Health minister Rona Ambrose announced a panel to look at improving the quality and efficiency of healthcare.
What would you suggest if you sat on the panel? What features do you consider essential to a great healthcare system?
If asked, I would offer the following list of concepts, ideas and axioms. Most apply to all healthcare systems – public, private, hybrid, etc. Most are funding agnostic and need consideration whether we use taxes, insurance or out-of-pocket dollars. Many points in the list already feature in Canadian Medicare.
Patient service can suffer in any healthcare system regardless of funding and design. We cannot assume some issues disappear simply by legislating a particular system.
One comment for my libertarian and small-government readers. Before you spit out your coffee at this list, I think we must acknowledge that no system will ever be 100% market based just like no socialist system can operate without some element of profit (e.g., using medications developed by industry). We need to make business oriented approaches as compassionate as possible, and statist approaches as customer-focussed and accountable as possible.
Books, lectures and conversations impacted the ideas. Please add more by sharing your comments!
A Vision for Healthcare –
110 Ideas
To incorporate feedback, I put a Vision for Healthcare on its own page. Please share your thoughts on this post and any other and I’m improve the content as you share. Thanks so much!
Dr Whatley,
I’ll phrase my comments positively as I’m aware that words can be misunderstood. I disclose early on my support of unions in society.
Whereas I share your desire to stimulate debate on our healthcare system, the section of your post referencing unions appears to my sensibilities to be based on anecdotes and ideologies. I thought I could offer mine to balance. I do not challenge your commitment to quality care, nor to the debate. Likewise I hope you do not see nurses with strong union philosophies being at odds with quality care either.
The Ontario Nurses’ Association (ONA) was created by front-line registered nurses 41 years ago. As the nurses’ union, ONA has successfully won a professional practice clause that is solely intended to ensure that our patients receive safe, quality patient care. We are somewhat unique in the fact that our contracts of employment demand the right to provide quality care.
As for Union membership,I’d suggest that the majority of our members by far are proud to be members of ONA. I know some question the value or the need, but this debate is always healthy. In fact this scenario quite possibly may not be dissimilar to membership in the OMA. This is the nature of large groups of membership.
ONA and its members do speak out when policies and practices negatively impact patient care. One policy for instance is the current trend of introducing more private, for-profit care into the system that, many feel,will hurt patient care and see funding that should be spent on care go instead to profits.
Many Public medicare advocates question increasing the support for-profit, private health care, looking at many world models demonstrating unfavourable societal outcomes.
It may also be worth adding that a number studies have shown, wages for the majority of workers in Ontario have stagnated for the past 40 years (as union membership has dropped), and many cannot afford the private care you advocate for.
I think that the constructive dialogue between RNs and physicians on these matters will serve to inform politicians and decision makers and furthermore for RN’s and Physicians to support one another for quality, publicly provided patient care. Perhaps having these discussions in this manner may elicit a better healthcare system for tomorrow.
Ontarians are counting on us.
Thank you.
What a thoughtful, well written comment! I am humbled that you would take the time to read and provide such thoughtful feedback. Thank you SO much.
I agree with your passion for discussion, debate and quality care. If we keep our focus on patients and the service and care they receive, we will all be pulling in the same direction.
Thank you for keeping me accountable on what I write! We often never know how our message comes across unless someone takes the time to challenge us. You are right: the section on unions was too loose, had vague generalizations, and seemed to focus on only one provider group. I have updated the content to be more general. I agree with your comments that physician groups (or other provider groups) all face the same issues with membership and accountability for messaging and behaviour.
I was delighted to see you push back on the issue of private care. I agree that private care does not guarantee great patient service. I think it far too simplistic to hope that private care will save us all. If nothing else, the US model has demonstrated that private care cannot save healthcare by itself. Having said that, monopolistic state funded and run healthcare has not worked anywhere around the world. There are dozens of countries we can look to that offer universal access, accountability, quality, and treat patients as valued instead of undeserving recipients of state altruism.
Since I see you are an expert on healthcare policy, funding and management, I cannot resist a final comment. You and I both profit from healthcare. Every provider profits from healthcare. Without profit, we would have no buildings, no technology, no uniforms or scrubs, no beds and no medication, just a bunch of nurses, doctors and allied health providers in a field in their underwear. We need to rethink our vilification of profit; we have not sworn vows of poverty and do not work for NGOs.
Again, thank you SO much for taking time to engage and comment. I fear I might have caused you grief that you even had to comment in the first place. If so, please forgive my ignorance and thanks for taking time to help me see things differently!
Highest regards,
Shawn