Category Archives: healthcare

Some healthcare rambling.

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Consistently in Canada we see opinion polls that indicate that healthcare is at the top of people’s concerns. It is undeniable that the vast majority of Canadians consider the provision of healthcare as one of the most important roles that government has. Despite such concern on the part of Canadians, the closed-minded attitudes and profound ignorance demonstrated by Canadians when it comes to any discussion of healthcare is staggering. One would think that an issue of such apparent importance would compel people to educate themselves on the issue itself. Alas, one would be thinking wrongly in that case.

Canada’s health system has been turned into a sacred cow. The only discussion allowed regarding our system is one of how much extra spending to dedicate to it. Should anybody dare peep about changing the status-quo in any sort of way they will be greeted with shrill hysteria and the discussion will be shouted down.

I frequent quite a few discussion forums on the web. Some I participate in and some I simply lurk on. One site I particularly enjoy is the Calgary Puck Forum.  The puck forum is a Calgary Flames fan site predominantly. Due to the volume of posters (that being due to the vast numbers of Flames fans out there of course) and the seasonal nature of the sport, there is a very busy off topic forum.  Things discussed in that forum range from light distractions to some pretty deep political issues. What I really enjoy at the site is that this is not a political based site of one stripe or another. There is no mandated left or right leaning to the discussions. Reading sites like that gives a person a much better idea of the thinking of the general public than any outright political site would be able to provide. I stick to lurking and not posting there as they have a great site and do not need my opinionated arse messing with it.

 As with any site that has a degree of political discussion, Canadian healthcare pops up now and then. Like any other sites on that issue, the discussion became extended and heated quickly.  The only real sad part was how quickly that conversation degenerated into the usual myopic and unproductive path that dominates Canadian healthcare discussions.

 To begin with, the shrill defenders of the status-quo immediately trot out horror stories within the American health system. This is standard tactic and unfortunately is effective. The debate immediatelybecomes polarized and turned into some sort of all or nothing debate discussing the merits of fully private provision versus fully socialised provision.

 Lets get something straight here:

CANADA AND THE UNITED STATES ARE NOT THE ONLY HEALTH JURISDICTIONS ON THE PLANET!!!!!!!

 Both systems are flawed and unsustainable. Think of it this way, are you more dead when you die on a waiting list or more dead when you die due to lack of coverage? Doesn’t really matter now does it?  

There are dozens and dozens of healthcare systems in the world. Many of those systems rate well above both the American system and our own when outcomes and cost are measured. In the last world ratings Canada had plummeted down below 30th place and was still falling.

 So what are the other 29 (and growing) countries doing that we are not? To hell with the American system. I don’t care what they do. I want to see successful systems. I am saying that again as when discussing this in person I have yet again reached a point where it is realized that I would like to change our system and somebody feels that it is time to try and sidetrack to the USA model again.

 To begin with. we have to look at why Canada’s system has been dropping in the rankings. Sadly, only Cuba and North Korea share Canada’s outlook of actually outlawing private healthcare. Think about that. Our system strangles any chance of innovation and reform and our almost religious-like protection of it assures that discussion of reform is stunted as well. If we can’t even discuss or try minor reforms within the system itself, it is inevitable that the system will stagnate.

 The demographics of Canada are changing. The baby boomers are getting on and thus need more and more treatment. Drug and diagnostic technology has grown by leaps and bounds but it is getting more expensive as well. The bottom line is that we need to spend an ever increasing amount of money simply to maintain our current standard of service. The real tragedy is that we have made massive increases on the amount spent on healthcare and the services have still declined.

 Socialized medicine means rationed medicine. Recent court rulings have literally found the waiting lists in Canada to be unconstitutional and the lists only grow longer. In scanning the newspapers around the country, one can find a person almost daily who has died while waiting for treatement in Canada. The stories of people living in agony while waiting years for knee or hip treatments are endless. Increased spending has done nothing to aid with this.

 In summary, our spending is exploding and our outcomes are deteriorating. While most would agree that such a trend is completely unsustainable, most still see challenging the status-quo as being akin to blasphemy. I wonder and fear how bad things will have to get before Canadians finally begin to treat what they see as one of their most cherished institutions with a little critical thought?

 France has consistently led the world rankings in healthcare systems. While the French have not mastered personal hygiene, they have clearly found something in healthcare that works. The French system offers universal coverage (yes everybody is covered), spends less per-capita on healthcare than Canada and has no waiting lists. How is this possible? Here comes the dirty word. The French have created a system that mixes private and public involvement. Here is where the average Canadian tries to digress into a hysterical comparison with American care again. Well shrill defender of the status-quo, blow it out your ass. I am seeking solutions not religion. Bringing up the American system when discussing Canadian healthcare is essentially an intellectual Godwin award.

 The public/private mixture in France provides many advantages. I am going to commit another form of Canadian blasphemy; I am going to compare healthcare provision with a business. The patient is the consumer. Now, what in every situation on the planet is the worst circumstance possible for a consumer? If you said “a monopoly” you are absolutely correct. The consumer is inevitably shafted when there is only one provider of a service or product. In Canada healthcare is a government monopoly and it shows in the terrible outcomes. Competition in some form or another is essential in the provision of any service. Why and how would any institution innovate if there was no competition? What incentive is there? Competition need not be a wide open free for all, it can be limited and regulated. Currently in Canada there is zero competition. Competition is illegal. In Alberta we are not even allowed to see the ratings of our hospitals for fear that it may shame the management of one or another of them.

 OK lack of a competitive model is stunting the management of our system and the efficiency. Now what else is causing the intolerable waiting lists? LACK OF SPECIALISTS. Unions have framed the debate well in this regard. When it comes to allocation of our increasingly scarce dollars the unions scream and demand that we have more beds. Not more diagnostic equipment, not more surgical theaters they only want to see more beds. Why so you ask? Well that is the normal self-serving nature of unions. You see more beds means more unionized nurses, LPNs, laundry services, dietary services etc. Machines and doctors don’t fill the union coffers even if indeed they do cure people.

 If we had the specialists that we need, we would not need all those beds for Canadians to languish in while waiting for specialized treatment would we? Now why can’t we retain specialists? This gets back to competition again. Set aside your ideals for a moment dear reader and have a look at reality. Specialized medical graduates have put in more than a decade of post-secondary education and are often entering the workforce six-figures in debt. These graduates are people too. They have aspirations for a family, a house, vacations etc. Now, like it or not, there is a competitive world market for these graduates. Canada’s socialized system makes it rather tough to gain or retain specialists as the compensation is capped and the specialists are overworked. While homeland and family ties are strong draws for people, it is hard for a new specialist who is deeply indebted to resist an offer of twice or more the compensation for their services in a foreign jurisdiction (not always those darned Americans by the way). The brain-drain is greatly harming our system.

 Again, a public/private hybrid need not be all or the other. Just for a ballpark example, lets say that we allow a group of specialists to open their own clinic and charge directly for services. We can still regulate this folks. Lets say that these doctors have to do 60% of their procedures within the public system at a set rate per procedure and they may charge whatever they like for the remainder of the 40% assuming they can find folks who want to pay it. This allows innovation and extra compensation to maintain these specialists.

 Now of course the envious will yelp  in indignation: “how dare people pay to get ahead of me in line!”. OK folks, this is one of the hard parts to understand. The “rich” will drive better cars, have larger houses, take nicer vacations, drink better wines, eat better foods and likely will be ****ing better looking women/men than you. Get over it. This is life. Instead of trying to drag these folks down, how about aspiring to get to where they are for a change?

 These mythical and evil rich actually make healthcare provision faster for people in the public system when hybrids are allowed. By paying extra to get faster treatment, that much public money is saved and a facility with specialists is funded. When done correctly, everybody gets faster and better treatment overall and for less public money as with in France.

  That hurdle of learning to get over the envy is tough with some folks however. I have debated many who even when it is absolutely proven that such systems benefit the whole overall, would rather stick to the current system. These people would rather see people die on waiting lists than conceive that somebody bought better or faster treatment. Yes, socialism is the equal distribution of misery indeed. Who are truly the cruel in this healthcare debate?

 A reality to be faced is that many people of means jump the line anyway. These people simply leave Canada in order to do so. If indeed this is going to be done, why the hell can’t we allow them to spend that money here? Lets keep our money and specialists in Canada. If done properly, we could supplement our health system with the revenue generated by foreigners coming here for treatment. Yes, we could actually profit from this (oops, profit is evil isn’t it).

 It is not simply “rich” people who are fleeing Canada for timely treatment. The people doing this are simply the desperate. Imagine this, you are diagnosed with a potentially fatal heart condition. You are scheduled for surgery in 18 months. Chances are however that you may suffer from a fatal heart episode within that period of waiting. You have a choice; roll the dice with your life and wait. or you can remortgage your home, fly overseas and get the procedure done within weeks. The home equity and RRSPs really don’t mean much when your life is on the line. This is happening all the time in Canada people.

 Is every concept that I pointed out in my extended rant completely correct? Perhaps not. Until we have a real discussion of healthcare options we will not be able to find out. Canada’s system is unsustainable and a crash is inevitable. The earlier we can set the sacred-cows aside and begin to look at what really may or may not work, the better we will be when the transition that must come occurs.

 The first step in improving Canada’s healthcare is for people to admit that the system is not perfect. We still are a long way from people generally accepting that unfortunately.

She’s just a celebrity folks.

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 Medicinal quackery knows no bounds. There are people who swear by crystal healing, ear candling, touch therapy, a frightening variety of enemas and herbs that cure everything from the sniffles to brain cancer.

 Hey, if people feel better trying such methods to cure disease and they want to pay for it themselves; go to town. I only become annoyed when the “alternative medicine” crowd does two things; ask for public funding for unproven therapies, and encourage people to eschew the use of conventional medicine for real conditions.

 A common thread for those who are locked in the world of witch-doctory is an irrational distrust of scientifically proven medicine and an almost evangelical compulsion to try and spread the word on their chosen conspiracy theories.

 The anti-vaccination group is one of the most kooky and dangerous out there. I say kooky as the evidence of the benefits of vaccination is rather overwhelming. How many people have we seen suffering from smallpox lately? Where did the polio epidemic go? What has happened to general life expectancies since inoculation became a broad practice? These people drift into the realm of dangerous when they lobby against such a clearly beneficial practice and they truly do put our children at risk with their odd notions.

 Most of the anti-vaccination nuts simply roam the internet spamming discussion forums with baseless links and youtube videos that they feel proves that the medicinal community is trying to kill us all with vaccinations. These cranks are easily dismissed as their case holds no merit. Unfortunately, now and then a celebrity jumps into the mix and gives a degree of perceived credibility to the baseless claims against things such as vaccination. Jenny McCarthy has been working hard on this one.

jenny mccarthy

 As we can see in the picture above, Jenny is well qualified for the role of being a former Playboy bunny as she is. McCarthy’s nude modelling hardly qualifies her as a medical expert however.

 It is a sad reflection on society that celebrity status often holds such weight with public opinion. The army of researchers and physicians who constantly demonstrate the scientifically proven benefits of vaccination are ignored by some as they take the medical council of a person who has only proven to be qualified to flash her boobs in a widely circulated magazine. Wake up people!!

 In Time magazine this month, Jenny spouted the profanity laced wisdom below:

“I do believe sadly it’s going to take some diseases coming back to realize that we need to change and develop vaccines that are safe. If the vaccine companies are not listening to us, it’s their f___ing fault that the diseases are comingback. They’re making a product that’s s___. If you give us a safe vaccine, we’ll use it. It shouldn’t be polio versus autism.”

 

 How profound. Never mind that the link to autism caused by vaccination has been repeatedly and completely debunked. Unfortunately Time magazine has a wider circulation than medical journals and McCarthy is easier on the eye than a pale researcher who is pointing out scientific fact.

 Jenny McCarthy would rather see massive outbreaks of diseases that kill children than accept the proven fact that there is no link between vaccination and autism.

 McCarthy’s crusade against science, common sense and fact has been going on for a couple years now. A website calculating the sickness and death potentially caused by Jenny’s vapid actions has been formed. I hope the count does not grow much more.

 Most people can rationally dismiss the kinds of claims that Jenny is making. Unfortunately, those few who have been listening to nuts like Jenny are not only putting their children at risk, they are putting all children at risk. Vaccination needs to be in broad use in order for it to be most effective. We can look forward to outbreaks of diseases that we had previously thought conquered if enough people listen to the pap McCarthy is spewing and the price will be dear.

 Keep in mind, many celebrities have fallen for and are promoting Scientology as well. That religion was created by a science fiction writer for crying out loud.

 Mass exposure does not mean instant credibility. I wish more people could understand that. Vaccinate your kids.

Something is very wrong.

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 Last week while at a local convenience store, I observed a young man demonstrating the telltale signs of being homeless. His hair and beard were overgrown and unkempt and his clothing was filthy. He appeared to be in his 20s and he got in line behind me. The young man was very polite at the counter as he deposited a handful of mixed change in order to purchase a cigar. What was most striking though was that when this man spoke it became quite obvious that this man was suffering from a developmental disability.

 About a month ago I had the opportunity to be taken on a tour of  The Vocational and Rehabilitation Research Institute by a friend. This is a non-profit institute that works in affiliation with the University of Calgary and has been doing so since 1969. This institute works with people with disabilities and helps them in a community support sort of role. The facility boasts a bottle depot and a contract with the Calgary Airport that employs people with disabilities. There are also some great recreational and rehabilitation facilities provided as well as their research facilities.

 I am sure that my description of the facility is doing it terrible justice so I do suggest that people click on the link to it in order to learn more about it. What I was most impressed with was that the people there are dedicated to trying to find rational and successful approaches to helping people with disabilities in our community.

 What I was not impressed with was the condition of the facility itself. While the functional areas were as well maintained as possible by staff with limited resources, entire sections were completely shut down. The building is getting old and they simply can’t afford the maintenance on sections of it. Old dorm rooms are now being used as offices and I saw three desks jammed into what obviously served as an individual dorm rooms for patients. The floors above that level were completely closed as was what used to be a cafeteria.

 Right-of-center people are often referred to as uncaring ogres and individualists to the point of not caring for anybody aside from themselves. In reality, most conservative-minded people live by the principle that we should take care of those who can’t take care of themselves as opposed to those who won’t take care of themselves.

 It should go without question that many people with mental disabilities and disorders fall into that category of not being able to take care of themselves. The degree of need varies from some limited community support to full institutional care.

 So why the hell is this realm of government programming so chronically underfunded?

 Crime and homelessness are constantly issues that people are concerned about. Unfortunately the solution always appears to be blind spending. For a person with a mental disability, affordable housing is not going to be of aid. New expensive downtown public washrooms will not help these people nor will expansion of homeless shelters. What is required are programs suited to helping these people based on the unique challenges that they face.

 Sadly, facilities such as the The Vocational and Rehabilitation Research Institute do not provide for the photo-op ribbon cutting ceremonies that new public toilets and expansions of homeless shelters provide. Such help for people is complicated and not romantic thus gets ignored by politicians.

 Decades ago a misguided initiative of deinstitutionalization took off in general public policy. It was considered inhumane that some people be kept in institutions for life and many people have been tossed in the streets due to this. Many of those people never should have been discharged and many of these people are the ones we see covered in rags under our bridges. The number of beds in mental health facilities in Canada are now a fraction of what they used to be. That statistic is not a victory, it means that thousands of people were put out on the streets that never had the life-skills required in order to make it on their own.

 I am not fond of the NDP. They are far to the other side of the ideological spectrum from myself. Credit must be given to the Alberta NDP today though for their persistence in obtaining and exposing a damning report of the Progressive Conservative’s treatment of mental health needs in Alberta.

 As is all too common with our provincial government, they have acted very strongly to suppress information that they determine to be detrimental to the Progressive Conservative Party of Alberta. A report entitled “Beyond Beds…to Balanced Care Mental Health” was commissioned and presented to Alberta Health and Wellness and the Alberta Mental Health Board in 2007 and was approved by the Steering Committee on Mental Health.

 The report then disappeared.

 Alberta Health and Wellness refused an access to information request by the NDP to see the report. Albertans paid for this report, why the hell can’t we see it? It took a leak (somebody, somewhere has a conscience) for the NDP to obtain the report.

 It is easy to see why the Progressive Conservatives wanted to hide that report. The report is very damning of the government and their complete inaction on mental health issues. It shows that Alberta has four times fewer mental health beds than the national average. The national average is too damn low as it is.

 Rather than act on shortcomings, our government works to hide them. The Stelmach government does not care about our most vulnerable in society, they simply want to remain in power.

 While on their decade long spending spree, the PC government has more than doubled provincial spending. While pissing away our tax-dollars to who knows where, the PC government was also starving our mental health programs to the point where Alberta is the shame of the country. How do we spend far more per-capita in Alberta than any other province yet have the least amount of mental health beds? What are the priorities of our government?

 It is past time to do more than pay lip-service to crime and homelessness in Alberta. How much improvement would we see in these areas if we invested in helping people with mental challenges instead of working to hide them? We will never know the answer to that as long as Ed Stelmach remains in power.

 Keep these thoughts in mind every time you see some poor soul dressed in rags while pushing a shopping cart and talking to themselves.

Why are we not dropping like flies?

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It seems every day I pick up the paper and read about how or why we are all reaching some kind of Armageddon due to our modern lifestyles. Whether it is somebody insisting that pesticides are killing us, to the idiotic and baseless anti-inoculation crowd, to the global warming kooks telling us that skin cancer will wipe us all out, to the anti-Genetically modified foods bunch, to the organic foods bunch, to the “alternative medicine” crowd and on and on and on.

Why do people feel this need to distrust technology? Why in light of the obvious fact that we in Canada are healthier than we ever have been do people feel compelled to jump on the fear bandwagon? People are afraid of modern medicine. People fear any chemical that they can’t pronounce. People are afraid of development and expansion.

One of the easiest stats to accurately trace is life expectancy in developed nations as we are prone to keeping good records of deaths. As of last January, the average life expectancy in Canada was 80.4 years.

I am having trouble finding the historical data for Canada, but the USA is similar. In 1900 life expectancy was 48.23 years. In 1950 life expectancy was 66.31 years.

 Is the trend clear enough for anti-development kooks yet? It appears not. Despite all the nasty pollutants and evil modern medicines, we are living vastly longer than we had only 100 years ago.

 When I hear some idiot telling me that their herbal remedy or whatnot is good as people have been using it for hundreds or thousands of years, I need only ask how long people expected to live only a hundred years ago. No need to go back thousands when the expectancy was about 30 years.

 The eco-nuts claim our lifestyles are unhealthy due to development. Well by that logic, undeveloped regions of Africa should enjoy blissful health should they not? Alas, in those parts of Africa they are struggling to live as long as 40.

 No we should not blindly accept any technological advancement and assume it is good. No we need not get rid of every old remedy that has been out there for a long time.

 We do need to end the fear-mongering though. The industrial revolution, capitalism and development have been the best thing to ever happen to mankind. One need only look at the life expectancies of undeveloped or non-capitalist societies in order to see that.

 Give me my chemical based medicines, pesticide laden foods, GM foods, vaccinations and modern pollution of the air. I want to see 100 years of age and with the direction life-expectancies are going I stand a reasonable chance of that.

Tax dollars at work.

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 I see that Ontario has resumed covering sex-change operations within their healthcare system. I wonder how long it will take before Alberta follows suit?

 Of course in trying to justify this utterly elective procedure, it has been pointed out that the de-bonings will only cost around $20,000 each. That must be comforting to people dying on waiting lists in Canada’s increasingly unsustainable socialized healthcare system. I would hate to be the nurse who has to explain to somebody; “I am sorry sir, we will have to delay your bypass surgery a little longer, the operating room is occupied by a man getting his weiner removed.”

 Well, clearly the push will be on soon for Alberta to cover these procedures. We have a few million people here and doubtless there has to be at least a handful who want to have healthy and functional portions of their bodies removed on the taxpayers backs.

 In anticipation of this, I am offering my surgical services for sex-change operations right now. My procedure will have the same outcome and will only cost $200 per organ. My special offer costs 1% of the Ontario procedure. I have invested in the required materials that are pictured below. 

Anesthetic.

Precision surgical organ removal tool.

Infection prevention.

Covering for the incision so the patient may leave my garage.

 Until the public system in Alberta can create casterati at a price comparable to mine, I would say there is utterly no reason to burden our doctors and hospitals with those excess peckers. I look forward to doing many procedures.

Fivefeetoffury kinda says it well too.

UPDATE

 With more digging I have found that sex changes are already covered in Alberta.

 According to Egale: “The Alberta Health Care Insurance Plan (AHCIP) covers SRS and a variety of related procedures including chest reconstruction and breast augmentation.

SRS is performed in a Montreal clinic while Alberta physicians perform the other procedures.”

 So not only are taxpayers paying for these operations, we are paying to fly people around the country to get them.

 In looking at Alberta medical benefits legislation however I find this: “

Alteration of appearance surgery

8   No benefit is payable with respect to a surgical procedure for the alteration of appearance performed for emotional, psychological or psychiatric reasons unless the Minister gives approval prior to the surgery being performed.” 

 Now would not the statement in the legislation preclude the wishes of these folks seeking to have their jewels cut off? Does the Minister approve every request?

 I must say I am confused (not so confused as to forget my own gender however).

 Hey, if somebody wants to surgically mutilate themselves, I truly could not care less if they are paying their own bill. Our healthcare system is way overtaxed as it is however and there are higher priority things to be done before paying for noodle removals.

 Now what am I going to do with all that stuff I bought for my garage surgery?