Health must become patient focused again
By Letter to the Editor on January 15, 2020.
In 2006 we tried doing hip and knee replacements in publicly-funded private clinics. Health Resources Centre in Calgary was doing 900 orthopedic surgeries per year. In 2010 it declared bankruptcy and the taxpayer was left responsible for the outstanding costs. The health authority acknowledged at the time that they had no choice but to pay 10% more for surgeries performed in the hospital setting as there was a shortage of operating rooms. Private clinics perform cataract surgeries now and we still have a long wait list. Will moving hip and knee replacements outside the hospital decrease wait times? Our system has flaws. There are caps on the number of cataract and joint replacements each hospital can perform. This leaves no ability for the surgeon to reduce his wait time. Operating rooms are not being utilized in the most efficient way. There are operating room closures in the summer, at Christmas and other times. There are limits on the amount of operating time available to each surgeon. The operating rooms are being left unused for large periods of time. Some of it may be due to lack of specialized staff but most is due to the budget. If the operating rooms are not being run more efficiently and there’s no increase to the caps on cataract and joint replacements, how is taking surgeries from the public system (and the money I assume) to the private system with potential cost increases going to reduce wait times? My understanding is the number of surgeries to be performed is not changing, just the venue. There is definitely room for improvement, and throwing money at health care is not the solution. But starving it of funds, underutilizing the space, a constant state of chaos, decreasing frontline staff and adding more bureaucracy will not fix it. Nor will privatization. Bureaucracy has pushed decision makers away from the most important part – the reason for public health care – the vulnerable patients and families. To find solutions we must work with everyone, and value and respect the ideas and opinions of all frontline workers, not just give them platitudes. Patient-centred care must become patient-focused care again. That is why we are here. Kathy Baker Medicine Hat 10-9
I would like to clarify the situation with the bankruptcy of Health Resources Center. It was open and running efficiently for five years in a facility that Mr. Klein had closed. The financial decline and subsequent bankruptcy was a result of a decision to expand and open a new facility. Whether or not Health Resource Center would have continued to provide hip and knee replacements if that decision was not made is speculation. Regardless, it did provide insight into what could be a successful integration of privately funded facilities, and obviously the converse. The question is, should Alberta remain rooted in a costly system no longer able to meet the needs of patients and threatened by ever increasing costs. It is not sustainable.
As an aside and response to your comments on patient centred care, I recently read a fascinating report: Agents of change: Physician Productivity in the Canadian healthcare system, which raised an interesting point. Patients have no accountability. This is a problem. We point our fingers at physicians, administration, government etc. and rarely if ever consider our impact on the cost of healthcare. Our belief in universal healthcare as a basic right combined with our ignorance of cost has allowed us to blindly seek services and demand tests and treatments which are either not needed or frankly futile. How do we address this abuse? We all have a role to play to not only preserve what works, but also improve what is broken. That can only be done without confirmation bias regarding the definition and structure of universal healthcare.
Unfortunately lefties think universal healthcare means unlimited healthcare. People just can’t handle the hands they are dealt with in life or think everyone else is to blame for their poor life choices. Double knee or hip replacements on a 90 year old is hardly an efficient use of resources. Slippery slope, you bet, solution, you got me. I would think this is where the big, bad boogeyman two tier public/private would work. If a person has the means to get the work done and is happy to pay for it, what’s the harm in that?
Your clarification of HRC is limited in a few respects. The HRC generally accepted patients with little or no co-morbidities, and when patients had complications they were sent to public hospitals. A review of the costs associated with delivery of services @ HRC, revealed that the taxpayer paid 5.5% more per joint replacement.
Of course acceptance of patients with co-morbitities would not be an option. Obviously limitations in these facilities are necessary. I suspect you read the Parkland Institute’s report. Although it claims to be non-partisan, I believe it to be rather left wing. What I gleaned form the report is the HRC served its purpose as an innovative solution, albeit flawed. The future of healthcare in this province relies on change.
Many of us true conservatives get a little tired of these Alberta seniors who automatically label us left-wing if we don’t agree with their way of thinking . In my conservative world the MLAs from the Lougheed era pointed out that you could believe everything the Parkland Institute told you. They made it crystal clear that the fact is they are a division of the University of Alberta and wouldn’t dare spread any lies about anything they say or it would likely cost them their government funding and therefore their jobs was good enough for me. Over the years I have never seen any of these so-called governments dispute anything they have published, have you?.