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Tuesday, August 24, 2010

WHO says? WHO says Canada is way down the List...



Letter to the Editor:
The headline for August 24, 2010 in a local newspaper read “Morale plunges at hospital say nurses.” Reading the details of the article left me unclear as to what “low morale” really means. How many nurses are demoralized and to what degree? Does that mean nurses are unable to provide good care because they are demoralized? Is this affecting other employees at the hospital? Are the patients suffering because of this?
We as patients and consumers pay through our taxes (about 40 % of the total provincial budget in BC) for what is becoming a very expensive and less than adequate system. In 2000 The World Health Organization ranked Canada as 30th among 191 member countries.
Last year Dr. Brian Crowley, the Founder and President of the Atlantic Institute for Market Studies in Halifax, Nova Scotia, described the Canadian healthcare system this way:
“Canadian Medicare operates in an unregulated, tax-financed, pay-as-you-go model. Our provincial governments are our monopoly provider. They not only pay for necessary care, but they also govern, administer, and evaluate the services that they themselves provide. They define what we call “medically necessary services” and pay for 99% of all physician services. They also forbid the use of private insurance for medically necessary services. They set the budgets for nominally private healthcare institutions. They appoint the majority of their board members and have explicit power to override management decisions. Under these circumstances, no hospital or hospital administrator can be expected to take any responsibility or initiative because decisions will always be second-guessed by those in political power.”
Several years ago the Supreme Court of Canada ruled that the healthcare system violates Quebec’s charter of rights because it collects taxes, promises healthcare in return, forbids competing suppliers and then often doesn’t deliver the care. The justices summarized the situation this way: “A place in a queue is not healthcare.”
WHO ranked France as number one. For starters, the French system is not what most Americans imagine, says historian Paul Dutton at Northern Arizona University, author of Differential Diagnoses: A Comparative History of Health Care Problems and Solutions in the United States and France. "Americans assume that if it's in Europe, which France is, that it's socialized medicine," he says. "The French don't consider their system socialized. In fact, they detest socialized medicine. For the French, that's the British, that's the Canadians. It's not the French system."
Don’t get me wrong. I am strongly in favour of the idea of a publically funded health care system. The problem we have in Canada is in the delivery and the accountability. We by and large have a monopoly that doesn’t and hasn’t responded to the needs of those it professes to serve for a long time.
I wouldn’t go as far as wanting the French or American versions. The fact remains that much of the health care delivery and services are done privately (naturopaths, acupuncturists, dentists, message therapists and many other practitioners). Health food stores are flourishing. Drug stores are selling many health products as well. This is an illustration that our publically funded system often treats the symptom (e.g. prescribing drugs) and and not often enough the cause. More focus on treating the cause would make us a healthier nation.
The infighting at our local hospital is the symptom. Maybe both sides can get at treating the cause.
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Published by the Comox Valley Record as Health monopoly ineffective August 31-2010

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