Do you think the Medical system needs to be revamped? (Discussion/Poll)

[KristoffWixenschon]

9 minutes ago, janisahockeynut said:

LOL, yeah! True enough!

 

I think all I am saying is that our system need some tweaks, and we should not be treated as kids.

 

If I am a diabetic, and am feeling unwell, and refuse to go see a doctor, and I get sicker, I put a larger demand on the system, because I will be using Emergency some day.

 

If, I however diagnose myself as being sick and needing medical assistance, well then I am softening the blow, so I am in fact making a diagnoses

 

All I am saying is that for those prescriptions that do not demand a change in a stable illness, simply seeing a pharmacist should be enough.

 

There are plenty of examples of such things...asthma, diabetes, lotions, some specialists, for some conditions....not all, but some.

 

All these prescription renewals have a cost on the system, that could be reduced or eliminated in some cases

Not all, but some. Completely agree. I think most physicians would agree. My wife is a family doctor and is annoyed when she has to see people just to write the same prescription again. 

Now her patients who are on pain medication for example... that's a different story. You want to be meeting with them regularly and not just renewing meds.

[J.I.A.H.N]

2 minutes ago, KristoffWixenschon said:

Not all, but some. Completely agree. I think most physicians would agree. My wife is a family doctor and is annoyed when she has to see people just to write the same prescription again. 

Now her patients who are on pain medication for example... that's a different story. You want to be meeting with them regularly and not just renewing meds.

Thank you for your comment

 

I also know alot of retired doctors (play hockey with them)

 

Now that they are not practicing.....and have to go to the doctor they also complain about this same issue

 

Money would certainly be saved and could be redirected for somethings............not all of course, which is all I am saying

[UKNuck96]

1 hour ago, Jimmy McGill said:

why does it need to be separate to be effective though? what good does that extra layer of decision making do for you? why have two systems for physician credentials? or purchasing? or capital planning? 

Completely agree, what you want is a single entity for things like medicinal purchasing, medical standards and accreditation’s, and then have local infrastructure in certain areas. That way the core administration is centralised and based on delivering value of service by utilising capital purchasing power to leverage contracts, whilst allowing the local hospitals and local practitioners more time on their core skill with only the administrative needed to deliver that service 

[Chris12345]

13 hours ago, drummer4now said:

Please quit your complaining here in the US people are dying because they can't afford health care. 

 

 

I had to use US medical care once. 

 

Lucky for me I had the resources to pay. Phenomenal care. 

 

So the question isn't how bad their system is, the question is what can we learn?

[NewbieCanuckFan]

32 minutes ago, Chris12345 said:

I had to use US medical care once. 

 

Lucky for me I had the resources to pay. Phenomenal care. 

 

So the question isn't how bad their system is, the question is what can we learn?

Same here.  Had the misfortune of having to use US medical care once as well.  First class service.  Zero waiting time.  Course before they did anything, they asked for my credit card & slapped several thousand dollars deposit charge on it.  I knew I was covered from work (travel insurance), I didn't worry too much (I'd get reinbursed for any charges put on the credit card later).

 

And no, you won't be turfed onto the streets if you couldn't pay.  You'd get just re-directed to one of the noticeably lower tier hospitals in the city (to my knowledge).  I'm guessing, they'd be on a level significantly worse than any hospital here in Canada.  Here's a tip:  if travel restrictions ever get lifted *DO NOT EVER* travel outside the country without adequate travel insurance.  If in doubt, get supplemental insurance - just in case.  VERY easy to accumulate charges in the several thousands of dollars (my ambulance ride alone cost me just under two grand (US$)!).

 

 

Edited April 18, 2021 by NewbieCanuckFan

[JM_]

3 hours ago, KristoffWixenschon said:

You would have a second layer of decision making either way, centralized system or not. Even if you took away the label of health authorities, theres no way a provincial system could operate with a "one size fits all" plan. 

The local health authority has insight into what the needs of their communities are. They (at least try to) spend money on what is actually important to community health, which is different in different areas.

 

I'm not saying that there isnt redundancy and waste in our system. I just dont think it's in the separation of health authorities. I think that leads to better outcomes 

I think a good example to look at is Australia. They manage to deal with an entire country with a lot of central planning and use smaller regional networks to deal with individual area needs. Its very efficient. 

 

What we do here is give a lot of autonomy to each health authority, so e.g., say you want to run out a provincial program. Each individual HA has to then run through the process of approvals, etc. Its just unnecessary waste and there are more efficient models that deliver just as good results. 

[Miss Korea Bob.Loblaw]

Yeah.  We do have a broken health care system.  Prescriptions, dental care, elderly care, and other services should not be entirely dependent on your private insurance.  Some of you guys are arguing for a more privatized system.  I think it should be even LESS private than it already is.

[KristoffWixenschon]

7 hours ago, Jimmy McGill said:

I think a good example to look at is Australia. They manage to deal with an entire country with a lot of central planning and use smaller regional networks to deal with individual area needs. Its very efficient. 

 

What we do here is give a lot of autonomy to each health authority, so e.g., say you want to run out a provincial program. Each individual HA has to then run through the process of approvals, etc. Its just unnecessary waste and there are more efficient models that deliver just as good results. 

I think we just have to disagree.

The autonomy of the health authorities is their greatest strength. Rural medicine does not function the same way that it does in urban centers. You cant have the same process for recruitment and care. 

[UKNuck96]

1 hour ago, KristoffWixenschon said:

I think we just have to disagree.

The autonomy of the health authorities is their greatest strength. Rural medicine does not function the same way that it does in urban centers. You cant have the same process for recruitment and care. 

You can give rural areas autonomy on how they deliver health care while still having a central medical licensing board, centralised procurement, and centralised standards 

[KristoffWixenschon]

2 hours ago, UKNuck96 said:

You can give rural areas autonomy on how they deliver health care while still having a central medical licensing board, centralised procurement, and centralised standards 

How is that really different than what we have now?

[UKNuck96]

2 hours ago, KristoffWixenschon said:

How is that really different than what we have now?

I don’t know the exact setup you guys have but by the sounds of it there more autonomy than what I’ve listed to the point where each health authority is duplicating a layer of administration, and a lack of communication between them, especially in regard the licensing and employment 

[The Colt 45s]

Access to care is a challenge, but not an impossible one. Here in the US, adaptability in the COVID crisis has changed how doctor's work and healthcare is implemented.  I mean, with an app I can be on my cellphone and speak with a doctor, get a diagnosis, prescribed medication, all within a half hour.  This type of care is not meant to supplant primary family medicine.  I do not know what the solution is in Canada, we just need Scrubs to come back on TV.

 

[Ilunga]

On 4/18/2021 at 12:50 PM, drummer4now said:

Please quit your complaining here in the US people are dying because they can't afford health care. 

 

 

What do you about this ?

Do you bother writing to your elected representatives  making your feelings about your medical system known to them ?

 

 

[Ilunga]

On 4/18/2021 at 6:24 PM, Lancaster said:

I'm on both sides here.  My story....

 

My wife and I were initially expecting (fraternal) twins, but one day during middle of the second trimester her water broke.  We obviously panicked, went to BC Women's, but for whatever reason, they didn't have anyone on staff to really look.  No one to man the ultrasound machine.  This wasn't like in the middle of the night, but just around 7-8pm.... or we went to a smaller hospital like Burnaby... this is BC Womens... where they specialized in helping pregnant women.  

A doctor eventually came and just said that maybe one of the water for the baby broke... that we should just go home and rest, that if anything else happens, come back again.  The doctor said they'll schedule for a follow-up and scans next morning.  We were really rattled, but we just listened and went back home.

Next day, came in extra early, was told that no booking was made and that it will be first come, first serve.  We waited for about 4-5 hours and when I went up to the desk to ask again, the woman working there was like, "I know you've been waiting a long time, but you're not really a priority right now...."

Eventually someone saw us and confirmed that water broke, potential for infection, early birth, potentially losing both babies, etc.  Then told to rest at home, and start deciding on whether we should just get an abortion (for both).

Had to wait a few days to see our regular OBGYN as she was on vacation.... saw another OBGYN in the meantime.... he asked if we were opting for an abortion and we said we were still deciding.... the doctor replied, "what's there to think about?" in a dismissing manner.  

Eventually we did see our regular OBGYN, she literally just went from the airport to her office to see us.  She was asking if we needed more antibiotics... which we replied that she was the first person that even mentioned it.  She was a bit shocked that no one prescribed it to us as infection was a serious concern, not just for the baby with the broken water, but the other baby and the mother too. 

 

After that, we just told that mother need to rest and hope for the best.  A couple of weeks past, followed-up with the doctor that handled abortions... we declined as it wouldn't be fair for both babies, especially the one that's still fine.  While remote, there's still a chance that the baby girl can still make it.  We just had to wait for 3 more weeks and she would have met the 23 week threshold required for the hospital to save a preemie.  Unfortunately she only made it to 20 weeks before she decided that it just wasn't meant to be... 

 

My wife was then finally admitted to stay in the hospital.... even though we didn't know at the time, if she was back in Japan or even some places in the US, she would have been admitted to stay in the hospital immediately after her water broke.  That she should have been basically confined to bed rest 24/7.  Sometimes we still believe that if stayed at the hospital immediately, we wouldn't have lost our daughter.

To continue... my wife stayed at BC women's for about 5 weeks.  The quality of the nurses during that time varied... mostly good, but a couple that were less enjoyable to be around with. 

 

From what happened above... my answer will be YES, the medical system does need to be revamped.  We got ****ed a few times already.  Which ultimately resulted in losing our daughter.  Maybe hypothetically, nothing would have changed that... but there were lots of gaps and negligence in care.  

 

Now for part 2....

The other twin decided to come out at week 25.  Now for NICU care... I can say BC Children's perhaps one of the best in the world.  Almost every single nurse were professional and friendly (a few that weren't but they were infrequent).  Supporting staff were also great, the doctors were good too.  There are even volunteers that comes back to hold/cuddle your baby when you are not present (skin to skin is essential at such an early stage).  The brand new facility was also state of the art... each pod with TV, fridge, sofa bed, etc... to allow parents to be as comfortable as possible when being with the baby.  

If we weren't covered by MSP or if we were in the US... it would be between $10000 to $15000 per day.  My son stayed in the NICU for over half year.  To put things into perspective, my son's stay, if pro-rated after a year.... would have almost the same salary cap at Loui Eriksson. 

 

From this, the medical system we have in Canada is great.  

 

 

Part 3:

My son still needed assistance after returning home.  Oxygen support, CPAP, g-tube feeding, etc... so expensive machines, and pricey food, medical supplies, and round-the-clock care required.... fortunately everything was covered by the government.  Our machines would have costed about $10000-12000 if we had to pay ourselves, each feeding bag was about $10 bucks and they are supposed to be changed daily... he had a g-tube for almost 3 years.  Other random medical supplies costed a few thousands more.  The special food he was on goes for about $10 per pack... and he gets about 3-4 per day for a few years.  Then there was private nursing care he received so my wife and I can actually get some sleep at night... they aren't cheap, so plus a few tens of thousands of dollars more.  

 

The follow-up support we have on-going are a hit and miss.  Lots of information gaps between different groups, sometimes decisions are made and no one bothered to tell us about it, etc... but overall, not bad.  

 

From all this... the medical system in Canada is great.  

 

 

Overall.... the system here isn't good enough at times, but superb in other times.  I hear of stories where some parents don't have enough insurance coverage to give the best care to their preemies.... but yet on the other side, I hear of situations that matches what my family went through, but they got way better service and treatment.  Hard to complain about a medical system that provided more than $3 million to save your son... but why didn't they seem to care as much for the other baby?

I am so sorry to hear about your loss my friend.

 

I hope you and your wife and son can move on from this tragedy a have a happy life.

 

[Ilunga]

15 hours ago, Jimmy McGill said:

I think a good example to look at is Australia. They manage to deal with an entire country with a lot of central planning and use smaller regional networks to deal with individual area needs. Its very efficient. 

 

What we do here is give a lot of autonomy to each health authority, so e.g., say you want to run out a provincial program. Each individual HA has to then run through the process of approvals, etc. Its just unnecessary waste and there are more efficient models that deliver just as good results. 

I cannot stress enough how good our healthcare system is here in Australia.

I have never had private health insurance and when I was younger I almost lived in the emergency room.

Even now I get rebates available on pyshc- care ,bulk billed doctors-free- appointment's.

I have had half dozen operations including 2 knee reconstructions.

Ambulance subsricbtion costs under 50 bucks a year for singles and 95 for families,can save you thousands.

[UKNuck96]

1 hour ago, Ilunga said:

I cannot stress enough how good our healthcare system is here in Australia.

I have never had private health insurance and when I was younger I almost lived in the emergency room.

Even now I get rebates available on pyshc- care ,bulk billed doctors-free- appointment's.

I have had half dozen operations including 2 knee reconstructions.

Ambulance subsricbtion costs under 50 bucks a year for singles and 95 for families,can save you thousands.

I’m happy with it the NHS but if we change to any system Australia is the one I would want to model it on 

[Boudrias]

3 hours ago, The Colt 45s said:

Access to care is a challenge, but not an impossible one. Here in the US, adaptability in the COVID crisis has changed how doctor's work and healthcare is implemented.  I mean, with an app I can be on my cellphone and speak with a doctor, get a diagnosis, prescribed medication, all within a half hour.  This type of care is not meant to supplant primary family medicine.  I do not know what the solution is in Canada, we just need Scrubs to come back on TV.

 

How will GP's maintain practices with the explosion in on-line medicine? It could take a big chunk out of their revenue. You say it is not meant to supplant family medicine but it likely will. Perhaps family practices can adapt and adopt their own form of telemedicine. 

[JM_]

11 hours ago, KristoffWixenschon said:

I think we just have to disagree.

The autonomy of the health authorities is their greatest strength. Rural medicine does not function the same way that it does in urban centers. You cant have the same process for recruitment and care. 

thats OK, it happens  

 

where we disagree is I see better models for care. I see the current structure of the HAs as one of the biggest problems to improving care in the. north. 

[KristoffWixenschon]

27 minutes ago, Jimmy McGill said:

thats OK, it happens  

 

where we disagree is I see better models for care. I see the current structure of the HAs as one of the biggest problems to improving care in the. north. 

At least we agree that there are better models for care. 

I just cant imagine that care for small communities improves when the needs of each small community must be decided provincially instead of by a health authority.

I might agree to at least centralize licensing to the federal government. It's never made sense to me why a physician who practices in BC has a bunch of bureaucracy to go through to become licensed in any other province. And for a country that imports many of our doctors from other countries, it's an unnecessary hurdle to their immigration process. 

[JM_]

10 minutes ago, 6of1_halfdozenofother said:

 

I think a lot of the problem with the local HAs has to do with critical mass - there's not enough population density/population base in each of the HAs to be able to make the bulk purchases (or hiring) necessary to stock up on important supplies (or personnel) at a reasonable cost. 

 

The licensing of medical professionals, as you mentioned, is handled provincially, and this is due to the fact that provision of health care is a provincial responsibility; much like how professional engineers or lawyers are also governed by provincial law.  Good luck trying to get the provinces to release their jurisdiction on this to the feds.

 

Drug and medical device regulation is addressed at the federal level.  Effective treatments are often dependent upon the ability to access the appropriate and efficacious drugs and medical interventions/devices by health care providers (provincially and locally), both physically and financially.

 

When you have that many layers of government with their hands in the cookie jar, and when funding is not sufficient at any level, there are bound to be inequities in provision of service - both in terms of quality and ability.  Sadly, when governments approach taxpayers with an empty palm, the most common reaction of the taxpayer is to tell the government that we're already taxed to death and to piss off.  

you're correct on all of that, I'd add that individual hospital privileges are granted at the HA level, and up until very recently it was a black box between HAs. That project took about 7 years to work out (I know some of the people involved in that one). That kind of inefficiency is whats hurting our ability to innovate. 

 

Last thing I want to see is the north get forgotten in an over-centralized system, but I also see a HA that's really understaffed and underfunded in many areas. I do think that could be different under a better organized provincial system.