Shawn Whatley, Author at shawn whatley md

Canadians Deserve Better Health Care

The ‘biggest court case in Canadian history‘ gets started in September. The 30 minute video below gives you enough to start talking about it with your friends and colleagues.

You can also check out: Charter Health – Canadians Deserve Better Health Care.

30 Second Summary:

7 plaintiffs suing BC government under Charter of Rights
All suffered harm from waiting (e.g. teenager waited 27 months for spine surgery, now paralyzed)
Only country in world where illegal to purchase care
Canada ranks at bottom of numerous lists comparing care in other countries
Queue jumping by: federal prisoners, government employees, workers compensation, etc
One defendant, former Attorney General of BC, purchased private spine surgery in BC (!)
Current BC Minister of Health is a veterinarian
Plaintiffs arguing for same rights as animals
Arguing for same rights for those Canadians not in jail as prisoners get now

Regardless of which side of this case you support, we need to spread the word. We need politicians to discuss this.

(photocredit: canadian-flag.org)

Healthcare Bureaucracy, Forms & Waste

Western civilization will not end from Ebola or nuclear disaster. It will choke to death under forms and bureaucracy.

Our tour guide spoke with both hands as he tilted our van through corners on the Amalfi coast in heavy traffic. I raised his blood pressure by asking him about Italian politics.

He told me how his friend struggled as a chef.

“He spends more time filling out paperwork for government than cooking for customers!” he said in a thick accent.

Our guide gladly took cash for the tour. Everywhere else, we filled out paperwork with passport numbers so government could monitor the tourism industry.

Bureaucrats love forms. Without asking for much input, bureaucracy creates new forms like dandelions in spring.

Healthcare Bureaucracy

When politicians promise voters more healthcare services, it usually includes some kind of form for doctors to fill out. Forms take longer to fill, than patients take to see. Ergo, politicians’ promises produce less service, not more, if they include a form to fill out. (Thanks, Philip!)

For the most part, bureaucratic forms do not contain medication orders. They usually ask for signatures confirming medical condition, explanations about clinical features and regurgitated treatments that have all been recorded elsewhere. These forms get designed in cubicles to serve bureaucratic ends.

Provincial Ministries of Health and Medical Associations have bilateral provincial Forms Committees to try to limit the negative impact of forms on clinical care while still meeting bureaucratic goals. Even so, some frustrated physicians have created ‘Doctors Against Forms’ committees.

Helpful Forms: PPOs

However, clinicians want some forms. Medical pre-printed order sheets improve accuracy and save tonnes of time. Clinical protocols could be written out long hand by any physician any time. But PPOs that improve care move glacially through dozens of drafts reviewed by committees of non-clinicians and physicians with little experience on a specific PPO. Hospital Forms Committees hold enormous power. Without their imprimatur, patients don’t benefit from PPOs. It’s often easier to change an out-of-date form manually for each patient than to run the Forms’ gauntlet for an update.

Overregulation

Forms represent one tiny feature of overregulation. Healthcare bureaucracy always creates more work for itself. It will never go on a diet. Touting accountability and audit, micromanagement will always bloat, will always crave more control.

Bureaucratic bloat drives cost, increases frustration and, most importantly, limits service.

Nobody likes whiners. Providers drowning in bureaucracy sound like whiners when they speak up. The only way to definitively erase bureaucracy is to demonstrate a better alternative.

(photocredit: eformsfactory.com)

Non-Profit Healthcare: Myth or Reality?

As one NHS manager put it, without business there would be no buildings, no drugs, no machinery, no beds, no scrubs – just a lot of doctors and nurses in a field in their underwear.

— God Bless the NHS by Roger Taylor

Healthcare profit is like sex in Victorian times. We pretend it rarely occurs, and we’d be better without it.

But,

Doctors, nurses, techs, clerks, administrators all get paid; they work for profit.
Paid bureaucrats profit from running Medicare.
Even politicians politicate on healthcare to keep their jobs; they profit.

Furthermore, healthcare cannot run without business providing almost everything needed for care. All the technology, medical wonders, and super drugs come from businesses driving innovation. Pharmaceutical company TKM hopes to have an Ebola treatment out soon. Businesses research and develop new products to help patients and to build profits. Patients benefit from businesses that profit.

Medicare is not a charity.

Can Medicare Ever Fail?

Business owners expect a return for their investment in business. Failing companies close. If they cannot serve customers, they go out of business. Owners hopefully salvage some of their investment.

Public organizations spend all their money. They never decrease spending voluntarily. In fact, they put operational savings into more staff or new buildings, even if service doesn’t change. When publicly run organizations fail to serve customers, they do not close. Instead, the state spends more to prop them up.

Only Non-profit Healthcare Cares

Fundamentalists insist that only non-profit healthcare values patients more than money. Only public organizations put patient interests first. They insist that only state run medicine can truly care, having had its motives purified with other people’s money. They imply that Dentists, Orthodontists, Pharmacists and everyone else not covered under Medicare cannot genuinely care about patients.

But in publicly run Medicare:

Patients wait for urgent surgery. The state rations operating room time to save money.

Patients wait for imaging (MRIs etc.). The state turns machines off at 5 pm to save money.

‘Non-profit’ medicine cares about money just as much as ‘for-profit’ healthcare. Non-profit care cuts services to save money. It cannot incentivize productivity or increase budgets by serving more patients. It can only cut, or raise taxes.

Who Cares Most About Patient Service?

The key difference between non-profit and private healthcare is the value each system places on patient service. Non-profit medicine cares comparatively little about service. Without incentive to pursue excellence, it aims for average.

Private healthcare must put patients first or risk insolvency.

Profit prudes impugn those who question ‘non-profit’ healthcare. It’s time to expose the myth. Non-profit zealots enjoy huge profits as healthcare burns up 50% of provincial budgets. Non-profit healthcare would have nothing to offer patients without the proceeds of business endeavours.

Non-profit chauvinists denigrate any care other than their own. It is hypocritical moral supremacy.