Canada wants to overhaul their system, too
posted at 10:11 am on August 17, 2009 by Ed Morrissey
While Barack Obama continues to hail Canada’s health-care system as a model for the US to follow, its own constituencies warn that it’s nearing a collapse. Saying that a “health care revolution has passed us by,” the president of the Canadian Medical Association wants a major change to eliminate long wait times and inject creativity back into the hidebound system. Dr. Robert Ouellette wants to use competition to do it:
The incoming president of the Canadian Medical Association says this country’s health-care system is sick and doctors need to develop a plan to cure it. …
The pitch for change at the conference is to start with a presentation from Dr. Robert Ouellet, the current president of the CMA, who has said there’s a critical need to make Canada’s health-care system patient-centred. He will present details from his fact-finding trip to Europe in January, where he met with health groups in England, Denmark, Belgium, Netherlands and France.
His thoughts on the issue are already clear. Ouellet has been saying since his return that “a health-care revolution has passed us by,” that it’s possible to make wait lists disappear while maintaining universal coverage and “that competition should be welcomed, not feared.”
In other words, Ouellet believes there could be a role for private health-care delivery within the public system.
He has also said the Canadian system could be restructured to focus on patients if hospitals and other health-care institutions received funding based on the patients they treat, instead of an annual, lump-sum budget. This “activity-based funding” would be an incentive to provide more efficient care, he has said.
Interestingly, the push for reform here in the US has taken the exact opposite approach. Stop paying doctors per procedure and service, the thinking goes, and the doctors will not have a profit incentive to overtreat patients. That would theoretically cut costs and make health care both more efficient and keep unnecessary treatments at a minimum.
Instead, it results in rationing and long wait times. If clinics and hospitals don’t get compensated for the procedures and treatments they deliver, then they have to make that lump-sum or annual salary stretch. They have to put off hiring more doctors to offer more services, even if the number of patients increase. The results are entirely predictable, as the artificially stunted resources get overwhelmed by legitimate demand.
Activity-based funding and competition. That’s what the American model has now. Why should we abandon that at the very moment when the single-payer system to our north has finally begun to realize the values of those qualities?
Blowback
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If you don’t have the money, you have to do something. Better to have some beds open than none.
I don’t know why anyone would reuse a syringe on a different patient even to inject drugs into IV lines. I assume their thinking was sterile needle to withdraw sterile medicine to inject into sterile line. However, the IV line may not always be sterile. Again, never heard of anyone doing this. It’s not taught. In the US, the pharmacy is responsible for mixing the drugs and dividing into the dosage for each individual hospital patient. It’s more expensive but it cuts back on medication errors and frees up the nurses.
Obviously, they don’t do this in Canada. Nice way to cut costs and increase errors.
Blake on August 17, 2009 at 12:26 PM
Racists!
jukin on August 17, 2009 at 12:32 PM
What is trully scary they have 2k surgeries schedules for oct 2010 -meaning some people who need surgery are to wait at least a year to get it.
anikol on August 17, 2009 at 12:37 PM
What a novel idea!
BigMike252 on August 17, 2009 at 12:51 PM
“Canadians Protest Plans to Ration Health Care in U.S.” http://optoons.blogspot.com/2009/07/canadians-protest-plans-to-ration.html
Mervis Winter on August 17, 2009 at 12:52 PM
“This “activity-based funding” would be an incentive to provide more efficient care,”
No it won’t. Dr. sees patient. Dr. prescribes pills. Next patient please!
Sounder on August 17, 2009 at 1:01 PM
My girlfriend is Canadian. She still lives there. She just got assigned her first Dr. in 7 years! Here town holds a lottery every month to select new patients to assign to a Dr. – she got lucky, she knows people that have been waiting 10+ years to get assigned. She’s told me that the greatest problem with the Canadian system is that there is too few doctors for the population (and the Canadian population isn’t that huge anyway). They are either unavailable because of budgets or they left Canada for the US because of pay caps.
But what illustrates the Canadian system and what should make the proposed system here a scary thing is what recently happened to her niece.
Here niece is a lovely, lively 16 year old. The other day she was walking home from her babysitting job when she suddenly collapsed on the street. Police & paramedics were called. She was unresponsive (but breathing)… they tried everything to try to wake her, they even tried pain to see if they could shock her back to lucidity. Nothing. She was taken to the local hospital where she was placed on an IV, intubated (just in case she stopped breathing) and given Dilantin. She finally regained consciousness.
Here’s the scary part. In the US currently if this happened to someone they would not be released. They would be admitted to the hospital and a battery of tests would be given to find out the cause of the problem. The results would be quickly reviewed and a course of action would be put into place.
In Canada it doesn’t work this way. They did some tests and then released her. They gave her 30 days of some medicine to try to prevent the situation from happening again and told not to be alone. The neurologist on assignment will review the results of whatever tests they did and will set up an appointment “sometime within the next 30-45 days”!
Here’s a young girl who suddenly and inexplicably falls into a sort-of “coma,” is rushed to the hospital unresponsive, they don’t know what’s causing it (this is the second time it’s happened, a few weeks before she also collapsed and she was misdiagnosed as being “hypoglycemic” and sent home too)… and now she has to wait 30-45 days to find out what is causing it, all the while praying that it doesn’t happen again… it could be a tumor, serious heart problems — heck anything! But she has to wait because they are short of neurologists who can review her case (and she lives in a moderately sized city connected to Toronto). After diagnosis she’ll probably have to wait even longer for treatment.
This is what we can expect here. You wait. You’re given pills and told that someone will see you sometime in the future. Specialists will be unavailable or thin. You live in fear that you may not see another tomorrow. And you pray that someday, somehow, somewhere you may be allowed to get the opportunity to get well before it’s too late.
That’s the future for us, and it should chill ever American to their core, to the bone, to their soul.
angrywonk on August 17, 2009 at 1:21 PM
sounds like they’re counting on the passage of Obamacare
Fighton03 on August 17, 2009 at 1:40 PM
Canada is looking more and more appealing if they continue to learn from the failures of liberalism.
Grafted on August 17, 2009 at 1:48 PM
Put the lime in the coconut, you called your doctor, woke him up,
And say, ‘Doctor, ain’t there nothing I can take,
I say, Doctor, to relieve this belly ache?
I say, Doctor, doctor, ain’t there nothin’ I can take,
I say, Doctor, dooooctor, to relieve this belly ache?’
Put the lime in the coconut, drink them both together,
Put the lime in the coconut, then you feel better,
Put the lime in the coconut, drink them both up,
Put the lime in the coconut, and call me in the morning
Now, don’t we feel better?
Cricket624 on August 17, 2009 at 1:49 PM
Our direction was toward activity-based compensation, so the comparison really doesn’t hold water.
AnninCA on August 17, 2009 at 2:06 PM
Where’s the canuck Drywall?
Euthanized?
Sapwolf on August 17, 2009 at 3:43 PM
Do people know that this already goes on in the N.H.S?
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4126013 .
I work in a foundation hospital.We compete for patients,funding is based on results.
http://www.nhs.uk/servicedirectories/Pages/ServiceSearch.aspx
I am not bothered what health system you have in the U.S ,obviously it is up to you.
I am not saying you should have ours.
But there seems to be and lack of understanding of how the N.H.S works and a lack of interest to gain more knowledge.
mags on August 17, 2009 at 12:25 PM
mags on August 17, 2009 at 3:45 PM
People, people, people….I can’t emphasis enough that ObamaCare has nothing to do with “health care” and everything to do with money/power grab.
.
People, people, people….I can’t emphasis enough that Crap&Tax has nothing to do with “climate change” and everything to do with money/power grab.
.
People, people, people….I can’t emphasis enough that TARP has nothing to do with “bailouts” and everything to do with money/power grab.
.
People, people, people….I can’t emphasis enough that Stimulus has nothing to do with “economic stability” and everything to do with money/power grab.
.
People, people, people….I can’t emphasis enough that Obama has nothing to do with “America” and everything to do with money/power grab.
.
Add your own…it’s fun and needs to be repeated often.
scituate_tgr on August 17, 2009 at 5:24 PM
‘emphasize” enough…what a maroon..
scituate_tgr on August 17, 2009 at 5:25 PM
I love illustrations of the difference between efficiency and efficacy. Patients per hour up; patient life expectancy way, way down.
Blacksmith on August 17, 2009 at 6:25 PM
OK, so let’s say it’s a few years down the Obamacare Road and, as it reads today, everyone is now “in the system”. No private insurance, no MD’s working for anyone but Uncle Obama. Does this mean that the MD’s can give up their malpractice insurance? Would Uncle Obama, being their employer, ultimately, be responsible if the wrong leg gets amputated? If so, would we then see tort reform? Perhaps all ambulance chasers would then work for Uncle Obama too? And ambulance drivers? Would Voodoo practitioners also fall under the plan (I’ve actually taken a “believer” to one, pretty weird stuff)? This has me chasing down rabbit trails that probably shouldn’t be navigated.
Robert17 on August 17, 2009 at 9:01 PM
Now we do!
ExpressoBold on August 17, 2009 at 10:17 PM
Robert17 on August 17, 2009 at 9:01 PM
Lol… you obviously didn’t even read the summary version.
lexhamfox on August 17, 2009 at 11:01 PM
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