Thursday, March 11, 2010

DYING TO GET IN

Is it just me or are things going from bad to worst on a constant basis. Most particularly Health care in this country and specifically in the province of Quebec. It has become abundantly clear that no one and I mean no one has a solution to the current crisis. I am so sick and tired of listening to politicians banter back and forth about who is to blame for the current situation. I am also fatigued by the claims by both Mr. Premier Ministre (Charest) and the Health Minister that the system is generally good. It is abundantly clear that neither they nor anyone of their families spend any amount of time in a Hospital emergency room. It is actually sickening to imagine that these very individuals who claim the system is good would never have to spend one minute let alone 20 hours waiting in an emergency room. What one quickly understands about these individuals is that they are so detached from actual reality that they may as well be living on Mars. Does anyone actually think that the Premier Ministre, Health Minister or the leader of the opposition would be ushered off to the local emergency room by their handlers if they were to fall ill or get injured? That they would sit there with the common folks waiting to be triaged and evaluated only to be told it will take 20 hours before being seen by a doctor? NEVER! Therein lies the biggest problem. How can those who are least affected or touched by a problem be in any position to correct it. What kills me (and for that matter many others for real) is the promises and the lies and the impotency to take any concrete action. Yesterday during question period in the House in Quebec this was the discussion between the Premier Ministre and the leader of the Opposition Madame Marois.

(NOT WORD FOR WORD BUT CLOSE ENOUGH)

Mr. Charest: Since 2003 our government and party has worked tirelessly to repair the debacle created by the previous government.

Madame Marois: Mr. Le Premier Ministre please stop blaming what happened over 7 years ago on the current government. It is you that has been in power for the last 7 years and the problems have not been fixed by your administration and when we were in power people did not die waiting for a heart operation.

Madame Marois: May i remind the ''Premier Ministre'' that he is the leader and that this situation is his responsibility

Mr. Charest: May i remind Madame Marois that this situation is her fault.

WHAT?????? Are you serious? Are you telling me that this is the way the people we elect manage issues facing the government and our society. Nah-Nah your to blame...NAH NAH its not my fault....for God sakes SHUT UP! While they are acting like 10 year olds people are dying. These people aren't from another planet. They are not strangers. They are our fathers, mothers, grand parents, children our brothers and sisters. While these politically motivated and irrelevant politicians debate about who is to blame members of our families die. These are not isolated cases. They are not anomalies, they are an indicator of just how broken the system is. Here is whats happening in the province.

These are some stories from a recent Montreal Gazette article by By CHARLIE FIDELMAN
  • On Friday, Jean-Guy Pitre, 65, a retired police officer, died after waiting six months for surgery to fix a blocked aorta. His heart operation was delayed because of a lack of beds in the intensive care unit, said officials with the Centre hospitalier de l'Université de Montréal.
  • Mariette Fournier died Feb. 23 after spending four days in a corridor of the Maisonneuve-Rosemont's ER. Her family wants an inquiry into Quebec's health-care system
  • Mieczyslaw Figiel died last month in the corridor of Maisonneuve-Rosemont Hospital's emergency room, right next to the triage nursing station where an ambulance had left him that morning. By late afternoon, when the 75-year-old Montrealer was gasping for air, triage couldn't locate his file in the computer. After he stopped breathing, medical staff came to his side with a blood-pressure device and a thermometer.
       "I watched my father pass away before my eyes," Della Figiel, his daughter, said yesterday.

        On Feb. 3, after Figiel fainted at home, an ambulance delivered him to Maisonneuve-   
       Rosemont Hospital at 9:45 a.m., hooked to oxygen and a heart monitor. He was still wearing
       his hospital bracelet from a week before. Ambulance staff took their equipment and left him
       with no oxygen or heart monitor right under the window of the triage office. His wife, Helen,
       was by his side. "I showed up at 4 p.m.," said Della Figiel, who drove in from Ottawa. "My
       mother was standing in the hallway. She said they couldn't do anything and there was a 16-
       hour wait to be seen." Operating at about 180-per-cent capacity, the hospital ER was jammed.

Listen the system is terribly broken. It is broken across this country. People are dying as a result of the in-actions of government. The Ontario Government recently released numbers showing that out of every tax dollar collected 40 cents went to health care and that within 10 years that number would jump to 70 cents. According to statistics the amount Canadians spend on health care in 1997 dollars has increased every year between 1975 and 2009 from $39.7 billion to $137.3 billion or a more than doubling of per capita spending from $1,715 to $4089. In 2009 dollars spending is expected to reach $183.1 billion ( a more than five percent increase over the previous year ) or $5,452 per person. Most of this increase in health care costs has been covered by public funds. The greatest proportion of this money goes to hospitals ($51B), followed by pharmaceuticals ($30B), and physicians ($26B). Total spending in 2007 was equivalent to 10.1% of the gross domestic product which was slightly above the average for OECD countries, and below the 16.0% of GDP spend on health care in the United States. The proportion spent on hospitals and physicians has declined between 1975 and 2009 while the amount spent on pharmaceuticals has increased.


The issue at hand is not only the failing of the existing system from an operational and management perspective but what will ultimately (and some say already has) become our inability to support it financially. The common idea has been to throw money at the problem. With a ''that will save it'' mentality. The idea that the system itself is not broken but simply the Political managerial system which supports it, is also WRONG! The true fact is all of it is broken regardless of who wields the stick of power and nothing short of a complete overhaul of the system is going to make it better. When i say overhaul i don't mean an inquiry or commission. I don't mean a few additional tax dollars raised and thrown at the problem. I mean serious ''knock it down and rebuild it''. What do i mean? Well i mean rebuild much more then the system. I mean rebuild the way we think, act and live. Here you go. Instead of just criticizing the problem or lamenting it I'll offer up my 1 cent worth of ideas

1. The administration of health care, the bureaucrats, the administrators, the boards, hospital structures they all need to be deconstructed and rebuilt.


2. The ''addicted to pharmaceuticals'' by both Doctor and patients. The out of control, ''prescribe drugs to fix it'' mentality has to change. The role of pharmaceutical companies in the system needs to be strictly regulated and controlled.

3. The implementation of an incentive program to encourage our youth to become doctors, nurses and medical specialists and to hold onto those already in the system. Including a potential, ''Service for Learning'' model could be adopted and implemented as well as a ''stay and earn more'' program for those already in the system.

4. The obesity factor. Everything from the food manufacturers, distributor and the consumer needs to change. Including heavy tax on food items (Soda, chocolate, cakes, candy etc..) which are predominant causes of obesity and other health problems (all taxes collected go directly back into the health care system).

5. The potential implementation of a modified and strictly controlled ''pay by user'' model needs to be seriously considered.

Now I'm sure your saying Ha! Good luck with any of that. The reality is that if something concrete does not take place there is going to be a health care system in this country that within 20 years will look like what they have in Africa or Mexico (which by the way is none!). The one item which has always been a flash point is number 5. The whole, ''pay as you go'' system. Every time this is mentioned everyone points across the border to the US and says, ''thank good that's not our system.'' The problem with this ideology or philosophy is simply that we have the ability to change our system and build a better one without becoming like the United States. Think about how many times you have seen someone in the Emergency room of a Hospital looking like anything other then an Emergency? 2 or 4 times or more. Sure you have. We all have. In many cases we ourselves have gone to the Emergency room when we were not really an emergency worthy patient. The whole ideology of a State System lends itself to abuse. It has gotten so bad that we have created bogus issues which we use to blame for the systems failure. Instead of looking directly at ourselves and our own actions we turn outward to find other things to blame. The other issue is that people will call you Un-Canadian for proposing such a system as if you wanting a better system makes you a Socialist or uncaring, or greedy. We all better get beyond that nonsense pretty fast because the train wreck is coming and were all either in the train of stuck on the tracks.

To implement a system that could potentially work Government would have to apply;

1. A ''pay as you go'' system would have to insure that those who cannot pay end up getting equal care to those that can. Is this hard? Not really. You implement a system that ensures that new Doctors or nurses coming into the system have to do 4 years in the no pay system before being able to leave for the ''pay as you go'' system. The Government pays for ALL the school bills for these individuals in return for service. Similar to a military, ''serve and learn program''. Government could establish those who cannot pay by annual income, set at a specific amount. Those on Social assistance programs such as Welfare, Unemployment, workers compensation. Those under the age of 18 and those over the age of 70. Those with diagnosed prescribed medical conditions or serious illnesses.

2. Giving back the percentage it currently collects in taxes for health care to each citizen who does not fall into anyone of the groups mentioned above to offset potential, ''pay as you go'' cost to the user.

3. Specific strategies need to be implemented to cover habitual users. (by this i do not mean those with legitimate health issues but those who tax the system in an unreasonable way).

4. This will sound brutal but those individuals who by their own actions and personal life style choices create their medical conditions such as smoking, over eaters (obesity) would not get a free pass into the government paid system. They in fact would have to assume the cost for their own care.

5. A 5% increase to corporate tax to be used directly to re-subsidize Company health care programs which could be used in a direct ''pay as you go'' system.

These are just a few of the ideas that could be used. I am not saying anyone idea alone will fix what is broken. There are many, many others and there are those way more qualified then me to come up with some ways to avert the upcoming train wreck. The hardest part is getting to the place we need to be, not just us but politicians, health-care workers and for that matter everyone. A place where everyone recognizes that if we don't pull together and fix it its going to die.

If your not convinced that anything needs to change then simply go pay a visit to your local emergency room. Or God forbid be forced into one as a result of a sick child, a friend or a member of your family. Then pray the system doesn't fail you as it did Jean-Guy Pitre, Mariette Fournier, Mieczyslaw Figiel or the many others we pretend not to know about.

9 comments:

  1. Mark Bray commented on your link:

    "Health care, what health care, I know all about it. Broke my ribs two yearg ago and at first got mis-diagonosed as being only bumps and bruises. Three days later and coughing up blood, got I guess we missed it , sorry and prescribed pain killers, again ang again that I myself said no more to the doctor!

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  2. One needs only look at our education system to understand that everything is basically busted in our world. Simply put the whole system; lock stock and barrel is eventually going to come crumbling down around our feet. Then it will be everyone for themselves and that will be ugly.

    Good article Rob

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  3. The sad thing partner is that its not going to get fixed. It is going to have to fall competely apart before anyone even attempts to fix it. Such is the life of politics. There are no parties or leaders with enough backbone to stand up and tackle the problem head on. As you mentioned they will simply pass along the blame until the general public is sick of their nonsense and can no longer tolerate the pain.

    cheers

    Rog

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  4. There has always been this belief in Canada that Health Care is just a given. Very rarely do Canadians stop to appreciate what exactly we have here. More is evidenced by how much the cost of providing free medical care has become. The spirit of free is in fact not free at all. Every cent collected to provide our Health Care comes directly from every tax payer. The question is and remains is this the best way to provide care. Perhaps there is a model which could take better advantage of the dollars being contributed by every Canadian. The challenge as you have mentioned is the resistance to change. we are very much caught up in our own fish net and have very few ideas on how to escape. the idea of cutting the net completely scares the shit out of almost everyone. Enjoyed reading your blog.

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  5. It's not just health care man. It's the whole medical profession. Doctors are suppose to take an oath but it seems this pledge is more to the almight dollar than to the preservation of life.Doctors are only slightly better than those whores we know as lawyers This is life in an Occidental country. Where else can a doctor remove two breasts unnecessarily and then be reinstated. People don't care about people in a monetary society and people lose track of what's important, like honesty, integrity and loyalty.

    Food for thought. Karma Lodro

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  6. I wonder when people are just going to revolt against the system. I don't just mean the health care system either. Taxes are going up, wages are frozen, cost of living is going through the roof. Unemployment is high and the politicians debate back and forth over trivial issues which are the least of concern to the average Joe. It is really hard to be a good member of the community when you look at where we are going. There is no light at the end of the tunnel and i fear that only a revolt against the machine will resolve these problems.

    All the best Rob

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  7. Robbie,

    When Charest ran the last time he and those running with him spent a ridiculous amount of time campaigning on a reformed Medicare program. The garbage coming out of their mouths was like diarrhea. They were going to fix the emergency waiting time, fix the waiting time for serious surgeries. Improve access to specialized medicine. They went on and on and on about how they had the solution. Fast forward to now. What has been the Liberals primary spending initiative? Infrastructure! Most importantly the road network. Do you know why that is? It is simple. Road works creates jobs and jobs create tax dollars into the coffer's of Government. Hospitals, emergency rooms and surgeries cost money. Do not look for any miraculous solution to the current problem. For the answers are simple. There is just no upside to investing in the health system. You see. You and me and our families living long and prosperous lives pale in comparison to roads and bridges. Those things bring in revenue and votes. You and me cost money.

    As Vicky said, only an eventual revolt against the powers that be will resolve any of this. Until then people will just keep on dying. We are after all, expendable.

    Cam

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  8. If we should take any lessons from the state of our health system it should come from the way the H1N1 pandemic was handled. You could tell that the system was totally unprepared to handle such an event. The subsequent scrambling showed how badly we are doomed should we ever really be faced with a planet altering event. As you mentioned Robbie the current leadership has no idea how to handle or for that matter begin to repair the system.

    The greatest problem however is not Government it is us the people. The users. The voters. I don't think anyone has much of a stomach for what truly needs to be done to fix the current problems. We would much rather simply bitch and moan about the problem rather then absorb some short term serious pain for some long term gain.

    We are as much to blame for allowing the system to become what it is and for turning a blind eye everytime we should have done something serious to fix it.

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