Coming Soon to a Hospital Near You...sorry you just have to wait

[HonestChieffan]

http://www.calgaryherald.com/Health/Wait+times+will+soar+surgeries/1313552/story.html

Wait times will soar for eye surgeries

Clinics running out of funding

By Michelle Lang, Calgary HeraldFebruary 21, 2009Comments (6)

New figures show a budget crunch will force Calgary eye clinics to perform nearly 2,000 fewer cataract surgeries this year, adding fuel to an already heated debate about long waiting times for the procedure.

Alberta's medical superboard, which contracts out all local cataract removals to private clinics, said Friday it can only afford to buy 8,500 of the procedures in 2008-09. That's a significant decline from last year when Calgary's health system bought 10,340 cataract operations.

The statistics come one day after it emerged that privately owned surgical clinics in Calgary have run out of public funding for the winter.

"It's a gap in our health care," said Marilyn Pfaefflin, a Calgary woman facing a year-long wait for cataract removal, even though she is clinically blind in one eye.

"Literally, you can't see. It's a black cloud over your eye."

Several Calgary clinics said this week they have already met their surgery quota from the public system and won't be performing any more cataract procedures in February or March. The operations will resume in April, when a new budget year begins.

In recent years, the former Calgary Health Region paid the clinics to continue performing additional surgeries beyond their initial quota, spending over its budget in an attempt to cut cataract waiting lists.

This year, however, the new "superboard,"which took over the delivery of medical care in Alberta from health regions, would not provide additional cash. The board is facing a massive operating and capital deficit of more than $1 billion.

"This year we are holding it to the funded amount, as per our direction from government," said Shawna Syverson of Alberta Health Services.

The decision to buy fewer eye surgeries will save Alberta Health Services about $1.4 mil-lion, compared to what it spent on the procedures last year.

But the cuts are expected to increase waiting times for cataract surgery, angering opposition parties who said Calgary's health system has been struggling since three hospitals closed in the city a decade ago.

The closures, in part, created a shortage of local operating rooms that has led the super-board to contract out all cataract surgeries to private clinics.

"The care(patients)are getting is delayed," said David Swann, the Alberta Liberal leader. "It's complicated, inefficient and frustrating for all."

Health Minister Ron Liepert was unavailable for comment Friday.

Most patients in Calgary are facing a 25-week wait for cataract surgery, according to the most recent statistics from Alberta Health's wait-list registry.

At least one local eye clinic said the actual cataract wait time today is much longer, at about 52 weeks.

"It's really hard to tell patients that we can't do their surgery for a year," said Dr.Howard Gimbel, of Gimbel Eye Centre.

He also noted the wait time in Edmonton, where all cataract surgeries are performed in hospitals, is shorter than in Calgary, at about 19 weeks.

The number of foot surgeries in Calgary, meanwhile, is also expected to drop. The superboard will buy 775 podiatry procedures from private clinics this year, down from 929 last year.

mlang@tHeHerald.Canwest.Com

© Copyright (c) The Calgary Herald

[Dave Lane]

Well it take 4-6 months to get one here so :shrug:

[stevieray]

Sorry, you'll just have to die...we've determined performing the the pricedure just isn't fiscally responsible.

[HonestChieffan]

Well it take 4-6 months to get one here so :shrug:

Huh?

Oh sorry, its you. Nevermind.

[banyon]

Why don't they just go to a private doctor if they have money? I mean unless they can't afford it, of course, and we don't care about that here.

[WilliamTheIrish]

Well it take 4-6 months to get one here so :shrug:

Um... Since when?

[HonestChieffan]

Why don't they just go to a private doctor if they have money? I mean unless they can't afford it, of course, and we don't care about that here.

According to the follow up to the story it is prohibited in the Canadian system to go solo and pay out of pocket for proceedures covered by the national system.

[banyon]

According to the follow up to the story it is prohibited in the Canadian system to go solo and pay out of pocket for proceedures covered by the national system.

what "follow up"?

[HonestChieffan]

Try the link....

Oh and here is a nice idea...in Canada, they are using "low cost provider" mentality to read x-rays. Just what I want, some outfit in Bagladesh doing x-rays and AOL help lines at same time.

Medical outsourcing trend hits health care
Indian radiologists
Tom Blackwell,
Published: Monday, January 26, 2009
When an Ontario man fell off a ladder and struck his head recently, the life-saving medical treatment he received included a surprising assist from halfway around the world.

The radiologist who read his brain scan, diagnosing a potentially lethal blood clot, was based in India, part of an unusual new twist on the overseas outsourcing trend.

A six-month-old arrangement between the Indian "teleradiology" company and an unnamed Canadian imaging centre is one of the first examples in this country of foreign medical outsourcing, a development that has professional groups and medical regulators here worried.


A patient has her brain scanned by a technologist.
Marcos Townsend

Email to a friend

Printer friendly
Font:****MRI, CT scan and X-ray images taken in Ontario and converted to digital format are zapped to the subcontinent over the Internet and interpreted by Canadian-trained Indian radiologists, who then report back on their findings.

A spokesman for Telediagnosys, based in the Western Indian city of Pune, said the service his firm offers is cheaper and faster than what is provided by overworked local specialists.

"Their earlier radiologist used to take at least 48 hours to give the reports and charged more than us," Dr. Ashish Dhawad, chief operating officer of Telediagnosys, said in an e-mail interview. His company turns around non-emergency work for the Ontario imaging centre within 12 hours.

Professional associations and regulators, however, question whether the quality of work would match that of a radiologist closer to hand, and ask whether disciplinary action would be possible against the offshore doctors if something went wrong.

"Imaging studies are not to be downplayed and treated as a commodity like a pound of butter or sack of wheat," said Dr. David Vickar, an Edmonton radiologist. "This is a consultation we are doing; it is not a laboratory test."

Meanwhile, as Canada continues to grapple with a severe physician shortage, observers speculate that foreign medical outsourcing could eventually expand to include other services, including pathology -- analysis of human tissue -- and even remote-control surgery.

In a paper just published in the journal Healthcare Quarterly, Sally Bean, a bio-ethicist at the University of Toronto, predicts that a lack of doctors and new technology will lead to a bigger role for health care outsourcing.

She suggests, though, that standards be developed to ensure privacy and quality are safeguarded and legal liability issues are addressed.

"It's a matter of how well it's done," Ms. Bean said. "If it's regulated and we're taking quality and safety and liability concerns seriously, then it could be a good thing."

Dr. Dhawad said his company has two radiologists who were trained in Canada and are certified in the specialty by the Royal College of Physicians and Surgeons. The firm has done mostly non-emergency work for a diagnostic-imaging centre in Ontario for the past six months.




© Canwest News Service 2009

[banyon]

Try the link....

I did try the link. Where was the "follow up" you were talking about, because the link goes to a page that is pretty much just your article that's already been posted and some user comments.

Were you referring to the user comments?

[HonestChieffan]

From another source of the Canadian's problems here is an interesting quote:

"Canada is almost alone in the Western world in outlawing people paying privately for services that are also publicly insured. One consequence of this is that there are many services, such as drugs or home care, that we cannot afford to cover publicly, whereas they are often publicly insured elsewhere.

Thus, by forbidding people who wish to do so the ability to pay, we satisfy our ideological craving for egalitarianism, but at the cost of an inability to make room in the public budget for a wider range of services that low-income people might truly need.

http://www.heritage.org/Research/HealthCare/hl856.cfm

[banyon]

From another source of the Canadian's problems here is an interesting quote:

"Canada is almost alone in the Western world in outlawing people paying privately for services that are also publicly insured. One consequence of this is that there are many services, such as drugs or home care, that we cannot afford to cover publicly, whereas they are often publicly insured elsewhere.

Thus, by forbidding people who wish to do so the ability to pay, we satisfy our ideological craving for egalitarianism, but at the cost of an inability to make room in the public budget for a wider range of services that low-income people might truly need.

http://www.heritage.org/Research/HealthCare/hl856.cfm

Was that the "follow up" you were talking about? A speech from a different site, Heritage.org?

Also: That doesn't say what you think it says.

[HonestChieffan]

Yes it does. Its quite clear.

[banyon]

Yes it does. Its quite clear.

He's referring to a particular provider. A single provider cannot take public funding and charge different rates to private customers for the same services.

If you don't take public funding, as many don't, then you can offer whatever you want privately.

It's right here:

[Private sector
About 30% of Canadians' health care is paid for through the private sector. This mostly goes towards services not covered or only partially covered by Medicare, such as prescription drugs, dentistry and optometry. Some 65% of Canadians have some form of supplementary private health insurance; many of them receive it through their employers.[14] There are also large private entities that can buy priority access to medical services in Canada, such as WCB in BC.

The Canadian system is for the most part publicly funded, yet most of the services are provided by private enterprises. Most doctors do not receive an annual salary, but receive a fee per visit or service.[1] According to Dr. Albert Schumacher, former president of the Canadian Medical Association, an estimated 75 percent of Canadian health care services are delivered privately, but funded publicly.

"Frontline practitioners whether they're GPs or specialists by and large are not salaried. They're small hardware stores. Same thing with labs and radiology clinics ...The situation we are seeing now are more services around not being funded publicly but people having to pay for them, or their insurance companies. We have sort of a passive privatization."[1]

The Canada Health Act of 1984 "does not directly bar private delivery or private insurance for publicly insured services," but provides financial disincentives for doing so. "Although there are laws prohibiting or curtailing private health care in some provinces, they can be changed," according to a report in the New England Journal of Medicine.[15][16] In June 2005, the Supreme Court of Canada ruled in Chaoulli v. Quebec (Attorney General) that Quebec's prohibition against private health insurance for medically necessary services laws violated the Quebec Charter of Human Rights and Freedoms, potentially opening the door to much more private sector participation in the health system. Justices Beverley McLachlin, Jack Major, Michel Bastarache and Marie Deschamps found for the majority. "Access to a waiting list is not access to health care," wrote Chief Justice Beverly McLachlin.

The Quebec and federal governments asked the high court to suspend its ruling for 18 months. Less than two months after its initial ruling, the court agreed to suspend its decision for 12 months, retroactive to June 9, 2005. This means that, for the interim, there would be no change to the status quo.[17]

http://en.wikipedia.org/wiki/Health_care_in_Canada

[HonestChieffan]

So, you know better what he said than he does. I dont think you do. As usual you are off chasing a bunny trail of your own making.

"Canada is almost alone in the Western world in outlawing people paying privately for services that are also publicly insured. "

But then the facts are not an issue for you on most of your bunny trails.

[banyon]

So, you know better what he said than he does. I dont think you do. As usual you are off chasing a bunny trail of your own making.

"Canada is almost alone in the Western world in outlawing people paying privately for services that are also publicly insured. "

But then the facts are not an issue for you on most of your bunny trails.

You're not concerned about the facts. Let's be real here. You tried to pretend that there was some sort of "follow up" in your article when there clearly wasn't.

You've taken one of context statement out of a speech posted on an extremely partisan cite and you've misuderstood how it is ambiguous. If you really were interested in the facts, you could easily scan through this link to the Canadian Health Care Act of 1984 and show me where it is outlawed by the Canadian government:

http://laws.justice.gc.ca/en/showdoc/cs/C-6///en?page=1

Somehow, I won't be holding my breath in anticipation of your relentless pursuit of "facts".

[HonestChieffan]

So the "site" makes the content wrong? Please.

[banyon]

So the "site" makes the content wrong? Please.

It's a factor to be considered, along with the other contrary information and interpretations I offered, yes.

Like I said, I posted the link to the act right there for you. But I won't be holding my breath for you to look at it.

[WilliamTheIrish]

Try the link....

Oh and here is a nice idea...in Canada, they are using "low cost provider" mentality to read x-rays. Just what I want, some outfit in Bagladesh doing x-rays and AOL help lines at same time.

Medical outsourcing trend hits health care
Indian radiologists....© Canwest News Service 2009

You're so far behind the curve, it's absolutely amazing. You do know that this has been happening in the US for about 15 years? Radiologists and hospitals have been sending "After hours" imaging to groups within and outside the US since broadband allowed quick compression and tansfer of images.

Try to keep up.

[HonestChieffan]

i guess small town hospitals like mine dont know but we also have digital xray imaging so you and the doc look at it together.

[VAChief]

i guess small town hospitals like mine dont know but we also have digital xray imaging so you and the doc look at it together.

It doesn't replace the gp or internist from reading your x-ray, but usually all x-rays are followed up by a radiologist report. It is probably more likely (depending on the availability of radiologists in the area) for more rural areas to rely on this type of service.

http://www.msnbc.msn.com/id/6621014/

[Ultra Peanut]

Sorry, you'll just have to die...we've determined performing the the pricedure just isn't fiscally responsible.Sorry, you can't afford to treat this condition until it's life-threatening. You'll just have to either live or die based on the emergency care you receive. In the meantime, keep suffering and missing work while you wait.

[WilliamTheIrish]

i guess small town hospitals like mine dont know but we also have digital xray imaging so you and the doc look at it together.

That doesn't mean that you Milburn Stone from Gunsmoke read them.