Re: OT: Heath Care (for Linus)


"Moro Grubb of Little Delving" wrote

1) Medical services should run as a business. In governmental
bureaucracies, personal success is linked to the size and extent of your
authority. Bigger is better for the people involved, despite any
protestations to the contrary. In business, success is measured by the
efficiency of your operation. Maximize revenue, minimize cost, and you're
an effective businessperson. Thus government organizations are not, and
never have been, any good at achieving efficiencies, because the
incentives work against it. When has a governmental organization ever
volunteered to reduce staff? But this happens all the time in businesses,
as a matter of survival. An inefficient business will fail, and and an
efficient one will flourish, the system ensures this. These incentives are
missing in governmental bureaucracies.
I'm not saying that the Government shouldn't fund medical services, just
that they shouldn't run them. Set appropriate standards, contract the
services out, and monitor delivery standards. I guarantee that their cost
per service will be significantly reduced, and service levels will be
similarly enhanced.

2) The patient must be empowered. There must be choice.

2a) In 1) above I suggest that services must be privatised, in order to
achieve efficiencies. Those efficiencies will only be achieved if the
patient has the option to "go somewhere else". Monopolies don't encourage
efficiency.

2b) Choice must include the option to purchase services privately.
Many of the communities in the Lower Mainland have Food Banks. This is so
the unemployed and otherwise disadvantaged can have their most basic
requirements met. The communities support these in a number of ways:
Through donations of food and money, volunteer time, etc. Now imagine that
the government took over the funding and operation of the food banks, and
then subverted every other food supplier (supermarkets, restaurants,
catering services) to the hierarchy of the food banks. So you could no
longer purchase food directly, a portion of your taxes would go towards
supplying your family with food, as the government saw fit. Absurd, you
say? Yet this is exactly how medical services are structured! Our medical
services are in such trouble, because the benefits that are required for
the most needy are diluted across the entire population, through some
perverted logic of "fairness".

3) Trivial services have to cost the consumer something.
The system is swamped by the trivial. Anyone who understands basic
economics understands that demand is a function of price. As price rises,
demand drops. And if price is zero, demand is limitless. So how does the
government limit their cost? By throttling back on the availability of
services. Medical services need to be relatively inaccessible, to weed out
the trivial. Hence the 10-hour wait. When my wife bemoaned our long wait
on Saturday, I responded that the system relies on it. I would suggest
that there are better ways to limit demand, namely cost. If the consumer
had the choice of going elsewhere for the service, at a nominal cost, the
less needy would be off the waiting lists, the system would become
financially more self-sustaining, and state services could be more
accessible to the truly needy.

The current structure of our medical services demonstrates the triumph of
good intentions over common sense. Natural and economic forces conspire in
its failure. It needs to be realigned with reality if it is to achieve its
mandate.

/M

Very well stated.

It's also in "Critical Condition", "How Health Care in America became Big
Business and Bad Medicine"
Those who believe the health care business in America is *NOT* in trouble
are contributing to the delay in fixing it.

Max (didn't intend to use the right wing motto, "If you criticize the
president, you're helping the enemy)


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