Posted on 03/21/2010 7:08:03 AM PDT by Clive
If you throw a stick for your dog and he just sits there looking at you, it doesn’t mean much. But if you keep throwing that stick for 10 years and the dog still just looks at you, there might be a message. The dog doesn’t want to play stick.
That sort of profound conclusion is missing from the health care debate.
Fifteen years ago Premier Mike Harris came to office determined to get a smart card for health. One card that contained all of a person’s health records and information. It was a great idea.
Harris also wanted patients to get, and sign for, an invoice for the health services they had received. That seemed like a pretty common sense way to make sure that people actually received the services OHIP got billed for.
It also seemed sensible for people to know exactly how much their health care cost.
Harris was not famous for giving up on good ideas, but when he left office eight years later there was no smart card and no patient invoice.
When Dalton McGuinty entered the premier’s office five years ago he wanted eHealth, electronic records that could follow a patient, reducing administrative costs and making the system safer for patients. Sounds like a good idea to me.
Five years and a billion dollars later the health system is still an information technology wasteland.
There might be a message here. Maybe, just maybe, the health care system doesn’t want to be more efficient.
That’s not to say that docs and nurses don’t want to be freed from mountains of paperwork or that hospital administrators don’t want to ... well, administer, but the incentives in the system don’t call for change.
Who pays for redundant tests or misdiagnosis? Who pays for an paramedic team to wait, sometimes for hours, for a patient to be admitted to emergency? Who pays for lost records? Who pays for improper or fraudulent billing?
You do. And until someone in health care has some skin in the cost side of the business, being more efficient and effective will be a nice thought, not a necessity.
Know the costs
If we want affordable health care we are going to have to get the people who pay for it, that would be you and I, to have a little more interest in the costs. That sounds like real public ownership to me.
But our version of public health care does not embrace you as a decision maker. Our system was designed to treat, not inform, you. You don’t need to know what a procedure costs or what the alternatives are. You don’t need to know what an aspirin dispensed in an emergency room costs. You don’t need to know much; in fact the less you know the smoother the system runs.
There are lots of ways to put people into a position of power in the health system. Some form of deductible is one of the most common suggestions. But every patient empowering initiative has been resisted by the medical community.
Every time a fundamental change to the health care system is suggested the same old tired arguments are dusted off and trotted out. But the truth is we are out of money and the cost of care has to come down. Spending 46¢ of every provincial dollar on health care is too much — and that number is expected to rise to 70¢ within 12 years if nothing is done.
Some dogs won’t chase sticks and the health care system won’t lower costs. That means you and I are going to have to be more involved or the government will continue to make health care choices for us. And, trust me here, that dog won’t hunt.
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This continual comment that comes up about electronic records...ask yourself this. Up until the last ten years...this was a fantasy...so do we really say that medicine is better now than over the past two hundred years when we had just plain old paper records being available?
I don’t buy this argument. I’ve sat and watched an office create a huge database of operations data over five years...and then some idiot screwed up the system and the back-up data copies failed. Paper doesn’t fail.
What this does do....is invite the tech industry which is in a lull period....to come into the health industry and sell them various databases...which it’s likely that one’s standards with one hospital...won’t equal the same database used by another hospital. So you won’t be able to share data like people think.
“Spending 46¢ of every provincial dollar on health care is too much — and that number is expected to rise to 70¢ within 12 years if nothing is done.”
It’s all cyclical. They’ll go back to Bob Rae’s plan to cap doctors’ salaries and force fresh “Rae Days” to save money. We’ll go back to a doctor shortage as a result of our professionals leaving the country. Nurses with cheaper salaries and limited liability (watch for it) will come in. And then the province will re-elect a conservative to clean it all up again—...a conservative who will be a whipping boy (or girl) for years to come. Then we’ll elect another NDP...yada yada
As a “Snowbird” I was down south recently and had occasion to accompany my sister to a stay in hospital. One week later a bill arrived at her home completely itemizing all services, drugs, and procedures, right down to the number of doctor visits at bedside. As a Canadian, I was stunned while viewing it. We have NOTHING like that, NO BILLS, NO RECORDS. They could be triple charging and billing for procedures not received, $200 aspirin, etc., etc., for all I know Wow. No wonder we’re taxed to death....it’s out of control.
Everyone should keep this data for themselves and/or their families.
Most people (especially older ones) don't remember 10 percent of what they are told. The recording is VERY helpful for family members and other health care workers.
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