The Alison Redford transgressions thread. Update- Redford quits.

[GP_Matt]

Originally Posted by Fozzie_DeBear

Why do people assume that moving to a private system (which now will have to include profit) will save money?

Will efficiencies from competition > increased cost for corporate profits

If they aren't then the status quo will remain.

One idea is that someone can open up a private practice and bid on procedures. If their bid comes in lower than the current system spends then they can be awarded for example 100 hip replacement surgeries per year at the bid price.

In the current system the family doctors are private already and it seems to be working out. Why can family doctors open their own clinic without ruining the system when surgeons are only allowed to work in government run facilities.

[Jacks]

See what I mean, bring up health care and all people can talk about is the US system.

[CaptainCrunch]

Originally Posted by Mean Mr. Mustard

How would wait times decrease under that system? Do you think that a hip replacement is just a simple in and out procedure? Other than the months of preparation for surgery, education, pharmacists, occupational therapy, physiotherapy, nursing care, rehabilitation, home care, potentially social work intervention, dieticians, and complications that arise... Things are not as simple as you are making them out to be. Actually it is quite laughable how simple you are making this out to be.

I would agree with the previous poster, your exaggerating especially on the whole months of prep.

Hip Replacement while not a simple surgery is about a 2 hour operation, there's not months of preparation and education for it and complications have nothing to do with wait time.

To give you an example a friend of mine just tore his rotator cuff, his doctor confirmed it, he's looking at up to an 18 month wait to get in to see a specialist and then to get the surgery, that's 18 months of effected work and standard of living.

He can book into a private clinic in B.C. and cut that down by a factor of 4, if he's willing to pay for it. Why, Why an 18 month cycle? Because we don't have a focus in the province on actually delivering effective health care. We have too many chiefs and managers and paper pushers and we've lost focus on getting equipment and facilities and doctors and nurses and specialists.

You can take those standard non critical surgeries and give a private option and nobody would be harmed as long as standards are met. Heck you can even implement a system where these clinics have to help reduce the load to the public system.

go in, do a heavy audit on the admin side cut non essential to delivery management levels and take that money and invest it in delivery. AHS doesn't need a billion executives, and managers and redundant senior managers.

I know its a sop to the unions to make AHS a jobs factory for administrators and managers but this health care system is in crisis, it can't afford to be run like this anymore the money needs to be invested back into the system and not into an over inflated payroll

I read a while ago that in terms of scoring for value for the money (services given, wait time, facilities etc) Alberta ranks 6th highest in Canada while spending over 40% of out provincial government on health care.

And absolutely we are an aging province, but absolutely we are spending money on the wrong things.

[Antithesis]

Originally Posted by GP_Matt

One idea is that someone can open up a private practice and bid on procedures. If their bid comes in lower than the current system spends then they can be awarded for example 100 hip replacement surgeries per year at the bid price.

At some point though, doesn't this system become another of the "lowest bid wins" types of scenario? I can't say I'm terribly comfortable of the idea of health care being provided by the for-profit company that had the lowest bid for the service.

Don't get me wrong - I am open to the conversation about health care privatization. I want the best health care system my money can pay for, and for me, best doesn't necessarily mean least expensive (and I'm not at all insinuating that is what anyone is arguing for here).

[Rerun]

Originally Posted by CaptainCrunch

To give you an example a friend of mine just tore his rotator cuff, his doctor confirmed it, he's looking at up to an 18 month wait to get in to see a specialist and then to get the surgery, that's 18 months of effected work and standard of living.

He can book into a private clinic in B.C. and cut that down by a factor of 4, if he's willing to pay for it. Why, Why an 18 month cycle? Because we don't have a focus in the province on actually delivering effective health care. We have too many chiefs and managers and paper pushers and we've lost focus on getting equipment and facilities and doctors and nurses and specialists.

That's 18 months to see a specialist... I wonder how much longer he'll have to wait for the actual operation?

[Rerun]

Originally Posted by Antithesis

At some point though, doesn't this system become another of the "lowest bid wins" types of scenario? I can't say I'm terribly comfortable of the idea of health care being provided by the for-profit company that had the lowest bid for the service.

Don't get me wrong - I am open to the conversation about health care privatization. I want the best health care system my money can pay for, and for me, best doesn't necessarily mean least expensive (and I'm not at all insinuating that is what anyone is arguing for here).

As long as defined standards are being met. Its not like the current system provides the "highest" standard of care.

[Jacks]

Originally Posted by nik-

I also don't want a for profit company responsible for my health care.

Pretend you go see your family doctor and he sends you for a blood test and an x-ray. He then diagnoses you and prescribes a medication and to see a physiotherapist.

Every step of the way you have been dealing with a for profit company, the only way the public system was involved was the multiple layers of bureaucracy that was required to write the cheque.

[CaptainCrunch]

Originally Posted by Rerun

That's 18 months to see a specialist... I wonder how much longer he'll have to wait for the actual operation?

that's the issue right, so at this time his doctor has basically put him on painkillers and sent him home until he can get into a specialist who will then book the surgery, so he's probably looking at 2 years of reduced mobility and living with pain.

[Antithesis]

Originally Posted by Rerun

As long as defined standards are being met. Its not like the current system provides the "highest" standard of care.

Yes, a set of defined standards would have to be in place, along with heavy corrective and punitive consequences for failure to meet said standards. I know that this is certainly the case at the moment, but it is not at all difficult to find examples of private enterprise pushing boundaries regarding what is acceptable. We would need to ensure that this didn't happen in such an important area.

[nik-]

Originally Posted by Jacks

Pretend you go see your family doctor and he sends you for a blood test and an x-ray. He then diagnoses you and prescribes a medication and to see a physiotherapist.

Every step of the way you have been dealing with a for profit company, the only way the public system was involved was the multiple layers of bureaucracy that was required to write the cheque.

But the corporation at the top is the government, not a publicly traded company.

[Mean Mr. Mustard]

[CaptainCrunch;4676593]I would agree with the previous poster, your exaggerating especially on the whole months of prep[/QUOTE]

No, I'm not exaggerating in the least. You need to go through months of workup, people need to meet certain criteria in order to be eligible for a major surgery. There is lab work that needs to be done, education about restrictions, diagnostic imaging, working with other professions, which just takes time, particularly when there are other complicating factors.

I do work for AHS, I do think that there are issues, but I will not delude myself into thinking that private surgery clinics are good ideas, especially when it comes from someone with no experience in the field.

As for months worth of preparation time, often people with a total hip anthroplasty will have to lose weight prior to the surgery in order to even be eligible, often times this will be done under the guidance of a dietician. There is education that needs to take place regarding limitations of activities that would cause issues with the new joint. Occupational therapy needs to ensure that the person has the appropriate tools to operate independently in the home environment, with such things as walkers, raised toilets, handles in the shower... Things that take time and cost money. The physician is involved in ensuring that the patient is aware of the procedure, has informed concent, actually seeing the damage, what needs to be done, actually talking to the patient, doing assessments... Even things like ensuring that the patient has all their dental work completed is an essential component to the surgery. They need to monitor labs, potential infections and complications before they arise.

People often have a 2-3 day stay in a hospital post surgery and the a week or so in a rehabilitation hospital post surgery....

The surgery itself takes 2 hours but to say that there isn't major preparation time in the months would be foolish.

[CaramonLS]

Originally Posted by CaptainCrunch

He can book into a private clinic in B.C. and cut that down by a factor of 4, if he's willing to pay for it. Why, Why an 18 month cycle? Because we don't have a focus in the province on actually delivering effective health care. We have too many chiefs and managers and paper pushers and we've lost focus on getting equipment and facilities and doctors and nurses and specialists.

Couple problems with that. First off the double billing practice (BC gives the clinic / dr money for performing the surgery and they also get direct money the patient).

Add this to the fact that a private job essentially means one less public job. So while he waits 4 months instead of 18, if all the private doctors were actually working in the public system, the wait time would probably be 15 months instead.

[Slava]

Originally Posted by GP_Matt

If they aren't then the status quo will remain.

One idea is that someone can open up a private practice and bid on procedures. If their bid comes in lower than the current system spends then they can be awarded for example 100 hip replacement surgeries per year at the bid price.

In the current system the family doctors are private already and it seems to be working out. Why can family doctors open their own clinic without ruining the system when surgeons are only allowed to work in government run facilities.

The family doctor situation, the MRI situation, these are examples of areas where privatisation has lead to people facing long wait times and not having a family doctor. Its basically the exact opposite of what we want, right? If it hasn't helped here, why would it help to expand to other services?

Originally Posted by Jacks

See what I mean, bring up health care and all people can talk about is the US system.

No one has brought up the US actually.

Originally Posted by Antithesis

At some point though, doesn't this system become another of the "lowest bid wins" types of scenario? I can't say I'm terribly comfortable of the idea of health care being provided by the for-profit company that had the lowest bid for the service.

Don't get me wrong - I am open to the conversation about health care privatization. I want the best health care system my money can pay for, and for me, best doesn't necessarily mean least expensive (and I'm not at all insinuating that is what anyone is arguing for here).

What it leads to is cherry picking by the corporations. They bid on stuff that is profitable, and leave the hard, messy and unprofitable stuff for the public system to deal with. I wouldn't hold that against a corporation, its just good business, but as a health care delivery model its pretty terrible.

[Jacks]

Originally Posted by Slava

No one has brought up the US actually.

I thought it was 2 people but it was just one.

Originally Posted by CaramonLS

We need look no further than the healthcare costs of the US to understand that a private system isn't the answer.

The best health care systems in the world are a combination of public and private, we should be trying to emulate those countries models.

But back to the topic of the thread, Redford is no good.

[GP_Matt]

Originally Posted by Slava

The family doctor situation, the MRI situation, these are examples of areas where privatisation has lead to people facing long wait times and not having a family doctor. Its basically the exact opposite of what we want, right? If it hasn't helped here, why would it help to expand to other services?

Are you suggesting that we move towards government run family doctors where you have two hundred salaried GPs in a big central building?

Originally Posted by Slava

What it leads to is cherry picking by the corporations. They bid on stuff that is profitable, and leave the hard, messy and unprofitable stuff for the public system to deal with. I wouldn't hold that against a corporation, its just good business, but as a health care delivery model its pretty terrible.

In my scenario the private companies have to bid against the established costs of the public system. If they cherry pick the easy stuff it is still saving money. And if there is a bunch of easy stuff that the public system is overpaying for then I would suggest we look there first to decrease costs.

[RedHot25]

Can you guys start a health care thread....

[Rerun]

... and more about Allison and her party....

http://www.edmontonjournal.com/Disgr...794/story.html

Dissenting MLAs can speak their minds, won’t be booted from caucus: Tory house leader

As two rookie Edmonton MLA openly muse about defecting from the Progressive Conservative caucus, Premier Alison Redford’s house leader suggested Tuesday neither would be turfed and insisted the party turmoil isn’t a distraction.

Matt Jeneroux and Steve Young, both first-term MLAs who are among a disgruntled group of Tory backbenchers, are considering leaving caucus over concerns with Premier Alison Redford’s leadership and expense scandals.

Despite their public comments, government house leader Robin Campbell said there are no distractions in caucus and MLAs have their own opinions.

PC party president Jim McCormick said he isn’t looking for a crackdown on those still in caucus who are wavering on whether to stay.

“I don’t think people should be disciplined for their thoughts or expressing them,” McCormick said

Wow... the Alberta PC's are so different than every other political party in Canada. Imagine that.... rookie back bench MLA's being able to publicly express a negative or controversial opinion without fear of censorship or reprisal from the party.

Redford wasn’t in the legislature for question period Tuesday. Her office cited an unspecified scheduling conflict.

... busy lady I guess.... new job interview?

[Makarov]

Originally Posted by Jacks

Pretend you go see your family doctor and he sends you for a blood test and an x-ray. He then diagnoses you and prescribes a medication and to see a physiotherapist.

Every step of the way you have been dealing with a for profit company, the only way the public system was involved was the multiple layers of bureaucracy that was required to write the cheque.

In fact, you are quite wrong. The most important way that the public system was involved was this: at no point did you have to make the excruciating, likely inefficient, decision regarding whether you could really afford to see your family doctor, have the blood test, have the x-ray, buy the medication, or see the physiotherapist.

[Jacks]

Originally Posted by Makarov

In fact, you are quite wrong. The most important way that the public system was involved was this: at no point did you have to make the excruciating, likely inefficient, decision regarding whether you could really afford to see your family doctor, have the blood test, have the x-ray, buy the medication, or see the physiotherapist.

Oh BS, nobody is talking about a user pay system. Give it a rest.

[Resolute 14]

Interesting to see both Mason basically tell the MLAs publicly musing about leaving the Tories to either sh*t or get off the pot. And Danielle Smith with some hilariously brilliant advice, telling Redford that she needs to assert her leadership. It is apparently Redford's assertion of leadership that largely has her in this position to begin with!