Thursday, November 15, 2012

Canadian Health Care System

I hear terrible things about it from my relatives who live in British Columbia. Now there's this story about a Canadian woman who had to be flown to the United States to deliver--because there weren't enough intensive care neonatal units in all of Canada to take care of her quadruplets. From the August 17, 2007 Calgary Herald:
A rare set of identical quadruplets, born this week to a Calgary woman at a Montana hospital, are in good health and two of them were strong enough to be transported back here Thursday.
The naturally conceived baby girls -- Autumn, Brooke, Calissa and Dahlia -- were delivered by caesarean section Sunday in Great Falls, their weights ranging between two pounds, six ounces and two pounds, 15 ounces.
Their mother, Calgarian Karen Jepp, was transferred to Benefis Hospital in Montana last week when she began showing signs of going into labour, and no Canadian hospital had enough neonatal intensive-care beds for all four babies.
...

Indeed, physicians said Thursday the quadruplets have a good prognosis. Although they will likely require between four and six weeks of continued hospitalization, Calissa and Dahlia were well enough to be brought back to Calgary's Foothills Medical Centre Thursday, accompanied by their father.
Karen Jepp, 35, is expected to be transported to Calgary with Autumn and Brooke today or Saturday.
...

Lange said local physicians had been closely monitoring Jepp's pregnancy and were anticipating her newborns would require care at Foothills' neonatal intensive care unit.
But when Jepp began experiencing labour symptoms last Friday, the unit at Foothills was over capacity with several unexpected pre-term births.
There was no room at any other Canadian neonatal intensive care unit, forcing CHR officials to look south of the border.
Jepp was transported to Benefis hospital in Great Falls last Friday -- making her the fifth Alberta woman to be transferred south of the border this year because of neonatal shortages in Calgary. [emphasis added]
One of the criticisms that I have long heard is that Canada's health care system works well for "normal" health care problems, but tends to fail for anything advanced or specialized. I had not realized that premature birth was specialized or advanced. Over at Small Dead Animals, Kate expressed her anger over the failure of the Canadian health care system:
After my mother died, my brother quipped sarcastically that no one should be admitted to Regina General unless they first survived two hours on a vibrating gurney.
Saskatchewan spends $4 billion a year on health - 44% of the total provincial budget - on a population of under one million, and those dollars are increasingly directed to more centralized systems of delivery. While debate about "wait times" tends to revolve around diagnostics and scheduling of surgery (especially "elective" surgery such as knee and hip replacement), few consider the "wait time" facing the farmer in Val Marie with a crushed pelvis or severed artery.
For when it is decreed that your local hospital is no longer "economically viable" (a curious complaint to put forward under not-for-profit ideology), bureaucrats gather a few hundred miles away, debate the best way to release the bad news, and with a big red pen, draw a line through your town. They will apologize, quite properly, while they advise you, quite improperly, to be grateful that health care is still "free." You'll just need to start out a little earlier in the morning to get to it.
Welcome to zero-tier health care.
While the sacred cow of "universality" grazes on in the world of the reality-challenged, vast regions of the country are being transformed into zones of health care prohibition.
With every new cut, more and more rural Canadians are faced with travelling long distances over crumbling roads to seek emergency care - the "vibrating gurney" of the rural ambulance. The only thing "universal" about the system is the rate of taxation and the powerlessness of the very people who pay the bills - the taxpaying patients. The patient taxpayers.
After waiting 10 days on oxygen in an intensive care ward, where it was more likely that a knowledgable visitor would tend to a distressed patient or dysfunctioning equipment than any of the five nurses charged with holding down chairs, we began to wonder when the lung specialist planned to show up to discuss our mother's condition.
He had to be reminded, as it turned out. Standing over the duct-taped linoleum, he shared the diagnosis and advised it was terminal. With no hope of treatment, we arranged for her return by ambulance the 120 miles to our local rural hospital, where she was finally treated for pain and was tended to by a nurse she knew as a friend. Thank heaven for small mercies - for it had been slated for closure earlier that year.
Along with Kate's depressing story, there are gobs of comments by Canadians (some of them in the health care business) recounting what a disaster it has turned out to be:
Thanks for reposting this. It made me think of my own Mom's passing away in 1997. She had liver cancer. My Dad had to threaten to punch a hospital manager back into the stone-age just to get her moved out of the hallway. At the time they had an entire wing shut down. Not economically viable, apparently.
This was in Toronto, by the way. I will never forget that and what they put our family through.
and:
It's not just rural areas that are suffering. My wife’s elderly grand parents have been to the emergency room in Mississauga 4 times in the past few years. They have not had to wait less than 6 hours on any of those visits. Even the local clinics for minor stuff usually come with a 2 hour wait. There is no benefit from our health care system to working people in this country. We get poor service at a premium cost.
and:
Here in B.C., one of the biggest problems, once you get outside the Lower Mainland, is lack of specialists in most communities, requiring long trips to the few communities where said care is available.
Combine that with drastically overcrowded and under equipped hospitals, and you have a situation where medical staff are in constant crisis mode.
This causes a lot of good people to take early retirement, exacerbating the shortage of staff. Governments talk of recruiting in Third World countries to fill the positions. The fact that those countries will now have shortages doesn't seem to matter, even while we're castigating the U.S. for raiding our doctors and nurses.
Eventually, even the most "socialist" will realize the current system is failing, probably when enough of us die in the Emergency ward, and we'll have to open the system to private medical providers.
and this comment that reminds of the joke about how in most urban areas, "Order a pizza. Dial 911. See which gets there first." Profit motive may not make us very happy as a method for getting people taken care of, but it's reliable and consistent in getting things done:
Another personal story: My dog was sick so I took her on a weekend to Vetrinary Emergency Hospital paid the fees and she was attended to in 30 minutes. My daughter had to be attended to after a cat attack and went to the local emergenency for the required stitches and shots.It took 4 hours but it was paid for indirectly by my taxes. What kind of society offers faster treatment to its pets than to its kids.Welcome to Leftyland.
and this remark from a Canadian doctor:
The problem with a monopsony (fi you want to define the Public Health care system that way) is that it results in an inefficient quantity purchased as compared to a competitive market.
As a doctor I can tell you that in our system people suffer constantly due to this.
In addition there are many medications for both cancers and auto-immunue diseases not covered by our system which are covered by both the priavte and public systems in the US.
Moreover our system results in worse outcomes in terms of mortality and morbidity for myocardial infarctions and cancer therapy compared to the US.

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