I'm a Canadian and one of the things I do is install/support EMRs for physicians. The Canadian 'free' healthcare model is broken. I see it first hand, as both a patient and IT worker, the mess that the government has made. The long waiting lists, overloaded emergency rooms, overloaded bureaucracy and lack of family physicians all demonstrate different issues. The government controls where physicians can work (see Quebec PREM), how many can graduate and what they get paid. They try to patch problems with incentives that have worse consequences.
Here in Canada, the government can only make the situation worse. They have no incentive to do a "better" job... Their motivations are expanding their bureaucracy and getting re-elected.
As long as government is in charge of the decision-making, I am not optimistic about the future of health-care in Canada.
Thank you for your comment. I know a prominent emergency physician in Canada and he is very frustrated by the closure of small, rural ERs. While a market system has its issues, I'm always surprised that anyone thinks a government system will be better. It just creates different perverse incentives. Well, stay healthy sir!
It's 'good' (not really) to read that we are not alone. Some Americans put Canada and your system on a pedestal which you clarify is not deserving. There is a reason we have so many foreign doctors here, including Canadian.
Mr. Wertheimer, we in the US have long waiting lists, overloaded emergency rooms, overloaded bureaucracy and a lack of family physicians as well. In addition, we have overpriced prescription medications and a profit motive that guarantees that those most in need of care often have the most difficulty accessing it. I guess we win.
You’ve hit all the reasons our healthcare is disintegrating, but the big one is the mismanagement of healthcare by private equity big business. The only way to fix this is for independent physicians to establish small, physician-owned hospitals (yes, need to undo that 1996 law preventing physicians from owning hospitals), and have physicians making medical decisions, not those trying to make a profit off of patient illness. Direct Primary Care is a start. I suspect in time we will wind up with a dual healthcare system, one which owns physicians and one which does not. I am tired of committees wringing their hands and doing nothing to fix the very obvious problems with private equity healthcare..
Thanks Diane! I think a dual system would be a nice way to go. My understanding is that Germany has this and it seems to work fairly well. And as for physician-owned hospitals, I'm all for it! I'd love to work in one before I retire. Have a great evening!
Dr. Leap - I one of your fan club. I found your writing when of my readers sent me a link. I feel like your inferior-writing-wise but share your inspiration to inform the public of the mess we are in. My mission is a bit more local and focused though some columns like this one have a broader reach. LMK if you would like to be in touch - I would! Keep on writing and I will keep reading. https://www.thejoltnews.com/stories/the-corporatization-of-healthcare-why-consolidation-matters-to-all-of-us,14882?
Re. the topic of healthcare preparedness, words that come to mind: vision, resources, effectiveness, fairness, innovation, adaptation, public education, public trust and leadership All things that I don't believe our current do-nothing congress and political system are capable of conceiving, designing or implementing. Looking back at the time just before our entrance into WW II, the writing was clearly on the wall that war was coming, but most Americans ignored those warnings or didn't want to think about it because it didn't directly affect them at the moment. They were more concerned about jobs, feeding their families, baseball, etc. When war finally came, the U.S. had to scramble to mobilize, build and train our military and to exponentially increase and revamp national production to supply the war effort. Like they say, history tends to repeat itself as it did during the COVID 19 Pandemic. Regrettably, our lack of preparedness is the cost of distraction and apathy.
Dr. Leap, as a fellow primary care physician I truly appreciate your concerns, your thoughts and your amazing writing skills. Have to ask, though, when the hell do you ever sleep!?
Jon, thanks as always for your great insights. As to when I sleep? Actually I sleep a decent amount and also have the gift of being able to fall asleep pretty much anywhere and in any position. Something I'm sure you've cultivated in both careers! And of course, I don't really have time for any other hobbies these days so writing is my side-vocation and my therapy. Have a great evening brother!
Are you going to AAEM in Austin? Maybe there could be a meeting of the minds there. I am looking into precision medicine as an out from the ED. There is no one to pass the torch to… They don’t want it.
I am going to Austin! I'd love to meet. And you're right, nobody wants it; certainly not when it's burned all the way down to the grip! Please look me up. Good evening!
I'm a Canadian and one of the things I do is install/support EMRs for physicians. The Canadian 'free' healthcare model is broken. I see it first hand, as both a patient and IT worker, the mess that the government has made. The long waiting lists, overloaded emergency rooms, overloaded bureaucracy and lack of family physicians all demonstrate different issues. The government controls where physicians can work (see Quebec PREM), how many can graduate and what they get paid. They try to patch problems with incentives that have worse consequences.
Here in Canada, the government can only make the situation worse. They have no incentive to do a "better" job... Their motivations are expanding their bureaucracy and getting re-elected.
As long as government is in charge of the decision-making, I am not optimistic about the future of health-care in Canada.
Thank you for your comment. I know a prominent emergency physician in Canada and he is very frustrated by the closure of small, rural ERs. While a market system has its issues, I'm always surprised that anyone thinks a government system will be better. It just creates different perverse incentives. Well, stay healthy sir!
It's 'good' (not really) to read that we are not alone. Some Americans put Canada and your system on a pedestal which you clarify is not deserving. There is a reason we have so many foreign doctors here, including Canadian.
Mr. Wertheimer, we in the US have long waiting lists, overloaded emergency rooms, overloaded bureaucracy and a lack of family physicians as well. In addition, we have overpriced prescription medications and a profit motive that guarantees that those most in need of care often have the most difficulty accessing it. I guess we win.
... or both lose ;-(
You’ve hit all the reasons our healthcare is disintegrating, but the big one is the mismanagement of healthcare by private equity big business. The only way to fix this is for independent physicians to establish small, physician-owned hospitals (yes, need to undo that 1996 law preventing physicians from owning hospitals), and have physicians making medical decisions, not those trying to make a profit off of patient illness. Direct Primary Care is a start. I suspect in time we will wind up with a dual healthcare system, one which owns physicians and one which does not. I am tired of committees wringing their hands and doing nothing to fix the very obvious problems with private equity healthcare..
Thanks Diane! I think a dual system would be a nice way to go. My understanding is that Germany has this and it seems to work fairly well. And as for physician-owned hospitals, I'm all for it! I'd love to work in one before I retire. Have a great evening!
Dr. Leap - I one of your fan club. I found your writing when of my readers sent me a link. I feel like your inferior-writing-wise but share your inspiration to inform the public of the mess we are in. My mission is a bit more local and focused though some columns like this one have a broader reach. LMK if you would like to be in touch - I would! Keep on writing and I will keep reading. https://www.thejoltnews.com/stories/the-corporatization-of-healthcare-why-consolidation-matters-to-all-of-us,14882?
Thank you for your kind note! Yes, let's get in touch. I'll read the story you linked. Have a great evening!
Re. the topic of healthcare preparedness, words that come to mind: vision, resources, effectiveness, fairness, innovation, adaptation, public education, public trust and leadership All things that I don't believe our current do-nothing congress and political system are capable of conceiving, designing or implementing. Looking back at the time just before our entrance into WW II, the writing was clearly on the wall that war was coming, but most Americans ignored those warnings or didn't want to think about it because it didn't directly affect them at the moment. They were more concerned about jobs, feeding their families, baseball, etc. When war finally came, the U.S. had to scramble to mobilize, build and train our military and to exponentially increase and revamp national production to supply the war effort. Like they say, history tends to repeat itself as it did during the COVID 19 Pandemic. Regrettably, our lack of preparedness is the cost of distraction and apathy.
Dr. Leap, as a fellow primary care physician I truly appreciate your concerns, your thoughts and your amazing writing skills. Have to ask, though, when the hell do you ever sleep!?
Jon, thanks as always for your great insights. As to when I sleep? Actually I sleep a decent amount and also have the gift of being able to fall asleep pretty much anywhere and in any position. Something I'm sure you've cultivated in both careers! And of course, I don't really have time for any other hobbies these days so writing is my side-vocation and my therapy. Have a great evening brother!
This was interesting to read and process. Thank you for sharing!
Dr. Leap,
Are you going to AAEM in Austin? Maybe there could be a meeting of the minds there. I am looking into precision medicine as an out from the ED. There is no one to pass the torch to… They don’t want it.
I am going to Austin! I'd love to meet. And you're right, nobody wants it; certainly not when it's burned all the way down to the grip! Please look me up. Good evening!