Wednesday, November 21, 2007

Sickening Canadian healthcare

There is a good reason Alberta spends more on health than any other province in the nation -- $3,695 per person -- and yet we wait longer for care. The Fraser Institute notes that if an Albertan sees a family doctor -- if you're lucky enough to have a family doctor, which in Alberta is fast becoming a mythical creature on the same order as a unicorn -- and are referred to a specialist, the average wait before actually getting treated is 19.5 weeks. This is not good.

It is not even up to the sad standard set by other Canadian provinces. Our American cousins look at such numbers and are appalled. Yet there is a very good reason for this. It is because the economic model for our health-care system, in Alberta and across the country, would be instantly recognizable to Josef Stalin and Mao Zedong. Mao and Stalin didn't believe in the rights of individuals to make economic decisions on their own, and neither do those who become hysterical and cry like little girls denied tickets to the new Avril Lavigne tour when it is suggested an absolute government monopoly on health care is killing us, financially and literally.

We have taken the economic model of the Soviet and Maoist collective farm -- the result of which was generally widespread starvation -- and applied it to the delivery of health care. Anyone surprised by the fact it doesn't work is probably also surprised Jack Layton isn't prime minister, the sun rises in the east, sticking a knife into a toaster hurts and that you can sit in a Calgary hospital emergency room suffering a serious gallbladder attack for eight hours before getting a shot of Demerol, which happened to the wife of a friend of mine recently.

Despite our institutionalized disdain in this country for all things American, if a U.S. citizen doesn't have health insurance and goes to a county hospital where medical care, as it is in Canada, is "free," the wait for treatment for a gallbladder attack is .... you guessed it ... about eight hours. The average Canadian, with his much-lauded, universal medical system, is treated like the average American without health-care insurance

Countries that provide a compassionate and intelligent mix of private and public health care simply do better. A recent survey of 28 countries that offer universal health care saw Canada place 26th in terms of medical outcomes for every dollar spent, 18th in access to CAT scans and 22nd in infant mortality. Because of the presence of (gasp of horror!) capitalists in the systems outperforming ours, such as Australia, they have embraced the discipline of the free market, which delivers any product -- from iPods to heart surgeries -- more efficiently and effectively. We place so low because if you're not rewarded for efficiency ... you'll be inefficient.

We used to have a mixed system in this country. Some doctors remained in the public system. Others opted out all the way. Some took publicly insured patients and extra-billed them. That has all been taken away in the name of equality -- the same sort of equality lauded by Mao and Stalin -- and the result has been predictable.

This country saw health care costs rising and decided it would .... restore free market discipline? Naw. We decided to limit the number of doctors graduating and, in a peculiarly Alberta solution, blew up a freaking hospital without having built a new one first. So we now have doctor shortages and hospital bed shortages and the only people surprised are the same ones wondering how come the sun rises in the same place every day. It'd be enough to make you sick if you weren't afraid you wouldn't get timely treatment.

Source





Australia: Regulators finally do something about irresponsible health bureaucrats

QUEENSLAND'S former chief health officer, Gerry FitzGerald, faces disciplinary action for his role in the Dr Death scandal at Bundaberg Base Hospital after a dogged two-year pursuit by a doctor with the Royal Flying Doctor Service on the other side of the country. The Medical Board of Queensland, which had been reluctant to launch proceedings against anyone over the Bundaberg hospital disaster, with the exception of surgeon Jayant Patel, is preparing to start disciplinary action against Dr FitzGerald, one of its former members, for failing to act swiftly.

The decision of the board is sensitive because it was initially dismissive of calls for top administrators to be held accountable. It was pressed into an investigation of Dr FitzGerald by a West Australian-based doctor with the RFDS, Simon Evans. Documents obtained by The Australian yesterday show the board has now agreed that Dr FitzGerald received serious complaints about Dr Patel in early 2005 but "failed to take proper action to ensure that Dr Patel was limited to surgical work that he and the hospital could satisfactorily perform". Dr FitzGerald said yesterday he was "very disappointed" with the board's decision. He said he had tried to do his best under difficult circumstances.

Dr Evans hopes the latest decision will send a powerful message to senior bureaucrats and administrators in charge of health systems that they are not immune from disciplinary action usually reserved for clinicians. Dr Evans urged the board two years ago to start disciplinary action against Dr FitzGerald, who had resigned from Queensland Health after giving evidence at a 2005 judicial inquiry into the problems at Bundaberg Base Hospital, as well as other administrators. "They told me they had absolutely no intention of taking any disciplinary action against any administrators adversely named in the report (of the inquiry)," DrEvans said yesterday from his home in Derby, in Western Australia.

Undeterred by the rebuffs, Dr Evans researched the evidence in greater detail, cited legislation and administrative negligence cases from Britain, and wrote several letters accusing the board of failing in its responsibilities. "From my time at Queensland Health as a clinician I could see where the major problems were - they were with senior medical administrators," Dr Evans said.

The board has concluded that Dr FitzGerald "failed to recommend suspension of Dr Patel when he could and should have done, thus exposing patients to undue risk of harm". The matter is to be heard by the Health Practitioners Tribunal. Medical practitioners found guilty of unprofessional conduct face penalties ranging from fines to being struck off as doctors.

Serious concerns relating to Dr Patel's performance at the Bundaberg hospital were not properly addressed until senior nurse Toni Hoffman put her job on the line by going public in 2005 with evidence of unnecessary deaths and injuries resulting from Dr Patel's surgery.

Dr Patel, who has lived in Portland in the US state of Oregon since fleeing Australia in April 2005, will be arrested by US marshals when the paperwork is completed between Australian and US authorities, possibly as early as next month. The extradition request is understood to relate to 16 charges, including manslaughter and grievous bodily harm, arising from his time at Bundaberg Base Hospital.

Tess Bramich, the widow of a patient who died at the hospital, said she had "forgiven" Dr FitzGerald. Mrs Bramich said since Dr FitzGerald was facing disciplinary proceedings, other administrators also needed to be dealt with. A senior source said the board had always been uncomfortable with the prospect of taking action against a former member. The board permitted Dr Patel to practise in Queensland, overlooking his history of serious disciplinary action for botched surgery in the US.

Retired Supreme Court judge Geoff Davies QC, head of a public inquiry in late 2005, made strong findings against Dr FitzGerald for not acting on a clinical audit that showed Dr Patel's complication rate was at alarming levels. The inquiry ruled that Dr FitzGerald's decision to permit Dr Patel to continue to practise "was a course designed to minimise publicity and in effect conceal the truth. The interests of the patients were ignored." Mr Davies told Dr FitzGerald: "You knew he had 25 times the complication rate for a very normal piece of surgery. "What more do you want to protect the potential patients of Bundaberg Hospital?"

Dr FitzGerald, who won support from patients and Ms Hoffman because of his candour and his apologies on behalf of the health system, has denied he set out to conceal information. He now works at the Queensland University of Technology.

Source

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