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Canadian Doctors: Current System is Unsustainable

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Overhauling health-care system tops agenda at annual meeting of Canada's doctors

By Jennifer Graham

SASKATOON — The incoming president of the Canadian Medical Association says this country's health-care system is sick and doctors need to develop a plan to cure it.

Dr. Anne Doig says patients are getting less than optimal care and she adds that physicians from across the country - who will gather in Saskatoon on Sunday for their annual meeting - recognize that changes must be made.

"We all agree that the system is imploding, we all agree that things are more precarious than perhaps Canadians realize," Doing said in an interview with The Canadian Press.

"We know that there must be change," she said. "We're all running flat out, we're all just trying to stay ahead of the immediate day-to-day demands."

The pitch for change at the conference is to start with a presentation from Dr. Robert Ouellet, the current president of the CMA, who has said there's a critical need to make Canada's health-care system patient-centred. He will present details from his fact-finding trip to Europe in January, where he met with health groups in England, Denmark, Belgium, Netherlands and France.

His thoughts on the issue are already clear. Ouellet has been saying since his return that "a health-care revolution has passed us by," that it's possible to make wait lists disappear while maintaining universal coverage and "that competition should be welcomed, not feared."

In other words, Ouellet believes there could be a role for private health-care delivery within the public system.

He has also said the Canadian system could be restructured to focus on patients if hospitals and other health-care institutions received funding based on the patients they treat, instead of an annual, lump-sum budget. This "activity-based funding" would be an incentive to provide more efficient care, he has said.

Doig says she doesn't know what a proposed "blueprint" toward patient-centred care might look like when the meeting wraps up Wednesday. She'd like to emerge with clear directions about where the association should focus efforts to direct change over the next few years. She also wants to see short-term, medium-term and long-term goals laid out.

"A short-term achievable goal would be to accelerate the process of getting electronic medical records into physicians' offices," she said. "That's one I think ought to be a priority and ought to be achievable."

A long-term goal would be getting health systems "talking to each other," so information can be quickly shared to help patients.

Doig, who has had a full-time family practice in Saskatoon for 30 years, acknowledges that when physicians have talked about changing the health-care system in the past, they've been accused of wanting an American-style structure. She insists that's not the case.

"It's not about choosing between an American system or a Canadian system," said Doig. "The whole thing is about looking at what other people do."

"That's called looking at the evidence, looking at how care is delivered and how care is paid for all around us (and) then saying 'Well, OK, that's good information. How do we make all of that work in the Canadian context? What do the Canadian people want?' "

Doig says there are some "very good things" about Canada's health-care system, but she points out that many people have stories about times when things didn't go well for them or their family.

"(Canadians) have to understand that the system that we have right now - if it keeps on going without change - is not sustainable," said Doig.

"They have to look at the evidence that's being presented and will be presented at (the meeting) and realize what Canada's doctors are trying to tell you, that you can get better care than what you're getting and we all have to participate in the discussion around how do we do that and of course how do we pay for it."


Added: Aug-16-2009 Occurred On: Aug-15-2009
By: vicsemprini
In: Other
Tags: Canadian health care, socialized medicine, health care reform
Marked as: approved
Views: 9328 | Comments: 11 | Votes: 0 | Favorites: 1 | Shared: 0 | Updates: 0 | Times used in channels: 1
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  • this is bullshit. our governemnt has been actively doing everything in its power to increase cost of health care while not investing in new discoveries and advanced.
    last year we were supplying one third of the worlds medical isotopes for cancer treatment, and now, due to incompeitence or at worst deliberate action we no longer supply any and have to import our supply at extremely higher costs draining our system of its life blood.
    and unions have been striking all over canada demanding extreme More..

    Posted Aug-16-2009 By 
    rocklives (50.94)

    (3)

  • Leave the Canadian health care system to Canadians and we won't comment on what's going on in the US. Both systems have their merits and limitations.

    Posted Aug-16-2009 By 
    mlivsey (1103.36)  

    (1)

  • "In other words, Ouellet believes there could be a role for private health-care delivery within the public system."

    I'm glad he isn't my doctor - over 30% of our system is already privatized, so yeah I'd say there is a place for it in our system as there has been pretty much forever. But all provinces need to open up to a small amount of privatization, as it is only some provinces allow it.

    Oh, and contrary to what the poster here is trying to present this has nothing to do the healt More..

    Posted Aug-16-2009 By 
    Macky_J (234.60)  

    (0)

    • I think the point of the article is that Canadian doctors see the nationalized system as broken and not patient focused...and not sustainable. This is OBVIOUSLY relevant to the debate in the US, because many of the fears regarding a government run system in the US are realized in the Canadian system.

      "The incoming president of the Canadian Medical Association says this country's health-care system is sick and doctors need to develop a plan to cure it."

      The implication there is obviou More..

      Posted Aug-16-2009 By 
      vicsemprini (1249.88)

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    • I had a lengthy point-by-point response for you but LL ate it and I forgot to save it before I posted, so I'll have to return tomorrow and redo it.

      But I will say for now that I do partially agree with you on some of your points, just not your conclusions.

      Posted Aug-16-2009 By 
      Macky_J (234.60)  

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    • Fair enough...interested to hear your thoughts.

      http://www.youtube.com/watch?v=ab8cDxLNRkE&feature=related

      Posted Aug-16-2009 By 
      vicsemprini (1249.88)

      (1)

    • Alright I'll try to address your points here now, though if anything is confusing it's due to a 12 hour day of pole sanding in extreme heat and humidity and me being mentally and physically exhausted - I'll try to correct it later if I mess something up...provided I don't die from heatstroke first, lol.

      r.

      Posted Aug-17-2009 By 
      Macky_J (234.60)  

      (0)

  • Hmm coming to a country near you.

    Posted Aug-16-2009 By 
    jpeterman57 (589.98)  

    (0)

  • Obama has said many times that the growth of Medicare spending must be restrained, and his budget director Peter Orszag has made it nearly his life's cause. Why then does Mr. Obama want to add to our fiscal burdens a new Medicare-like program for everyone under 65 too? Medicare already rations care, refusing, for example, to pay for virtual colonoscopies and has payment policies or directives to curtail the use of certain cancer drugs, diagnostic tools, asthma medications and many others. Senior More..

    Posted Aug-16-2009 By 
    jpeterman57 (589.98)  

    (0)

  • Firstly, this same statement has been surfacing for 20 years, and will continue. Second, there is no way we will end up with a more privatized system, as soon as a politician attempts it, they feel the backlash. What we need to do is stop spending tax dollars in other countries and keep it at home. Starting with Israel and Afghanistan. There is no valid reason for us to be wasting our money in either place for zero return. There are others, but those two should be first.

    Posted Aug-17-2009 By 
    steveaustin1971 (377.72)

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  • Oops, capitalized a quote tag by accident there and messed up the page. I hate that something so simple does that here, but LL bugs are part of the experience here, eh? :D

    I'll repost here and you can delete the last one - if possible. Sorry.

    ---

    Alright I'll try to address your points here now, though if anything is confusing it's due to a 12 hour day of pole sanding in extreme heat and humidity and me being mentally and physically exhausted - I'll try to correct it later if I mess somethin More..

    : "I think the point of the article is that Canadian doctors see the nationalized system as broken and not patient focused...and not sustainable. This is OBVIOUSLY relevant to the debate in the US, because many of the fears regarding a government run system in the US are realized in the Canadian system."


    It's not the nationalized system that is "broken", it's the way it has been managed and the way in which serious issues have been neglected for decades that have piled up and is causing issues. The same will happen with any system(including a 100% privatized one) when necessary maintenance is ignored or treated in an ineffective manner.

    Both Dr. Doig and Dr. Ouellet are proponents of the nationalized system and want to make it better by integrating it more efficiently with privatized industry(which already exists in many parts of Canada) like they have in many European countries.

    Every system requires maintenance to keep it going but our government hasn't wanted to spend the money needed to actually fix the major issues and instead has pursued band-aid after band-aid.

    It should also be noted that Dr. Doig has been criticized in the past for exaggerating certain things to push issues that she thinks are important(and this one is). Given that there are many doctors who disagree with her on this(about how bad it is, not about their being some problems in general which I think every doctor and Canadian citizen is well aware of) I have no doubt this is a case of exaggeration to push the issue, though I don't mind it if it actually works and leads to improvements.

    : "The implication there is obvious...doctors, rather than bureaucrats and politicians should be in charge of how health care gets delivered."


    This I agree with 100%, the government should provide the insurance coverage for everyone and that is where their direct involvement should end. Any and all other funding should be given to a peer-elected panel of doctors to decide where, how and when it should be spent to maximize the effectiveness of our system.

    : "You do not have a competitive market in Canada. You have a lot of wait lists. Even doctors are now figuring out that competition and the profit motive would help improve the supply of health care there."


    This I also agree with for the most part, I have always been a proponent of having a small privatized sector/industry integrated into the public system to allow for competitive advancement and of course for personal choice. It already exists to some extent but only in some provinces, it should be across the board in all provinces.

    We do in fact have a competitive market to a small extent, but as I already mentioned it's only in certain provinces and that just doesn't work for me - it should be all or nothing in this type of situation.

    To address Dr. Ouellet's "revolution" comment again - he's referring to the way that the 5 countries he visited have managed to integrate the public and private system while still maintaining an even more socialized system than we have here(all 5 of the countries he visited are "socialized" to an extent far beyond just healthcare or postal or educational services).

    In those countries the government is still in control of the system and provides universal coverage but the healthcare delivery/treatment has been split between the public and private sectors to allow for competitive advancement and "freedom of choice" while actually making the universal/nationalized system more efficient and effective due to it's very well done integration of the two sectors. And in most cases rather than people paying directly for the services they pay in taxes and then the government pays the private sector for the services.

    For example - they have electronic records available online for any doctor(with the patient's consent) and the patients themselves, which means that when you go to a doctor all you have to do is say "yes" to them viewing your records and pretty much instantly through the miracle of the internet they have access not only to your typical medical records but also every single prescription you've ever had and numerous other valuable pieces of info which allow for extreme efficiency in dealing with patients.

    In America for some reason the medical industry seems to be afraid of a nationally integrated electronic records system and as a result it can take days or weeks for a doctor to collect all the different records for a patient(which don't provide as much actual info), and even then they may not get the complete records. This is anything but efficient and has in many cases led to medical records being lost completely(it happens here as well to a lesser extent).

    The system is operated and maintained(in most of those countries) by private companies but governmental agencies have oversight of it and the companies are basically contracted by the government(something that happens a lot in America).

    This is the "revolution" being referred to - A government run nationalized/universal system that integrates the private and public sectors for the greatest benefit of the people.

    This is what I'd love to see here, but our current government is probably far too stupid to manage that.

    : "This is a painfully obvious point. Treating patients like the customers that they are would improve the system there. The problem in nationalized systems is that the government is the payer, not the consumer. Customer satisfaction is only marginally important, because the customer isn't paying."


    I disagree on this as it has nothing to do with the government being the payer as they are paying with the patient's tax money and thus the patient is still paying. It has to do with the government not wanting to take the time or spend the resources necessary to provide case-specific funding for hospitals - it's easier to just give all hospitals lump sums.

    To create such an "activity based funding" program would require establishing a system of checks and balances and oversight to monitor the hospitals and patients and patient treatment efficiency and such, and under a Conservative government the idea of spending some money in order to save money and allow money to be spent more efficiently is a foreign concept, especially if it involves expanding government programs. It goes against the very nature of Conservatism, in theory(our Con's seem to pick and choose when it's okay and when not).

    Such a system where you have to pay to save is Liberal in nature and I usually oppose such liberal fiscal policies but in this case I feel it would be worth it, maybe. If done right - and that's a big if.

    : "The line about "how do we pay for it" has everything to do with making improvements and yet maintaining "universal" coverage...which will remain a pipe dream."


    I fail to see how it's a pipe dream, there are at least 5 countries in Europe that successfully accomplished it already. A pipe dream is something that is not really possible, but those 5 countries(and possibly more) have proven it is possible, so a pipe dream it is not.

    : "The point is that physicians see problems when health care isn't patient focused, and is instead controlled by political policy decisions."


    Although I may disagree with you in regards to there being a role for a political/government hand in the system I do agree that healthcare services need to be more patient focused here than they currently are.

    The political part of it needs to remain in the political arena, when a patient is in a hospital then that patient should be the only thing that hospital and it's staff care about. With the problems created by our government's lack of proper maintenance and foresight and especially the funding issues as it is there is too much unnecessary BS is involved at the cost of the patient thanks to politics.

    Attacking our system is easy for Americans because our government has been retarded and is running it into the ground(slowly, it will be many years/decades before the dooms-day predictions of Dr. Doig actually occur, if it occurs at all), but this is not a product of a nationalized system it's a product of poor management.

    There is a reason the opponents of nationalized healthcare in the U.S largely ignore the European countries that have such systems but who actually manage it properly in favor of targeting our poorly managed system. It's hard to say nationalized healthcare doesn't work if you are objective and show all the countries in which it does work, and work better than any solely privatized system could.

    I think what I'm trying to say is this - our government is ******* retarded, but there are many intelligent government's out there that have made a nationalized system work extremely well, so to use our government's stupidity to argue against nationalized healthcare in general is pushing commonsense to the breaking point.

    An American nationalized system would not be exactly the same as Canada's, just as Canada's is not exactly the same as Germany's, or as Germany's is not exactly the same as France's, etc. Every nationalized system is uniquely based on that country's needs and resources available, and one can clearly see by viewing Obama's healthcare bill that the system he is proposing has very little in common with our system beyond the fact that it will be government run.

    I don't see why Americans are using our system as an example either negative or positive, it's not like they are going to come up here and pick up our system and move it south. An American system would be built around American needs, not built around what other countries are doing(although it should factor in, as the doctors in this articles mention).

    If you are going to use Canada as an example either way so to should you be objective and show all the other examples around the world as well to give people a clear understanding of what does and doesn't work and what will suit America the best.

    Both sides that use our system as an example are just fear mongering - the left is fear mongering about the privatized system and the right is fear mongering about our "socialized" system(which is actually quite moderate compared to true socialized system of Europe and elsewhere).

    I think I can speak for most Canadians when I say we're getting really tired of it. We couldn't care less what Americans want in their system and we couldn't care less what they think of our system, most of us like our system the way it is even if it does need some improvements and better management.

    I'm not referring to you specifically as you seem to be a decent person, rather than those a-holes who attack our system and then when we defend it they tell us to "mind our own business" - as if defending our own system from attacks by foreigners isn't our own business.

    Anyways I think that's it for now, I can't remember all the points I had last night to make but I think I got most of them.

    Again, sorry if there is any confusion/errors, I'm too tired to proof read it all right now so I'm just posting. Provided LL doesn't eat it again. <_<

    Oh, and I don't really have much to say about that vid you linked too other than the fact John Stossel isn't exactly known for being unbiased and I've never cared much for him, but I don't really care either way since I've never supported Obama's healthcare bill and all it's unnecessary bureaucracy and crap.

    Obama's proposal is much different than what we have here, and it's what we have here that I'm willing to defend. I've read parts of the bill(I tried reading the whole thing but it's so damn long, even for me) and there are many parts that turn me off of it even though I do support nationalized systems.

    I defend Canada's system when it is unfairly dragged into this debate, but I don't support Obama's plans. Just to make that clear, I supported it when it was just an idea but the plans to put the idea into action are a bloody joke and probably wouldn't fly here either.

    ---

    Let's hope this doesn't just mess it up worse, lol.

    *crosses fingers*

    Posted Aug-17-2009 By 
    Macky_J (234.60)  

    (0)