Ok. I admit it. I’m scared. But not because we’re facing a huge challenge in our healthcare system – we’ve seen this coming for years.  No, I’m scared because we’re looking for scapegoats. Hopefully we begin to see a rapid change in both Canadians' mentality towards heathcare and in our practice of it.

 

Recent health headlines such as: Most Canadians fear for health system: report card, Canadians brace for higher health costs: poll and Survey finds most fear boomers will cripple health-care system scream warnings about Canadian’s fear that boomers will cripple our healthcare system over the next several years; and because aging seniors cannot afford care the result will be a toxic increase in tax hikes that our younger generations will have to endure.

 

According to an Ipsos Reid survey released this week by the Canadian Medical Association:

·   Four out of five Canadians believe that the demands placed on the health system by aging Baby Boomers will result in reduced access and lower quality care

·   75 per cent of respondents fear that growing health costs will result in significant tax hikes

·   And there is also strong support for user fees and having wealthy Canadians pay more out-of-pocket to help ease the burden of caring for seniors

·   Younger Canadians are willing to adapt to the pressures on the system by buying private health insurance to supplement publicly provided care

 

Obviously we are worried – and rightfully so.  But I would challenge the concept that one generation of individuals is going to be totally responsible for decimating our healthcare system.

 

Instead of looking for places to lay blame perhaps we should be looking at the failures in the system as a whole – not just those who use it.  According to a wonderfully written essay titled, “Spare the Policy, Spoil the Profession” by Steven Lewis (www.longwoods.com) “we owe the doctors of Canada a serious apology for spoiling a noble profession.  By kowtowing to organized medicine, we end up with collective agreements and policies that entrench the status quo and keep Canadian healthcare in the dark ages.”

 

Lewis goes on to make another truly poignant observation:  “We should apologize for letting doctors practice in the 21st century with the tools of Bob Cratchit.  Government’s sign collective agreements that condone quill pen medicine – we’re at the bottom of the G7 pack in the adoption of the electronic medical record. Quality improvement tools and techniques are optional. There is no obligation to undergo practice profiling and recertification. Most doctors have no clue about the quality and effectiveness of what they deliver – and those who think they do are almost certainly wrong. The inevitable results: medical practice harms 10% of patients in hospitals; there is routine prescribing of dangerous dosages and drug combinations to the elderly; there is widespread failure to diagnose and effectively manage the most common and straightforward chronic diseases; primary healthcare patients get all of the evidence-based care they need only about half the time; and the list goes on.”

 

Clearly change needs to happen quickly within the system in order for care to improve. We need to make significant investments in health information technologies to help reduce errors, improve the way information is used and to link care across the continuum. There must be a focus on implementing ePrescribing tools to reduce drug errors and interactions and we must collectively find ways to ensure all Canadians have affordable access to the medications they need.


All of us, at one time or another, will need to use our healthcare system – not just the Boomers. Governments, healthcare providers, clinicians and the private sector need to work together to find solutions to ensure the delivery of safe, high quality care now and for generations to come.

Comments

9/12/2010 2:01:14 AM #

I am thrilled to see a commitment to information technology in healthcare on this site. As a Registered Nurse I encounter numerous obstacles in my daily care that could be significantly reduced through the implementation of improved health information technology. Barriers in delivering quality care include: transcirption errors, incomplete clinical information, poor access to existing information and redunancy of clincal data recording. Not to mention the inability of patients to access information regarding their own care or the maintanence of their health.
Information technology is deeply rooted in all other aspects of our lives. So why in 2010 when evidence based practice so clearly demonstrates improved health outcomes with available health informatics do we fail to implement these technologies?
Frustrating to say the least...

Laura Canada

9/16/2010 6:59:21 AM #

It is scary looking at the percentage of budgets being consumed by healthcare and wondering how much longer can we sustain this pace without experiencing another knee jerk reaction of slash and burn (Mike Harris's solution) that can end up crippling the health care system as we know it.
Lets stop looking for scapegoats and really try to fix and strenghten a system that is an asset to all of us.
I would first start looking at the funding mechanism, I think most people in healthcare would agree that it can be more efficient and we need to move toward a more activity based funding which makes more sense as it channels the funds more equitably towards the institutions that are providing the care. I get the feeling we are going there, but the pace is much too slow. One of the main barriers to progress has been the reluctance in some quarters to relate cost with patient care. It is time we got past this and realize that developing accurate costs for our procedures will only benefit us.
a. Properly equating costs to outcomes will ensure excellent patient care remains our area of focus
b. It will provide more meaningful information for funding allocation
c. It will encourage a more efficient use of funds increasing productivity in healthcare
d. I am convinced that our costs per procedure in Ontario hospitals and related outcomes are competitive with any private institution when compared on an apples to apples basis and this will be the strongest defense against those believe that private hospitals are always more efficient.
None of the above is new and there are barriers, but its time we put more effort to move in the right direction while we can still do it in a planned and disciplined manner, the alternative is an ugly end result we will all regret.
The next area should be looking at how efficiently are the capital dollars beng utilized.
a. Are we really spending it on what we need, when we need it?
b. What are the factors that determine the priority on what capital is being purchased?
c. Are our project management skills adequate to ensure we are clearly defining objectives, relating our success measures with current strategy and have the support of senior management?
d. Is there a change management process in place to ensure the change gains acceptance, and the capital installed is utilized as intended to provide the expected outcomes?
There are more questions and comments but these are enough for one rainy day.

Lionel Mann Canada

9/27/2010 7:14:15 AM #

Thank you so much for the thoughtful and informative comments!  I agree that we need to re-look at funding mechanisms and, perhaps, at how the government procurement processes work.

with the issues around eHealth, the processes have become ever more rigorous and by the time an RFP is awarded it's often months or even years later.

We need to find a way to fast-track or streamline the approvals so we can get on with the job of bringing healthcare into the 21st century.

Keep the comments coming!

Janice Murray Canada

1/9/2012 9:17:13 PM #

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