Fixing The Healthcare System
Sunday, December 17
The problem is not that we are spending too little but our current system's structure prevents the reduction in healthcare costs. This is not just a Canadian issue but also very much an American problem. Americans spend $1.7 trillion a year healthcare costs and instead of government paying 70% of healthcare costs in Canada; the American government covers 36% of healthcare costs. That's right our beloved healthcare system in Canada is 30% privately funded and the US doesn't have 'fend for yourself' care. The Canadian system is more like the US than one might think and both systems are horribly flawed and in need of significant reform.
The first thing we must understand is healthcare is a service and is currently administered for a fee, paid for by the patients/taxpayer. We are all aware of the 3 basic needs for life: food, clothing and shelter. All three of these products are offered through private industry and it works very well if I do say so myself. What we need to do is start transitioning our healthcare system to a highly regulated privately funded sector. Much like environmental protection where the government acts as a regulator; setting and enforcing standards to be followed, the government need not step in to engineer pollution prevention systems (this is left to the corporations).
It is not as simple as cutting government funding and allowing the free market to work itself out; there's a list of items I'd like to see implemented as part of the reform process.
1) Increase the number of medical professionals. There is a shortage of medical professionals, largely because not enough spaces are being created. Many talented people are turned away from med school every year and even if this results in lower wages for doctors, at least accessibility and costs are improved.
2) Reduce pharmaceutical patent times. The number one cost after primary care is drugs; there is some room to reduce patent times without reducing profits for those investing in research and development of new drugs. The sooner we can get generic drugs, the sooner we can reduce costs through competition and increased accessibility.
3) Ensure a competitive environment for care providers and insurers. It will be the obligation of government to make sure care providers and insurers do not get into a monopoly situation where people are exploited. Competition will reduce costs and create the diversity of services required for such a large and personalized sector.
4) Eliminate political donations from corporations. This is more for the US as Canada has already rolled this out with the Conservative's Accountability Act. This will prevent pharmaceutical companies from lobbying for longer patent times, and prevent corporate influence with regards to a competitive environment.
5) Strict rules with regards to liability when treating patients. One thing we can learn from the US system is the abuse of the legal system for medical claims. This area must be regulated as well so people take some responsibility when they require treatment. Something along the lines of the 'good samaritan law' will significantly reduce potential legal costs for those helping others.
6) Allow professional immigrants to practice. If immigrants went to a respectable institution and pass preliminary testing here, they should be given the opportunity to work. Even if they are ESL, they will be helpful in regions where other immigrants from similar regions. This applies more to all technical positions rather than healthcare exclusively.
7) Creation of charitable care facilities. Charitable care facilities would be privately funded and created to administer care to the less fortunate. Luckily with the initiatives above, the costs of care will be much less. Private fundraising for hospitals is nothing new; this is something we see on an annual basis at most public facilities.
I also advocate other initiatives like more home care instead of centralized care, again to reduce costs. Many companies have turned to the model of 'out of office professionals'. This system works well and this is already something the customers want in a service. Government involvement makes us think there's one and only one way, they are slow to evolve to the needs and suggestions of customers. Having different facilities for different services would help the healthcare system as well. The most expensive costs are associated with immediate/emergency care and people go there with non-critical issues. Costs can be distributed much more easily if they are predictive and measurable. Currently people do whatever they please because they are not paying for the service.
Alberta is the first province in Canada to start the transition to private involvement in the healthcare system. CBC had a story explaining how Alberta has had great success implementing queuing theory (found in private service industries) into hospitals. Addressing patient flow with understanding demand and throughput allows for quicker service with no additional funds. Many waiting rooms have constant wait times where patients wait a constant 30 minutes (as an example) for service; contracting an extra doctor to service those waiting will eliminate the wait altogether. The extra doctor, once the ‘waiters’ are done he can be used elsewhere; as long as lines don’t go longer, flow is created. ie. 1 patient an hour serviced, and 1 per hour shows up, there’s no point in having a line (wait).
We have so much to gain from a fully private healthcare system; it's time we start addressing healthcare costs instead of throwing money at a broken system. It's high time we start getting our money's worth; $102 billion a year is more than enough to buy the best healthcare in the world. We should not fear privatization just because the US has tried and failed; their system is not even close to what I advocate and needs just as much work if not more than ours. If you'd like to read about some of the misperceptions and shortfalls of socialized medicine, I encourage you to read this article.