. How to get people not only in the field, but to work in small towns in the middle of nowhere. That's a harder issue to deal with.

Quote: Originally Posted by L Gilbert

I don't mind the idea of private healthcare at all. The Swiss have been using a 3-layer jobby for a long time and it is extremely efficient.
http://www.civitas.org.uk/pdf/Switzerland.pdf
http://www.cagi.ch/en/Bien_se_soigner_en_Suisse.htm
If our system was working as it did in the past, in the next couple decades it would suck up about 70% of the gov't budget. Education would claim a large chunk of what's left which would leave other programs with little or nothing.

Quote: Originally Posted by L Gilbert

Well, then I guess we're doomed to either spending ¾ of the budget or having American private companies alongside the public system.
Makes little difference to me as my family comes first and anything serious goes wrong with one of us, I'm not waiting for the idiots in this country to finally get around to treating the malady. I'm going outside the country to get the situation repaired quickly.

Quote: Originally Posted by tracy

Romanow Report anyone? Several cost effective solutions in there that didn't include getting rid of a publicly funded and universally available system.

BTW, there is no reason to think private companies wherever they are from will necessarily alleviate the burden on the public system or be more cost effective.

The US which has this type of private system still spends more per person on health care than Canadians. That's mainly because despite what a lot of Canadians think, Americans ARE entitled to healthcare when it's needed so the government often picks up the tab through programs like Medicare or the state versions (Medical here in California) or the hospital just has to write it off as a loss. Few of my patients have their entire treatment covered by private insurance. There are a lot of great things I LOVE about the American system that I think the Canadian system could benefit from, but the notion that private companies have made things cheaper or more efficient here... well that, I don't see.

A friend of mine has just gone back to England for surgery. Her doctor here told her she wouldn't get it done here any faster and since it's free in England, the choice was easy.

Quote: Originally Posted by snfu73

I really don't think things are that bad...I've used the health system extensively and have recieved excellent attention, I've had great doctors, I've been well taken care of and monitored. The system is not as broke as I see some claiming it to be.

Quote: Originally Posted by L Gilbert

Well, don't give us a for instance..

Quote: Originally Posted by L Gilbert

I think there are several reasons to think that. Since when has any gov't been as efficient as a private concern? I'd love to see an example of a noticeable result.

Quote: Originally Posted by L Gilbert

Also, it just plain makes sense that if some people are going to private concerns for healthcare that they aren't in the lineups for public healthcare and the burden would be less on the public system. The 3 level system seems to work like a hot damn for Switzerland. Maybe they are simply more efficient than the US is.

Quote: Originally Posted by L Gilbert

Yep. Lotsa people from Canada go elsewhere in the world for healthcare. I would be one of them if something serious happened in my family because I refuse to wait months to have a bypass, a hip replacement, or whatever.

Quote: Originally Posted by tracy

You can google for the report. It includes things like focusing more money on preventative care, home care, rural health care, investing in staff, etc.

The answer is exactly what we're discussing: in health care. The most efficient systems financially speaking are government run. Medicare spends less on administrative costs than any private insurance system down here. That was the waste you were discussing before, no?

Actually, that doesn't just plain make sense. The line ups in the public system are generally because of staff shortages and budget problems. Creating extra facilities doesn't create extra health care workers. It also won't help with the budget. Private facilities will need to make some nice profits to pay for their business investments (building costs for instance) and to pay their investors. The point of a business is to make a profit right? That's money that could have been reinvested to pay for staff, equipment, etc. in a not for profit system.

But, if you can afford to seek treatment elsewhere and are happier with it, more power to you. You'd be a rare person though. My 45 minute long day surgery last year would have cost me over 20K had I not had insurance. I doubt many Canadians could afford the bill for a bypass or hip replacement which would be a much more involved procedure and at least a few days in the hospital. I suppose there is always India or something, but I'd prefer to stay in North America for my medical care.

Quote: Originally Posted by L Gilbert

Well, perhaps in the States the gov'ts run things more efficiently than private outfits, but not here. Also, the farther left the gov't is the less efficient it gets.
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Quote: Originally Posted by L Gilbert

It makes sense when you consider that BC's gov't was doing exactly nothing to attract anyone towards training in healthcare, while at the same time was changing from hospital boards to these idiotic health authorities who started laying off maintenance staff, kitchen staff, cleaning staff, etc. which resulted in the closing of beds which in turn increased the waiting peoriods. Now they've decided to hire non-resident workers at overtime rates + living out expenses. Yep. That's efficiency.
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Quote: Originally Posted by L Gilbert

People from Canada go elsewheres quite a bit for medical procedures. It isn't rare. My health insurance covers quite a bit of stuff done outside the country, so I don't have to be wealthy. Besides if one of my family was in need of a hip replacement, I would not want to see them suffer for an extra 6 months to get the thing replaced when it could be done somewhere else in a week or 2.
At any rate, there are waaaaaaaaaaaaaaaaaaaaaay better examples of healthcare around than what we have here.

Quote: Originally Posted by tracy

People say that here too. It just isn't true that private always means more efficient or cheaper.

By definition, they need to make a profit. They don't do that by making services cheaper than the market already determines them to be worth. Why would a private company offer you surgery for cheaper than a public institution when they are in business to make money off of you?

The problem isn't that people haven't been attracted to training into health care professions. There have been waitlists for nursing and medical programs for years. When I went through there were 3 applicants for every spot. Nowadays it's something like 6 or 9 in some programs.

If you think that private companies don't make inefficient staff decisions, you've never worked down here. My unit relies heavily on travel nurses. They pay us more than regular staff and pay our housing as well. The reason they have to do this is that they laid off a lot of their nurses years ago when the "efficiency experts" told them that untrained aides could do a lot of our jobs. That turned out to be untrue and more costly because of poorer patient care outcomes, then they had to try to lure nurses back. Great for me, bad for their bottom line. Bad management decisions are made in both public and privately run companies unfortunately. This latest round of foul ups was done by the most private friendly government we've had in ages.

It is rare. Someone posted a study not long ago about this and found the numbers to be quite small. I personally don't know anyone who has intentionally sought treatment abroad. I know people who have done so when they were already out of the country and got sick, but none of that was planned.

I'd be interested in knowing the details of your health insurance. I can't imagine they would cover planned procedures outside the country routinely. I also can't imagine it would be done quickly. Most countries treat their own citizens first. I know down here, you'd wait more than a week or two just to get your insurance pre-approved before they would do your surgery. That's of course after you'd seen the doctor, had your tests and been told you needed the surgery in the first place. It isn't how a lot of people back home think it is.

I do think there are a lot of things BC could do to improve healthcare and I do think they could learn a lot from places like the United States. I just don't see privatization as the magic bullet a lot of other people do. I've lived down here with it.

Quote: Originally Posted by L Gilbert

No-one said "always", but I did say I'd be interested in seeing something done more efficiently in public than in private. Also by definition, private companies don't like an overabundance of administration, paying the proverbial "$400 for a toilet seat", etc. sort of thing whereas gov'ts don't seem to mind..

Quote: Originally Posted by L Gilbert

In BC?

Quote: Originally Posted by L Gilbert

I'm not saying that all private companies are all efficient all the time. I'm saying that gov'ts are rarely as efficient as most private companies and it's simply because gov't people think the supply of money is endless and have no responsibility for accounting for the money.

Quote: Originally Posted by L Gilbert

Maybe it's rare there, but it sure ain't rare here.

Quote: Originally Posted by L Gilbert

I don't know where you got the idea that healthcare in the US is like healthcare here. The last time I needed surgery for anything it was planned out. There was 3 days between the time my doc decided I should have it and the day of the operation, but that was before we acquired these idiotic health authorities. Now, the issue would probably take weeks before I got the needed surgery. So much for gov't efficiency here.
According to my insurance, the people covered under the plan are covered for up to 30 days and a maximum of $5,000,000CA. Premiums are a bit high, but are tax deductable and the plan also covers regular holidays and work related travel..

Quote: Originally Posted by L Gilbert

I never suggested that BC should adopt the US style private system. I said I think BC should adopt the Swiss 3 level system (I provided a couple links and actually the WorldHealthOrganisation seem to think highly of the Swiss system) or something based on it because it's pretty obvious what we have isn't working. If there was no need for people to go to private places for healthcare, there wouldn't be any here; but they seem to have started appearing and seem to be doing business.

Quote: Originally Posted by tracy

They do cause that sort of waste. Administrative costs are much more expensive here because of the different insurance companies, different plans, etc. It adds an entirely new level of beaurocracy to what already existed.

Yep. Did my nursing in Kamloops and in Vancouver. A friend just graduated last year and another will next year. The number of applicants greatly exceeds the number of spaces. One of them did her first two years in Calgary because she couldn't get into a BC program.

Trust me, those of us working in health care were never under the impression that money was limitless. The budget constraints are always there, as the manager will always remind you. That's the way of it in Canada and the US, government and private.

You mean there are scores of rural British Columbians going to India or the US or Switzerland to avoid wait times? I would love to hear from them.

I've lived in and worked in both systems. I get the annoyance of waits. My only point is that people wait here too. You don't show up at your GP's today and book your surgery for tomorrow. I had surgery here. I was very happy with the care I received and the price wasn't too bad, but the wait was fairly long (over 2 months from GP to surgery). It sounds like you think the system in BC was efficient before and that was still a government run system, so I don't see why government vs private is the issue.

I would wonder if your insurance is meant to cover you while travelling as opposed to you planning an operation out of the country? I had that type of travel insurance, but it wasn't like I could use it to book bypass surgery in Washington state.

According to my insurance, the people covered under the plan are covered for up to 30 days and a maximum of $5,000,000CA. Premiums are a bit high, but are tax deductable and the plan also covers regular holidays and work related travel.

I'd happily see us learn from other countries. My only concern would be, how do we ensure that we wind up with something like the Swiss system and not the British or American ones? Do we have the resources to manage that kind of system? Do we have the population? Do we have the geographical conviniences they do? Is our population as good at prevention as the Swiss? Do we have the personnel? How would our laws and trade agreements affect our efforts? There could be a lot of reasons why it works for them and it may or may not work for us.

Quote: Originally Posted by L Gilbert

Ah, so the reason behind the closed beds must be that the Health Authorities don't want posistions filled in the smaller communities. Maybe the whole plan is to get people out of the rural areas and moving into cities where the remaining hospitals are. Extremely intelligent plan..

Quote: Originally Posted by L Gilbert

I said "scores"?
But, anyway:

http://www.ccac-accc.ca/news.php?id=53

http://www.cbc.ca/news/background/he...altourism.html
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Quote: Originally Posted by L Gilbert

I guess you missed part of what I said: Notice the part in red?[/color].

Quote: Originally Posted by L Gilbert

So? That is reason to do research into other plans; not reason to shrug, fling ones arms up in the air, and stick to the status quo. As the axiom goes: nothing ventured, nothing gained.

Quote: Originally Posted by tracy

I did notice that part. That doesn't sound like you could plan an operation out of the country and they'd pay for it. It sounds like you would have it paid for if you happened to need it while you were outside of the country.

Did I say we should do that? I agree completely into looking to make improvements and learning from others. Again,the Romanow report has been out for a while now. We know a lot of things we could do to improve the system. We just have to have the political will to do it, and that's not likely to happen with this government. I really think they want the system to fail.

Quote: Originally Posted by L Gilbert

So, you think we went looking around specifically for a plan that would pay for out-of-country surgery and we bought into this one on the sayso of a friend in the insurance business that it would only cover travel insurance and not what we wanted? I guess you don't think very much of mine or my wife's intelligence.
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