Sunday, March 21, 2010

Why Ontario's health-care system is allergic to efficiency

Toronto Sun ^ | 2010-03-21 | John Snobelen

Posted on Sunday, March 21, 2010 10:08:03 AM 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.


Pissedoff said...

If you throw a stick for a dog and after 10 yrs he still doesn't chase it, it could mean he is blind. Or it could mean like jackass Liberals the person throwing it is just dumb and stupid. Of course the dog might not be blind just the idiot throwing the stick.

Big Red Magnum said...

The Bigger Picture.
If you lose a million men and women fighting the socialist political system in Europe then allow it's adoption 30 yrs later in your own country what's that make us?
The health-care system is just a symptom of what is wrong with the whole country.

Anonymous said...

when you call to make an as soon as possible appointment with your doctor and can't get in for a few days the receptionist tells you to go to emergency. You say you don't want to do that because it is more expensive. Their answer is "Well you don't have to pay for it."

What an asinine way of thinking.
I agree give me a copy of the bill, let me know how much pills at the emergency ward are. Instead give me a prescription for the next day at the drug store.

If I have a broken arm I go to emergency, If I have a hang nail I fix it myself.

We have to give up the idea of entitlement. It is putting the country into the poor house.

Harris wanted to stop throwing the stick to the dog, lets try it now instead of later.

Anonymous said...

I have a better one, you come you invade a country and put down the locals. You build up that country into one of the best in the world. Then you open your doors wide open with dollar signs in your eyes... they you watch as the place slips into the gutter as the trash of the world is dumped onto you. Who in their right mind would do such a thing??? (real conservative)

Anonymous said...

Anon 8:56

It's even worse now because I'm trying to get Justice because a Corp I dedicated 25 years to had caused my mental burn-out from down-sizing and 10 hour days with scattered Holidays even though i was granted 3 weeks per year and then 4 weeks after 20 years service. When I got a rest and tried to return to work I was fired with only a 2-week notice that my job was no longer there.

BUT....the CHRC and OHRC appear to be useless for me because I get automated answering machines and they are only open from 8:30am to 4:30pm to protect our rights,and more insulting is the people wroking there that seem to be bigots with a chip on their shoulder wanting to get-even for Century Old sins.
My point is that the HRC's have become as cash-cow for Minority Lawyers and Career Victims with hurt feelings,it's now a Legal Lawfare to extort money via HRC's Tribunals that can bankrupt innocent people with fabricated claims of Racism or Discrimination.

Is it any surprise that Terrorists want to use canada to raise money and recruit fighters when the RCMP and CSIS can't do squat when Lawfare money via the HRC's scams bypass the Money transfers into canada to fund Terror cells. Maher Arar got $10.4 million for alleged harm outside of canada while he was globe-trotting to know Terrorist producing Nations.
He cried "Racism" and "Profiling" while a pro-Whahhabi Saudi-Funded Islamic Org. in Canada supplied Witnesses and Lawyers for the $400'000'000.00 original Lawsuit that forced his pay-off to save us the costs for a decade long Court case.

I get another good laugh from Jack and Olivia that collect 2 M.P. Salaries and enjoy the Golden private Medical coverage while claiming to fight for the poor and oppressed denied quick access to "Free" health care.
Soon our "Free" stuff will become an inverted Pyamid scam that crushes the taxpayers carrying the full loads and the Public Union costs to boot.

Anonymous said...

We are missing an important point.
Non Profit organizzations (such our health care and school system)
do not have any incentive to perform (quality service).
Performance in the non profit sector is viewed as counterproductive and it effects the bottom line.(More funding).
The worst they perform the more funding they can ask for.

Isnt that simple?

Anonymous said...

Why Ontario's health-care system is allergic to efficiency"?

Very simple answer.
Like any other public funded organizzation the Non Profit Sector has no incentive to perform (quality service).
Perfomance in the Non Profit is viewed as counterproductive to the bottom line (funding).

Bad perfomance calls for more "investment" (taxpayers money).

We give away $billion...and no strings attached. Wouldn't be nice to run a business on those terms?

So...there you go.

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