Deconstructing Healthcare

“America’s health care system is neither healthy, caring or a system”  – Walter Cronkite

This opening quote can also be said of Canada now.  I grew up in a Canada when health-care had doctors who came to your home.  I grew up in a Canada where home birth’s were not uncommon quite often performed by a grand-mother or other community member.  Despite surviving the polio epidemic, I grew up in a healthcare system where we were encouraged to thrive.  And all of that was done despite the lack of a universal healthcare system.

The development of a national healthcare program did not happen overnight.  It was a process that took almost 20 years and didn’t become national until July 1, 1968.  For the past 30 years we have been dismantling advances made up to the late 80’s.

I grew up surrounded by healthcare.  I spend twenty-five years of my life working in an ever evolving healthcare system.  I think it is fair to say I have extensive experience and first hand knowledge of healthcare from the perspective of a service receiver and a service provider.

I left that profession in 1989 when it became apparent the erosion of healthcare was in its infancy.  Dollars, degrees and image were becoming more important than care, largely stemming from the rise of credentialism pushed the 80’s.  Prior to the 80’s hospital trained nurses were excellent but then hospitals started receiving more accreditation points for having more degreed nurses than hospital grads.  Today nobody remembers hospital grads.

Interestingly enough Robert Reich, (Chancellor’s Professor of Public Policy at the University of California Berkeley) identifies the 80’s as a starting point of the major erosion we are now seeing in so many areas of public policy.  The Big Picture is worth the 6 minutes view, educate yourself.  However that’s fodder for another day, back to the topic at hand, healthcare or lack there of.

From healthcare I moved into the field of policy development.  I began working for the government as a policy analyst and discovered the same skills required to be a good medical social worker were not all that different from the abilities needed to be a policy analyst.  The only thing that changed was the content I was dealing with.

That career change heightened my awareness of “silo thinking” and the effect it has in society.  You cannot manage a healthy environment by separating health from education from labour and from social programs.  Those are really the four pillars of any healthy community and to focus on one while ignoring the others leads to chaos and decay.

The credentialed professionals we pushed in the 80’s have spend the last 30 years establishing policies and falsehoods designed to protect their turf.  We now live in a country where health “administration” has been sold to a whole generation as health “care”.  Healthcare involves taking care of those requiring care, health “administration” is about how money is spread out to accomplish health care.  It’s about budgets and spreadsheets not care.  But guess who gets paid first, administration.  Most of the VIHA administrators I have met have never been by a patients bedside.

But they keep creating ridiculous policies to justify their existence.  A few quick lessons in health administration budgeting.  I use a sleeping pill that I have used on and off for over twenty years.  It’s been around for so long it is only available now by it’s generic name, Nitrazepam 10mg.  It’s an low end hypnotic and a very safe sleeping aid.  It’s part of my medication regime (one of 7 prescriptions).  My doctor, on a yearly basis, writes prescriptions which I then give to my pharmacist so they can go on my record.  I pick up three months supply at a time except for the Nitrazepam.

Pharmacare, the BC government program that helps with the cost of prescriptions, will only pay for one month at a time of that particular med.  The cost of that pill is $15.87 for a months supply however on top of that is the $10.00 dispensing fee making the total price $25.87 for the month.  Remember the other prescriptions I get are three month supplies (which is still only $10 dispensing fee per refill).  That translates into an additional yearly cost of $90 for that one prescription.

I am pretty sure there are thousand of British Columbians in the same situation so those figures can add up quickly.  WASTED MONEY…except that cost doesn’t come out of the local health authorities budget, it comes out of Pharmacare.  Wake up people tax money is tax money, I don’t give a damn if Peter or Paul are spending it, it’s ALL tax money regardless of what budget line we put it on.

Another waste.  Because of an irregular arrhythmia I have been seeing the same specialist for the past four years.  He likes to see me every six months which is no big deal.  However for some reason (one I haven’t been able to get information on) each time I see him I have to go to my family doctor for another referral.  Each time I see my family doctor she bills healthcare which is another WASTED MONEY issue but policy says I have to.  This isn’t good fiscal management let alone good patient care.

Health “care” is about the patient while health “administration” is about money management.  If I was receiving the level of care from my doctor that is representative of the fiscal management from the administrators I would be looking for a new doctor.  The deterioration of our healthcare system is really self inflicted so wake up Canada before there is nothing left except for bean counters…

Food for thought people, are you receiving health CARE or are you letting health administration destroy what was once the envy of the healthcare world…