This evening I saw a commercial for a fundraiser for a hospital in our fair province of Ontario. This is yet another in a long list of lotteries, concerts and general appeals for money to cover the costs of hospital and research budgets. Add to these the fact that people suffer through long waits just to be seen by a general practitioner. For the privilege of seeing a specialist your wait stretches into the weeks and perhaps even months. Our hospitals are staffed with doctors and nurses that are overtaxed with patients and too many levels of management. We can’t hire more productive staff members (ie. not another layer of management) because there isn’t enough government money available. It makes me wonder how we as a country can claim universal access to healthcare.
The heart of the solution is managing the system as though it were a US based health system. I realize that will make most Canadians cringe, but I don’t mean what most people would naturally imply. I don’t believe we need to introduce some sort of pay-per-service or a two-tiered health system. What I believe must happen is that Canadian hospitals must run their hospitals with the philosophy of a for-profit hospital. Consider that all US hospitals run their hospitals with the ultimate of fiscal responsibility. That includes trimming superfluous and redundant expenses. Specifically that means eliminating layers of unnecessary management. This idea comes from living with a nurse who has worked in the OR of both systems. Transitioning from a US hospital into a Canadian hospital she was amazed to see how many levels of management there were in the Canadian hospital. One of her supervisors wasn’t even trained in the operating room. If Canadian hospitals were forced to evaluate their structures and eliminate the unnecessary elements it would free up considerable resources for actual health care. I would like to see a Canadian health system that actually works for Canadians. As it currently stands I think Canadians are victims of a system that simply denies them of critical tests and treatments that could save lives. I wonder how many people have died because they were denied care due to a misallocation of money and resources.
This observation doesn’t solve all the problems. The culture of our Canadian system is too diseased to be altered in one blog post. What we need to do as Canadians is stop bragging about a system that is woefully inadequate. Moreover, we should look at systems, even the American system, and apply the strengths of those systems into ours where applicable. No one in my family is need of critical care. I can’t imagine the frustration of the many who are in such a position and simply can not receive life saving care. What I see is a system that doesn’t work. Instead of universal access we’re relegated to a universal inaccess to healthcare. With an aging population it becomes even more important to repair the system, perhaps breaking it down in order to build it back up again. The longer we wait the harder it will be for anyone to receive adequate health care.