Tuesday, January 17, 2023

On The Brink Of Collapse

Doug Ford has announced that his government will move some surgeries out of hospitals into for-profit clinics. I was skeptical of the idea. But Martin Regg Cohn adds some context:

The claim that Ontario is breaking new ground betrays a simplistic ignorance of recent innovations by other progressive provinces. By expanding the number of private clinics delivering publicly funded treatment in Ontario, Ford is following the lead of British Columbia, Quebec, and other provinces that have experimented with practical alternatives to hospital-based care.

The fear of for-profit operators exploiting desperate patients suggests a misunderstanding of medicare’s basic principles: It is a single-payer public system bankrolled by governments; but it is a multi-player delivery system buttressed by private colonoscopy clinics, stand-alone cataract clinics, chain pharmacies, contractor doctors and independent midwives who will deliver your baby in your own private home — far from not-for-profit hospitals. The NDP campaign slogan claiming you’ll have to pay your own way with credit cards has been repurposed by Ford into a guarantee that you’ll only need an OHIP card.

The most cogent criticism of Ford's plan is that medical personnel will be siphoned from hospitals to clinics. That criticism hits at the biggest problem in our health system: We don't have the people to staff the system -- in either hospitals or clinics. The problem existed before the pandemic. The pandemic made the situation worse.

It takes time to train healthcare workers. You can't simply put up a Help Wanted sign and have people walk in off the street. We live in an area where several of our doctors have retired.  New doctors are not coming in to replace them.

Ford may move the location of surgeries. But until he does something about the people who perform the surgeries, the system will be on the brink of collapse.

Image: Twitter

14 comments:

Lulymay said...

Went to an appointment recently with our family doctor and he let us know that he will be retiring in the fall. Very worrisome for us as seniors as he said they have been putting the word out that his practice will be available but is getting no response. (We live in the greater Vancouver area.)

Problem is that we know of 3 highly qualified university grads who could not get past the gatekeepers of approval to attend medical school at UBC. One of the major reasons is that this institution, built by the citizens of the day, is primarily interested in foreign students (because they pay more for tuition).

None of those 3 that had to go elsewhere for medical school and none of them have come back to BC to practice.

Owen Gray said...

We are in the same situation here, Lulymay. We have to invest in our healthcare workers. You can't fix this problem with tax breaks.

Anonymous said...

To see how this'll turn out, we need only look at for-profit long-term care facilities. These provide such outstanding care that the army found cockroach and rodent infestations, rotting food, and seniors left in soiled diapers on mattresses without sheets.

Ford will use taxpayer money to expand or build private, for-profit, facilities that will draw medical workers from public facilities, which are currently in crisis because of staffing shortages. And then the private sector will do what it does best - turn a profit by cutting corners on patient care and driving down wages and benefits for healthcare workers. I'm sure that'll encourage more people to enter the field.

Cap

Owen Gray said...

Unfortunately, Cap, Doug believes that profit encourages quality.

rumleyfips said...

Cohn missed upselling. ' We are all out of the standard knee but we have one available at a slightly higher cost'. Every stand alone will be looking to hire an ex used car salesperson used to the old bait and switch.

Owen Gray said...

That's the problem with for-profit healthcare, rumley. The most important beneficiary is not the patient.

zoombats said...

"Doug believes that profit encourages quality". The only quality that Tweedle Doug believes in is the quality of the paybacks from all his friends enriching themselves. Never trust a conservative and in the immortal words of my father, "have a dream about a conservative, expect a disappointment".

Owen Gray said...

Your father was a wise man, zoombats.

Northern PoV said...

The devil is in the details (Right next to Doug Ford!)

The BC MSP (our OHIP) is paying private clinics this way. My wife got a badly needed back surgery done in a clinic two years ago when MSP decided to clear the 'pandemic backlog' with extra funds for 'elective' surgeries. I dropped her at 8 am, she went under full anesthetic for the surgery and I picked her up at 5 pm. No 'extras' offered or needed. We did jump the queue and paid paid for the MRI that confirmed the need of the surgery, so there still is work to be done to get off the slippery slope ... down into the debacle they have in the USA.

As long as the actual medical services are first come first served and can ONLY be paid by the provincial health care plan, it may be ok.

The providers will need to be under scrutiny so that they don't take the rich (who can pay for the the 'extras' or 'options' Ford is promoting) ahead of everyone else.

Owen Gray said...

There is an incentive under private medicine to serve the wealthy first, PoV. That's always going to be a danger,

Toby said...

This is part of a long term process of eliminating public health care in Canada. The Baby Boom is retiring and entering the time when serious medical issues surface. There's a fortune there to be mined.

Some years ago a private clinic popped up in the Vancouver area. To advertise their services they put up a Web site which included a list of their backers. The list included many big American corporations. The list was removed from the Web site and you won't find any trace of it. I'd love to post a link but I am unable.

Doug Ford's description of his private clinic fix looks a sounds reasonable. The problem is that it won't end with what he described. The vultures will want profits; wages will be cut, benefits reduced, executive wages will go up, customers will be charged for extras.



Ben Burd said...

"The NDP campaign slogan claiming you’ll have to pay your own way with credit cards has been repurposed by Ford into a guarantee that you’ll only need an OHIP card."

That is such bollocks Owen, anybody who is now 'coerced' into paying the optional but mandatory $250 for cataract surgery better be prepared to double that the next time.

Why are we using double the amount of public funds to get the same healthcare should be the question we need to press home.

Owen Gray said...

Ford's plan adds to costs unnecessarily, Ben.

Owen Gray said...

Ford's plan is only reasonable, Toby, if you believe -- like Ford -- that profit makes the world go round.