Aug. 10, 2022

Healthcare can no longer be entrusted to governments

In my worst nightmares, the federal and provincial governments sit down to consider how to fix healthcare. Not fix it – 'consider' how to fix it. They are incapable of doing so, incompetent and apathetic. They have starved our systems for decades and so far refuse to admit they are sitting on a crisis that will stir the public as no other issue has in our history.

Governments and about 29,000 healthcare administrators  allowed this healthcare crisis to develop. These incompetent bureaucrats, appointed by the unwilling to do the unnecessary, are focused on managing money, not on providing health care.

Replace the administrators with trained medical professionals who can deliver services.

Healthcare is too important to continue as the political football it has been since 1965. The elderly patient with a broken hip cannot be treated with political placebos and families unable to connect with a family doctor may not discover a serious illness until it is beyond any hope of successful treatment.

We have to take action to prevent an epidemic of unnecessary premature deaths. We cannot endure the failed management of a core public service and cannot trust politicians to repair the systems they ruined. We are faced with stark choices.  

We can create an independent, apolitical body to oversee healthcare administration or contract out healthcare delivery to the private sector. In my opinion, the latter option is preferable.

The costs of public health care delivery are a mystery. We know how much money is spent on the system and how much money the health care departments cost. Those global numbers are useless.

What we need to know is how much it costs to replace a knee joint, remove a gall bladder and every other procedure that constitutes healthcare. The cost figures have to include money spent on land, buildings, equipment, maintenance, supplies and taxes.       

The basis for our healthcare system is socialist ideology; people should have access to hospital care irrespective of their ability to pay for services. That was soon expanded to medical care so that people could see a doctor for examination and treatment to prevent having to go to a hospital. That is neither bad nor wrong.

Where ideology transformed into idiotology was in assuming that a hospital could provide all services needed, also act as a training ground for nurses and doctors and include an element of research. Rapid advances in medical procedures, science and technology have made that impossible. Modern medicine is not a one-stop shop.

The inflexibility of the public sector system killed healthcare.

You visit a family doctor because you feel ill or notice symptoms that concern you. The doctor does some investigation and basic tests. When he has results, he will prescribe medications if needed or refer you to a specialist for further investigation. That is where the wheels fall off the wagon.

Assume that the specialist is an orthopaedic surgeon, and establishes that you need a knee replacement. You are now in a competition for space in a hospital operating room with every other person needing an operation. The hospital will give priority to those in most dire need so you wait in line while cardiac patients and others will life-threatening ailments get attention.

Throw accident victims in the mix. They arrive by ambulance or private vehicle in dire condition. They need immediate attention and take up operating room hours, lengthening the lines of people awaiting access.

Consider the flexibility of private healthcare delivery. A private system can and will build hospitals dedicated to cancer care, heart surgery, trauma victims, joint replacement or numerous other specialties. They are efficient as they are dedicated and equipped for a specialty. They reduce the competition for general hospital operating rooms.

The key lies in the eighth paragraph above – we need to establish a cost per service provided. Once we know the cost of a knee replacement, we can find out how many knee replacements are done in a year and how much the cost is. We will soon know if a hospital dedicated to joint replacements is viable.

If so, create the facility and improve the efficiency of delivery. Whether the service is delivered by a private or public facility is irrelevant as the fee to the facility is the same.

Chronic understaffing of healthcare facilities has created toxic work environments. Small groups of medical professionals are dealing with a growing population. Workloads keep growing and the combination of long hours and high stress is devastating. Worse, there is no relief in sight.

Our pay scales for medical professionals have to be at least 15 per cent higher than the median for similarly qualified persons across North America.

Medical professionals must not be required to work in excess of 40 hours a week and be able to enjoy a minimum three-week vacation each year to avoid burnout.

Public facilities must operate 24/7 until wait times for approved medical procedures are reduced to a three-week maximum and then reduced to 16 hours per day until demand allows for further reduction.

Family doctors are the nucleus of personal health care, manage medications to ensure the good health of their patients, make referrals to specialists as needed and monitor public health. They must be far better paid and have support to ensure they have adequate time off and vacations.

We have to consciously alter the environment in healthcare facilities to reduce stress, provide for adequate breaks, and create electronic supports to track everything from monitoring controlled medications to recording vital signs. Healthcare professionals spend far too much time and effort recording trivia in case the facility is sued.

Healthcare professionals don’t have the answers. They have vested interests and are not trained administrators. We need on-site administrators who can walk the fine line between the demands of medical professionals and the practical constraints of financial viability.

Prior to 1950, all healthcare was delivered by religious or charitable organizations and private enterprises. Control was taken over by governments who have bungled it. They don’t get a second chance when our lives and those of the people we love are at risk.