Health Authorities

[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?

 

[tracy]

Is it any wonder I chose to leave the province years ago? I couldn't get a regular full time position, but now they're willing to fly me into an area, pay for my housing and give me a rate of $48 an hour... Makes perfect sense eh?

Have I mentioned how great it is to be a nurse in California? No where is perfect, but it's as close as I've found to it.

 

[L Gilbert]

Good for you, hun.
BC's nurses have the highest pay in Canada right now, I think, but the system is folding like the house of cards it is. I'm damned sure it isn't going to get any better till it is rearranged, and the health authorities sure as hell aren't doing that.
I think we could do just fine with a system like the Swiss have.

Switzerland's consumer-driven health care system achieves universal insurance and high quality of care at significantly lower costs than the employer-based ... - http://jama.ama-assn.org/cgi/content/full/292/10/1213

http://www.cagi.ch/en/Bien_se_soigner_en_Suisse.htm

http://en.wikipedia.org/wiki/Categor...in_Switzerland

http://www.civitas.org.uk/pdf/Switzerland.pdf

 

[Tomtom]

As I recall, many others (groups and individuals) have been saying the exact same thing as you have LG, but they were all dismissed as naysayers, union-activists, NDP clingons and various other euphemisms.
It is a PROVEN and DOCUMENTED FACT that outsourcing costs MORE in the long run, than having in-house services.
Love or hate the Public sector workers, they serve a purpose; and when the emphasis is on QUALITY as opposed to profit, then the end result is a better environment for the patients.

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?

 

[Cobalt_Kid]

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?

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.

 

[snfu73]

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?

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.

 

[Tomtom]

I don't think "sharing the wealth" would be a popular idea, and I for one don't endorse it. By "sharing" wealth, you encourage complacency such that a few will end up doing the work for all.

What needs to be done is an independent audit of the Healthcare System from the top down, so we can see where the money is going. A lot of the union-bashers will state (erroneously) that "most" of the money is going to unionized wages...well, it either goes into union-workers wallets or into private corporate wallets, but in the end it's still gone! Private industry has no mandate to save the taxpayers, and the unionized workers only want to earn whatever they can to pay their mortgages and bills...simple economy!
The issue that needs to be addressed is the WASTE, as LGilbert stated: Why is there no money to keep staff, but money to paint and re-decorate? Would the patients prefer someone to clean their room, or a nice new coast of eggshell enamel on the hallways?
Does it serve the patient's best interests to have a functional heating and ventilation system, or a new set of furniture in the middle-manager's office?
Does the patient care if an Administrator is given a bonus, or if the OR will be open to complete his/her surgery tomorrow?

Rather than trying to emulate the American system, which is known to be lacking, this government should be looking at ways to IMPROVE and streamline this system. There are enough WORKING models of effiiciency in the world...pick one!

 

[snfu73]

I don't buy into the few doing work for the whole deal. We are a nation...it's time we started to work with eachother, rather than against eachother. Like I said, in a union, there should not be have provinces and have not provinces. That just doesn't make any sense to me.

 

[L Gilbert]

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.

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.

 

[L Gilbert]

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.

That sounds like a Dpper attitude - don't fix the problem, just throw more money at it. Anyway, the entire country's healthcare system is in dire straights in case you haven't heard, not just BC's. The Liberals (for the most part) have ignored the regular maintenance on a good machine and now it is breaking down. Either the feds butt out completely and leave the provinces to their own systems, or else they adopt something like the Swiss system and alleviate the burden. I cannot see any other way out. As I said earlier, if the simple plan of throwing more money at the problem is implemented, in a few years the system will suck up a large majority of the budget. It's a bandaid solution to a deep incision. Temporary at best.

 

[Cobalt_Kid]

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.

Switzerland doesn't have the U.S. right next door with huge corporations just waiting to get their foot in the door. Under NAFTA, once we allow American corporations in it's almost impossible to get them out. Unless the transition was extremely well planned(1:1,000,000 chance of that) we'd rapidly lose control of our health care system. We already have a Texas based company administering Health Care here in B.C. and have had serious problems with service.

There's no easy answer to rising costs but turning over health care to massive corporations who's only concern is the bottom line is harsh medicine(pun intended).

 

[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.

 

[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.

 

[snfu73]

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.

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.

But, again, I argue that all wealth should be shared across the nation, and hopefully some of these issues can be attended to. But, the other thing is...how, like I mentioned, can young doctors and nurses be attracted to small communities? But, in the bigger picture, small communities will never have the same amenities as larger centres...so the larger centre is still crucial in overall health care...if something serious goes wrong.

 

[L Gilbert]

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

Well, don't give us a for instance.

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.

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. 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 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.

The 3 level system seems to work like a hot damn for Switzerland. Maybe they are simply more efficient than the US is.

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.

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. If there was a private outfit here that could do the job sooner than the public system, you bet yer boots I'd go there.

 

[L Gilbert]

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.

Well, then you live in a major center. Here in BC, we have to travel all over the province for this that and the other thing because our Regional Health Authorities are trying to close everything down outside of major centers. The rural areas are just plain f'd. Nelson & area probably has a population of about 30,000 people, yet Kootenay lake hospital is nothing more than a large firstaid station now. The nearest hospital with a fair bit of services is Trail. That's 1½ hours ambulance ride away. People have died because the ORs have been shut down here. But, I guess that's not what you'd call seriously broke.

But, again, I argue that all wealth should be shared across the nation, and hopefully some of these issues can be attended to. But, the other thing is...how, like I mentioned, can young doctors and nurses be attracted to small communities? But, in the bigger picture, small communities will never have the same amenities as larger centres...so the larger centre is still crucial in overall health care...if something serious goes wrong.

Wealth is shared. What do you think transfer or equalisation payments are all about?
BTW, the people in this neighborhood all pitched in for a CT scanner for our hospital among other things. They were OUR machines, not bought by gov't, but by us. The Interior Health Authority had them moved to Trail.

 

[tracy]

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

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.

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.

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?

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.

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.

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.

Well, she's actually not leaving Canada to go elsewhere, she lives here in California like I do and went to England. The 2 week guaranteed wait was as good as anything she could get here according to her doctor.

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.

 

[L Gilbert]

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.

I'll do that.

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?

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.

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.

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.

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.

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.

 

[tracy]

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.
.

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?

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.
.

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.

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.

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.

 

[L Gilbert]

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

No-one said "always", but I did say I'd be interested in seeing something done more efficiently in public than in private.

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?

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.

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.

In BC?

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.

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.

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.

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

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 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.

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.

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.