Friday, October 06, 2006

Health 'conversation' too good to miss

VICTORIA - You can come up with a long list of reasons to shun Premier Gordon Campbell’s “conversation” on health care.
Maybe you’re irked at a $5-million budget for lightweight ads, wishing that money had gone to fix your knee.
And maybe you’re put off by the premier’s bogus claim that they within the next 10 years health care costs will somehow suddenly become this all-consuming monster. The facts contradict the spin. Health care costs represented about one-third of government revenue in 1985, and 1995, and 2005. Cost pressures are a concern, but there’s no crisis.
But the wise move is to leap into the debate and sign up for the chance to be one of the 100 citizens chosen for each of 16 regional forums.
For starters, give Campbell credit. He handed the question of electoral reform over to a random assembly of citizens even though it was not in his political interests. When their STV proposal was narrowly defeated in a referendum, despite majority support, Campbell decided on a second vote.
No Canadian politician has ever showed so much confidence in the good judgment of average citizens.
The health-care conversation owes a lot to the citizens’ assembly on electoral reform. There are opportunities to participate through web forums but the main element, so far, looks to be the regional forums on care.
The expectation is that a lot of people will want to talk about the future of heath care, knowing their deliberations might matter. So if 2,000 people apply to take part in one of the forums, a random draw will be used to select the 100 participants.
You can have a lot of confidence in the wisdom of 100 citizens, if they are genuinely representative. The group would then include some hard-nosed numbers types, a doctor and nurse or two, patients and people on waiting lists, perhaps an engineer and a therapist, strident lefties and archconservatives. You would have a vast amount of life experience, a broad range of skills and perspectives, With time and competent facilitation you can expect some very useful ideas.
But it only works if everybody is represented at the table. If unions or politicos of whatever stripe or any other interest group dominates the process, the results will be inevitably be second-rate. Too much experience and wisdom will be missing.
You can fix that problem by going to bcconversationonhealth.ca and signing up.
In the meantime, there are a lot of issues to consider and research to be done to help make for an intelligent debate.
It’s disappointing that the government’s ads promoting the health-care conversation have so been short on useful content. The PR flyer mailed to every household could easily have included some useful background material on budgets and wait lists and an explanation of the Canada Health Act and a directory of web sites. Instead it was devoid of useful content.
But there’s time for a full debate and a lot of exchanges of facts and ideas before things really get going.
For instance, what do we mean when we talk about controlling health-care spending? Some people seem to think allowing patients to pay for private care reduces health-care costs, when in fact it drives up total health spending significantly. The way the bills are paid changes, shifting from taxes to direct payments. But the money going out the door for health increases.
And what sort of changes are we prepared to make? About 25 per cent of health spending goes towards people in the last 12 months of their lives. In B.C. about $2.8 billion will be spent on 28,000 people who will die within 12 months, or $100,000 each. The average expense for the rest of us will be $2,100. Is that money well-spent, or are we committing large amounts for little benefit. (And perhaps prolonged suffering.)
These are big questions. You should take the chance to help answer them.
Footnote: This is the first time patients or consumers get a real voice in the health-care debate. Doctors, unions, business groups, big pharmaceutical companies, they all have clout. And politicians don’t really speak for patients, because they’re worried about cutting taxes and other pressures as well as health care. Finally, we get a real voice. The first regional forums are planned for Burnaby, Campbell River, Castlegar, Chilliwack, Cranbrook, Fort St. John, Kamloops, Kelowna, Nanaimo, North Vancouver, Prince George, Richmond, Smithers, Surrey, Vancouver and Victoria.

8 comments:

Marc said...

Paul,

This is an amazing run of stats:

"About 25 per cent of health spending goes towards people in the last 12 months of their lives. In B.C. about $2.8 billion will be spent on 28,000 people who will die within 12 months, or $100,000 each. The average expense for the rest of us will be $2,100."

Could you please provide a source?

Anonymous said...

A little birdy... whispered Windsor Manor in my ear.

It seems AdvoCare Health Services Ltd. - operators of the Kelowna seniors facility - fired the 70 regular and part-time care aides at the facility on September 20, 2006 because they refused to accept major cuts to their wages and benefits.

So what happened after September 20?

Apparently a resident died when a new staff assisted the resident with the wrong kind of food. O0ops!

A couple of residents wandered away from the dementia unit - AdvoCare was made aware of the missing seniors when the RCMP returned them to the facility. O0ops!

When the Interior Health Authority started to investigate AdvoCare's ongoing 'O0opssies' - AdvoCare fired the line staff who talked with the IHA.

Campbell's "conversation" on health care should start with a public verbal lashing of the Health Minister and then stripping Abbott of his cabinet post.

Anonymous said...

Instead of telling us as he usually does and will at the end of this farce. Why not give us a vote in the Health Authorities which do his bidding and ignore the local issues. I for one have no faith in the liberal government which speaks out of both sides of its mouth to give us its lies. Such a poor track record of truths almost ranks with Lyin Brian oops I guess it does rank with him in broken promises.

Anonymous said...

Interesting article out today.It's in the T/C. It list the salaries of the big folks at VIHA. Ranges from the president getting 311,000 down through 13 others making over 200,000.The Interior health senior guy made 320,519. Of the lower wage group of 860 people it seems that half are doctors, nurses. So who are the middle rankers and just what do they do?

So do the tax payers get a great deal form these folks? GO ask somebody on wait list for a couple of years, who had relations die in Emergency Care rooms? If I recall those sort of jobs were done at much less cost under the last government. But Gordon always talks about having to pay more to get the best. Hell, he couldn't even keep his deputy minister but these guys, hey give us the money and our PR Hacks will tell you they are just great and of course remind us other province pay more.
The numbers can be found at VIHA's web site under about us. followed by financial reports and then year end expenses. Looks like it exists but doesn't actually jump out at you.

paul willcocks said...

Marc:
I first heard the 25-per-cent stat in a presentation to a Pacific Health Forum by former Health DM Dr. Penny Ballem and checked out the U.S. study. The study also looked at patients over 85 with types of cancer considered unresponsive to chemotherapy. And one in eight of them had received costly and unpleasant chemo in the last three months of their lives.
Didn't keep the references, but a starting point is:
http://www.ahrq.gov/research/apr03/0403ra25.htm

Anonymous said...

Turns out the VIHA have told everyone working for them that they are not to talk to the media or MLA's. all questions to be referred to the PR folks for the VIHA. IN some place that sure cuts down the folks numbers who actually might have some good idea, after many years on the job.
The premier talked about Tsunami's heading our way, do we just stand and watch or do something. Maybe he might talk to VIHA and suggest when he discussed talking to folks , not a one way discourse, it might well be just what VIHA says the "folks" cannot do. Sure there are confidentiality rules. Most folks know that but if a MD, nurse, or cleaner sees a way to make things better why not listen to them? Or does he too, condone the idea that the workers are out to get him? People with blinders get blindsided. I would think the opposition critic is getting lots of pieces of paper and emails so why the gag order. Oh it's not a gag says VIHA. what else could it be?

John said...

As long as economy growth is greater than the growth in health costs not just year to year but over several years. As long as revenue growth is greater than the growth in health costs, not just year to year but over several years it is not credible to claim that growth in health care spending is not sustainable You will be pleasantly surprised!
used to get more people covered their health insurance but now a days lot less.
I am sure you had to do lot research to show us this stats and good one

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