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1/ This is such a crucial question for Americans @DGlaucomflecken so I'll take time to give a fulsome answer because I've written about this.
I'm older than @mverbora so my response is different. In
until the 1990s we had good wait times and were in the OECD top 5 countries
I'm older than @mverbora so my response is different. In
until the 1990s we had good wait times and were in the OECD top 5 countries
2/ In 1989 a report - no research, just anecdotes (Barer-Stoddart)- was presented to the first ministers of - identifying doctors as the driver of healthcare costs. This resulted in a tsunami of bureaucrats to control doctors and hospitals. This is when the underfunding of
- identifying doctors as the driver of healthcare costs. This resulted in a tsunami of bureaucrats to control doctors and hospitals. This is when the underfunding of
3/ doctors and hospitals happened - resulting in our present crises of increased wait times. It is NOT a function of a public system - it a function of too many bureaucrats. This is parallel to what you write about @DGlaucomflecken - imagine the insurance bureaucrats as
4/ those in control of public health. Our doctors are shut out from impact in hospital funding and in any say of the number of doctors that need to be trained.
In the EU - evidence dictates resources - for ex: over 85% hospital capacity means they MUST add beds. In,many of
In the EU - evidence dictates resources - for ex: over 85% hospital capacity means they MUST add beds. In
,many of
5/ our hospitals run at over 100% capacity (unheard of before) because the bureaucrats are ok with this.
So the moral: clinicians - doctors and nurses - must remain in charge of resources or you get an admin run system that never works for patients.
So the moral: clinicians - doctors and nurses - must remain in charge of resources or you get an admin run system that never works for patients.
6/ why doesn’t it work for patients if admins are in charge? Because clinicians use patient-care as their guide. Admins use pencils and charts and want to prove their worth by saving money but increase the funding allotted to them to ‘save’ more money. It’s a very bad structure.
7/ Canada has had some form of public healthcare since the 1960s. It served us well. It meant people didn’t go bankrupt from medical bills. I believe deeply in public healthcare. But not in the system it’s morphed into.
