Say you want a revolution…

Looks like Ron Liepert is looking to make some major changes in the public Alberta healthcare system. He has set up a task force that will look at all aspects of healthcare services delivery, and get this, will be completed and ready to rock in 10 weeks. This is the same guy who nuked all of the Health Authorities in AB without anyone getting wind of it, until after the fact. Here is a link to a good story about the situation

http://www.calgaryherald.com/business/Alberta+health+review+sparks+delisting+concerns/1952632/story.html

Based on the Minister’s past exploits, and the current financial situation in AB, I expect we will see some major changes in how things are delivered and funded in short order. Taking a page out of AB government requesting input from AB residents, I would like to ask Mike what changes he would do if he was the Minister? I know that given carte blanche (without worrying about the Canada Health Act), I would consider:

  • Engage the public in a real conversation about the unsustainable rise in healthcare spending. Only with public support could you actually change anything. Once this is done you:
  1. Increasing the role of Nurse Practioners in the practice of Primary Care;
  2. Get rid of Fee for Service, and replace it to one tied to health outcomes;
  3. Shift significant funding out of hospitals and into the non-acute sector;
  4. Allow a publicly-funded, but privately delivered system to offer additional services;
  5. Tie healthcare senior management pay to incentives/disincentives around running a system within a set budget;
  6. Invest in eHealth that automates the new delivery system

I intentionally would leave eHealth to the end. Why automate broken healthcare business practices…wait until you reform them and then spend the right amount of money to create efficiencies.

Mark

3 responses to “Say you want a revolution…

  1. Wow, that’s quite the challenge that you pose. While I surely don’t feed qualified to be a Minister of Health, I do agree that more public debate is needed. We spend a considerable amount of money in Canada on healthcare and it is something that we all want to be able to depend on.

    First question I would ask before suggesting solutions is whether people feel that our healthcare system needs to be changed and, if so, whether minor or major changes are needed? I think, Mark, that I can guess your answers 🙂

    While I’d like to think that the general population feels that are healthcare system needs reform, I’m not entirely convinced that they do. What evidence do you feel exists to demonstrate that the current system is not sustainable. I would point to:

    – Annual increase in the cost of healthcare that exceeds GDP growth

    – Long wait lists (though the definition of “long” is probably subject to considerable debate)

    – Insufficient number of family physicians such that many people do not have one.

    Mike

  2. I have never been accused of being “unclear” in my comments or statements. 🙂

    I’m not suggesting that I have all the right ideas, nor am I saying that I’m qualified to be a health minister. I just want to get an intelligent conversation started, based on logic and evidence. As far as your final question on evidence, I would concur on all your measurements. The problem is that we as a society tend to wait until we have a full blown crisis before we do anything besides use a bandage…pun intended.

    I would also point back to the original that made me post in the first place. BC and AB appear to be facing a healthcare cash crunch in the next year that cannot be addressed without major reform/service cut backs.

    Mark

  3. Given the focus of this blog, how can we tie the cash crunch in many provinces back to the Canadian eHealth agenda? I suggest that we will need to make even more convincing arguments in face of budget cuts as to why we need to invest in eHealth now.

    Mike

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