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Topic Canadian health system "is imploding" per incoming president of Canadian Medical Associatio Go to previous topic Go to next topic Go to higher level

By lurkingforacure On 2009.08.18 20:48
The irony. Apparently our Canadian doctor friends are saying that healthcare reform is their top priority. Incoming president of the Canadian Medical Association, Dr. Doig, voices the concerns in this article:

And also, there are hints that surgeries may start to be a limited item...

I don't know the answers, and for those that claim the nay-sayers to public healthcare don't offer up an alternative plan, I wonder if that's perhaps because they do not believe healthcare should be an entitlement. I wish everyone could have healthcare, I wish we had better healthcare ourselves, but this is a very slippery slope. Once you start down that path of providing what people "should have", it is very hard to stop the entitlement train.

By trapper On 2009.08.18 21:52

I tied to go to that site but just got message that URL could not be found.

By lurkingforacure On 2009.08.19 09:11's the article:

"Overhauling health-care system tops agenda at annual meeting of Canada's doctors
By Jennifer Graham (CP) 3 days ago

SASKATOON The incoming president of the Canadian Medical Association says this country's health-care system is sick and doctors need to develop a plan to cure it.

Dr. Anne Doig says patients are getting less than optimal care and she adds that physicians from across the country - who will gather in Saskatoon on Sunday for their annual meeting - recognize that changes must be made.

"We all agree that the system is imploding, we all agree that things are more precarious than perhaps Canadians realize," Doing said in an interview with The Canadian Press.

"We know that there must be change," she said. "We're all running flat out, we're all just trying to stay ahead of the immediate day-to-day demands."

The pitch for change at the conference is to start with a presentation from Dr. Robert Ouellet, the current president of the CMA, who has said there's a critical need to make Canada's health-care system patient-centred. He will present details from his fact-finding trip to Europe in January, where he met with health groups in England, Denmark, Belgium, Netherlands and France.

His thoughts on the issue are already clear. Ouellet has been saying since his return that "a health-care revolution has passed us by," that it's possible to make wait lists disappear while maintaining universal coverage and "that competition should be welcomed, not feared."

In other words, Ouellet believes there could be a role for private health-care delivery within the public system.

He has also said the Canadian system could be restructured to focus on patients if hospitals and other health-care institutions received funding based on the patients they treat, instead of an annual, lump-sum budget. This "activity-based funding" would be an incentive to provide more efficient care, he has said.

Doig says she doesn't know what a proposed "blueprint" toward patient-centred care might look like when the meeting wraps up Wednesday. She'd like to emerge with clear directions about where the association should focus efforts to direct change over the next few years. She also wants to see short-term, medium-term and long-term goals laid out.

"A short-term achievable goal would be to accelerate the process of getting electronic medical records into physicians' offices," she said. "That's one I think ought to be a priority and ought to be achievable."

A long-term goal would be getting health systems "talking to each other," so information can be quickly shared to help patients.

Doig, who has had a full-time family practice in Saskatoon for 30 years, acknowledges that when physicians have talked about changing the health-care system in the past, they've been accused of wanting an American-style structure. She insists that's not the case.

"It's not about choosing between an American system or a Canadian system," said Doig. "The whole thing is about looking at what other people do."

"That's called looking at the evidence, looking at how care is delivered and how care is paid for all around us (and) then saying 'Well, OK, that's good information. How do we make all of that work in the Canadian context? What do the Canadian people want?' "

Doig says there are some "very good things" about Canada's health-care system, but she points out that many people have stories about times when things didn't go well for them or their family.

"(Canadians) have to understand that the system that we have right now - if it keeps on going without change - is not sustainable," said Doig.

"They have to look at the evidence that's being presented and will be presented at (the meeting) and realize what Canada's doctors are trying to tell you, that you can get better care than what you're getting and we all have to participate in the discussion around how do we do that and of course how do we pay for it."

Copyright 2009 The Canadian Press. All rights reserved.

By WitsEnd On 2009.08.19 09:20
I thought I read somewhere that Obama had visited Canada recently and had discussions there about various issues including health care. Upon returning he said the Canadian system is good for the Canadians....but would not work for the US.

By Newcaregiver On 2009.08.20 09:16
That is correct. Obama has said that the England and Canadian single payer systems are not what America is all about.

By trapper On 2009.08.25 00:01
Then, what is America all about?

By lurkingforacure On 2009.08.25 15:27
Odd, I saw a clip of Obama before the election and he clearly said he favored a single payer system and would like to see us move towards that....I think this was in's probably on YouTube like everything else now. If you really wanna get depressed, watch ABC's 20/20 clip with that John Stossel fellow as he talks about national health care, it's on youtube as well. 23-hour waits for emergency care, IF they take you as an "emergency", 6 months wait to see a doc or have any test done, people are pulling their own teeth because they can't stand the pain long enough to see a dentist, view for yourself. It was pretty bleak, I thought, and covered both the UK and Canada.

By trapper On 2009.08.25 20:40
I live in Canada and am amazed at some of the horror stories being bandied about:
Pulling your own teeth yet?????????

There are horror stories that we Canadians hear about living in the USA without health insurance: millions having to declare bankruptcy because of no health insurance coverage.

I hope that Obama is successful in his quest for a national health care plan for our American friends!

By Newcaregiver On 2009.08.26 13:27
There is so much talk about "letting grandma die". Let me tell you of a current situation I am in. I have had a sudden attack of upper GI problems (never in past). Could not swallow - though I was having a heart attack. Other details I will leave out, but shows this could be serious (hopefully not!). Doctor on call leads me to medicine until I can get to the gastro. Gastro's office says it has been too long since I have been there and must first be referred by the primary. Primary's office says I have to come in. That is fine. No problem. I go in and they try and schedule an appointment for me with the gastro. I cannot get an appointment with the gastro until mid-October. They are trying to figure out how to get me in now since this cannot wait. I have good insurance.

And we fear that we will be in long lines waiting for healthcare with new proposals? We are there right now!

By WitsEnd On 2009.08.31 15:46

Sounds like your problem is the doctor. Some doctors, even if their schedules are full are good about "working you in". You may have to sit there for a couple of hours--but bottomline is the doc will work you in with little or no notice. And then there's the other doctors who have a calculator where their hearts should be and that's not going to change regardless of what happens. They're the ones who triple book to begin with and then you have to wait for two hours anyway even though you had an appointment.

........think I'd ask if they could refer me to somebody else who is a little more flexible if I could. I hope you get to feeling better and I'm sorry you're having problems. Having health problems yourself and dealing with PWP ain't easy.

By mylove On 2009.08.31 16:16
If your area is dealing with a doctor shortage as is, you are stuck no matter what. Our area has that problem.

My doc is one of those triple booked - not by choice, but by necessity. I am lucky to get an appointment for myself within a six week period, even WITH an emergency issue. They will tell you if you ask to work in that if you feel it is an emergency, you need to go to walk in or the emergency room. You can sit in the emergency room on a weeknight or slow period, and if you are LUCKY get seen within two hours. Walk-in clinic hours are comparable to slightly better, depending on the 'busy time'.

My personal record for a weekend was with my DH who was in excruciating abdominal pain and triaged OUT to the waiting room. That visit took *eight hours* to be seen. Frequently, by the time I get an appointment for something less earth-shattering, the issue has either resolved itself or has gotten worse and necessitated that ER or walk-in clinic visit.

Something is definitely broke, and needs fixing. Thank GOD my DH has a personal physician who has him on a short list of 'preferred patients' that he will work in within a few hours notice most times. I confess to feeling somewhat jealous at times, but I am so grateful we have even this. For all I get to use my insurance, I might as well not even be covered. And it's GOOD insurance.

I loathe the fact that any proposal in changes in our health care system are viewed with such witch hunting fanaticism. As was said earlier, as far as health care rationing goes WE ARE THERE RIGHT NOW, and it is compounded by the fact that the pharma companies and the private insurers hold the strings that we dance by. Be assured that they work on a profit margin - they are businesses, not charities, after all. It's broke, folks, and pretending that it isn't isn't gonna fix it. Wariness of change is only natural, but do we really want to leave the system in the hands of the companies that broke it in the first place, or shall we give someone else a shot at fixing things?

By Newcaregiver On 2009.09.01 08:50
Wits End: thank you! you are right about this to some extent. small town, less doctors and this is a good, good doctor so I don't want to switch. They called last Friday with a cancellation so I see him this Thursday. I really think that having a parkie spouse/parent has a profound effect on the caregivers state of health. Of course, my health problems could have arisen no matter what, but I am under stress, trying to hold down a job and take care of a parkie too. I am very lucky that my parkie is pretty functional at this time, but....

And, my work situation seems to have no leeway for my situation - they push me hard (and of course, I try and push back as much as I can while still doing a good job at work) - my employer seems to think I should be available to work nights, weekends and holidays - hah!. I hate to tell her, I am - but not at my job!

mylove: you are also right. I know the healthcare issue is a mess, but we do need to sort this out and come up with a viable decision to change healthcare. I just wish they would stop the partisan bickering and get on with some real work!

By WitsEnd On 2009.09.01 10:04
I know about the good doctors. I had to wait about two months to get into the one I am using now. He is terrific....but he only takes new patients from existing patient referrals (fortunately by OBGyn was his patient and my OBGyn's wife was his patient). He was worth the wait, but in the meantime I went to one of those 24 hour emergency clinics who wasn't able to diagnose the problem, but was able to give me some medication and advice to tide me over until I could get in to see the good doctor. My situation wasn't life threatening but my body was swelling--especially my legs--so much that it hurt to walk. It was very uncomfortable and the old doctor's solution was to just keep telling me to "try a little exercise". A good doctor is really important.

Yeah, between care giving and work there was lots of time for that exercise (like I didn't do anything all day)! Besides that wasn't really the problem any way. The new doctor got me fixed up right away.

As for work my boss always said he understood--but he didn't really. My performance appraisal turned into crap for the first time in a 20 year history with the company. My boss always had perfect teeth, perfect eyes, never sick. His mom is up in years and has Alzheimers but his brother is dealing with that issue in another state and he doesn't even go visit. His dad dropped dead from a heart attack years ago on the golf course. So no he didn't understand no matter what he said. Nobody who hasn't been through it could understand. That's why the forum means so much.

As far as health care reform, I personally still think the massive, every changing, not sure what they are proposals are are screwed up....but your small town situation is a clear example of how health care can get on an improved track with some very selective and strategic action by our government. If some of that stimulus money was given to educate medical doctors and fund medical research the students could work on....and those doctors would have to pay that money back by practicing in areas where the doctors are needed for a period of time after they graduated--that would do several things. First, it keeps the money in the US and helps fund education and hopefully research as well. Second, it increases the number of doctors which should drive down waiting time and costs. Third it teaches young folks about the importance of giving back to the community while giving them a chance to get an education to support themselves.

My other pet peeve is medical research. Today many different companies spend money doing duplicate research in an effort to be first to the line to market a new drug and secure exclusive patent rights. The companies get a big payoff for the exclusive patent rights for a number of years. While approaching research from different perspectives is good, having multiple companies spending money on the same research is a horrible waste of money that ultimately gets passed along to all of us when the drugs go to market.

Rather than the track they are on now, I would have them look at changing the way medical patents are handled and drugs are approved. The government administers patents today. I would have some of those medical students spend a year in a research lab funded by the government actually doing research studies that are directed by the drug companies. Drug companies would have to collaborate on drug development and would share the patent proceeds. I'm not sure exactly how I would set that up. But let's say 5 drug companies say they want a Parkinson drug. They go to the government and file their theory about how the drug would work. They would get an "idea" patent. Rather than trying to implement their own ideas, they could go to a government subsidized lab and work together to develop and share their ideas and basic shared research in a joint venture. If they work together they get to market faster, it costs them less--but of course they share a reduced return for this effort which reduces consumer costs. If a drug company still wants to do their own independent research, they could still do that, but their competition will be a group of competitors who are getting a subsidy and the patent return will still be less because joint venture patents would be good for 20 years and non joint venture patents would only be good for 10 or something like that to incent the companies to work together. The testing done at the government subsidized lab also has some "independence" to it so companies who do the joint venture at the government subsidized lab would also get a faster track for FDA approval than ones done by independent companies which would also be a benefit to working together.

Anyway, this idea is still half baked, but I think something like this might could get costs down and get drugs to market faster if the mechanics could be worked out.

I'd also work on improving the quality and education of doctors. I'd have an independent complaint process (like the BBB). A doctor who gets a certain number of complaints would have to go through a retraining class at night to keep his license. Medical malpractice issues aren't all doctors--yet all doctors pay insurance for the few that aren't so good a doctors. If the bad eggs were weeded out and the marginal ones educated better, then their insurance costs should go down. Maybe the government could help subsidize the malpractice insurance costs of doctors who completed certain educational training and had no complaints. Maybe the government could also provide office space for doctors who agree to treat a subset of patients at a reduced cost. The billions of dollars being tossed out in the stimulus could buy a lot of office space.....

Again, another half baked idea, but something that would mean something direct to the consumer in better health care.

Okay, so much for my soap box today...

By Newcaregiver On 2009.09.02 08:44
Witsend: I think you have some very interesting ideas! that is really the point. We have many people with areas of expertise that need to be listened to. The whole screaming and ranting at these healthcare forums distracts Americans from really working on how to reform healthcare in the best way. I think there are a lot of bright minds who could really find best practices in improving healthcare. I am hoping we move beyond the divisiveness toward a consensus of improvements through thoughtful discussion.

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