Re: The Death of the Canadian Model
From: fran wilson (530rose@msn.com)
Mon Feb 27 11:07:23 2006
>>>>I couldn't begin to imagine emptying beds because the state said I had to.<<<<
Yesterday I went to discharge a patient from the hospital. The patient and baby were fine and ready to go. The pediatrician declined to discharge the baby because it was evening and mom was a primip. At other times, when the unit is busy, the nurses call us and request that we discharge our patients to free up rooms. When we are not busy the nurses discourage us from discharging patients because they don't want to get sent home for low census or floated to a medical or surgical unit. The hospital has also warned us that when census is low, we should consider keeping patients longer so the revenue is not affected (not in exactly those words<G>).
There are lots of reasons that we keep or discharge patients that have nothing to do with the stability of the patient. I think saving the taxpayers a few bucks is not the worst reason in the world. Most of my OB patients are anxious to get out of there back to the comfort of their own home.
The babies are essentially being held hostage by the new pediatricians who have no faith in the parents or their own ability to tell a healthy baby from a sick one. And if they parents ask to leave AMA, which is their right, the nurses scare the heck out of them by telling them "well, if the baby gets sick and dies it will be your fault" and vague threats of talking to "social services" (which the patient interprets as CPS). AND they have to find a new provider for the baby.
Fran Wilson CNM
Kennewick, WA
From: "William McIntosh" <wdmcintosh@charter.net>
Reply-To: ob-gyn-l@obgyn.net
To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
Subject: RE: The Death of the Canadian Model
Date: Mon, 27 Feb 2006 10:18:20 -0600
I did a Gyn Onc rotation in Canada while I was a resident, as we did not
have much of a cancer service. It was a wonderful experience, and the care
was top notch by and large, but I was jarred by one thing. During morning
rounds one day, the chief of service asked which 2 patients could be sent
home that day. I was stumped as no one was actually medically ready to go
home, though some were ready for hospice care. I was told that the
Provincial authority had decommissioned 2 Onc beds, and we had to empty
them. We transferred 2 terminal patients either home or to hospice, I
don't
remember which. This was the only source of gyn onc care in the province
(another bizarre thing from my perspective. I mean really, flying a
thousand miles for a colpo!?) I am not sure what was happening. I couldn't
begin to imagine emptying beds because the state said I had to. I still
can't.
I loved my time there, and I learned so very much from the wonderful
attendings I had, but it gave me a very jaundiced view of single-payer
medical models. If there is no competition, there is no incentive to
improve. Good intentions are not enough.
William D McIntosh, MD, FACOG
Clarksville, TN
-----Original Message-----
From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of art
fougner, md
Sent: Monday, February 27, 2006 7:05 AM
To: Multiple recipients of list OB-GYN-L
Subject: Gen: The Death of the Canadian
Model
Proponents of single-payer health care reform in the United States have
long pointed toward Canada as a model for the US to emulate.
The New York Times reports that the Canadian system is imploding. A
recent Candian Supreme Court decision allowed private health care (oh,
the shame, the horror) and as a result, Canadians tired of waiting for
radiation therapy, eye surgery and hip replacements have turned toward
private alternatives springing up under the new legal environment.
The Times reports:
Canada remains the only industrialized country that outlaws privately
financed purchases of core medical services. Prime Minister Stephen
Harper and other politicians remain reluctant to openly propose sweeping
changes even though costs for the national and provincial governments
are exploding and some cancer patients are waiting months
for diagnostic
tests and treatment.
But a Supreme Court ruling last June - it found that a Quebec provincial
ban on private health insurance was unconstitutional when patients were
suffering and even dying on waiting lists - appears to have become a
turning point for the entire country.
"The prohibition on obtaining private health insurance is not
constitutional where the public system fails to deliver reasonable
services," the court ruled.
The key paragraph:
The country's publicly financed health insurance system - frequently
described as the third rail of its political system and a core value of
its national identity - is gradually breaking down. Private clinics are
opening around the country by an estimated one a week, and private
insurance companies are about to find a gold mine.
Posted by Russell Roberts in
Health
http://cafehayek.typepad.com/hayek/2006/02/the_death_of_th.html
Art
--
art fougner, md
Support Free Speech
Buy Danish!
|
|
