First step in privatizing healthcare? | Page 8 | GTAMotorcycle.com

First step in privatizing healthcare?

My understanding is the shortage in hospitals for surgery etc. is mostly due to lack of staff. Opening up another avenue to compete for the already short staffing is not going to magically create more trained staff. It ranks right up there with solving staffing by making healthcare workers more portable across provinces.... well if every province has a shortage it just creates a bidding war and the poorest citizens get screwed.

It is like solving a lumber supply shortage by opening up more lumber retail locations....
 
My wife works for two private hospitals in two different cities. She's worked a lot of short-handed shifts, I'd estimate 1-in-5 was the usual, but over the last couple months it has become the norm. If she's lucky, she WON'T be short-staffed once a week. Our system is getting worse, not better.
 
mimico_polak said:
In shocking news to no one...


While I understand some of GTAM believes it's good to have a 'private' option for health care in Ontario...I'm against it, simply because it's going to cost us more, and Douggie is on a bad path IMO that he's trekking here.

It's happening in Alberta already, and that seems to be going toward a dumpster fire.
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I don't know that it costs more, the CBC and union guys forgot to mention only 40% of a hospital's funding is based on procedural billing, and the other 60% is directly funded. The private centers get one fee to cover all. So, a private clinic gets $1264 for cataract surgery, a public hospital gets $508 for the procedure and $762 (approx 60%) in direct funding is for a total of $1280 for a public hospital.

If it's reducing wait times, and customer satisfaction is better than public hospitals -- then why not? It's still a publicly funded system with universal access.
 
WestBrantKid said:
My wife works for two private hospitals in two different cities. She's worked a lot of short-handed shifts, I'd estimate 1-in-5 was the usual, but over the last couple months it has become the norm. If she's lucky, she WON'T be short-staffed once a week. Our system is getting worse, not better.
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Daughter and DIL both nurse in public hospitals - they are short-staffed 100% of the time. OT for both is all they can eat and almost always offerred at 2x. The daughter's hospital stopped allowing unpaid leave.
 
backmarkerducati said:
My understanding is the shortage in hospitals for surgery etc. is mostly due to lack of staff. Opening up another avenue to compete for the already short staffing is not going to magically create more trained staff. It ranks right up there with solving staffing by making healthcare workers more portable across provinces.... well if every province has a shortage it just creates a bidding war and the poorest citizens get screwed.

It is like solving a lumber supply shortage by opening up more lumber retail locations....
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I'l bet there are some throughput efficiencies related to specialization likely more effective management. For example, the MRI machine at my local hospital was doing an average of 8 scans a day, (16hrs of operation), private MRI clinics do 22.5 scans in 24 hours.


That would reduce wait times.
 
Mad Mike said:
I don't know that it costs more, the CBC and union guys forgot to mention only 40% of a hospital's funding is based on procedural billing, and the other 60% is directly funded. The private centers get one fee to cover all. So, a private clinic gets $1264 for cataract surgery, a public hospital gets $508 for the procedure and $762 (approx 60%) in direct funding is for a total of $1280 for a public hospital.
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I'm sure the CBC and union guys intentionally left out that information. It's a real shame that today we have to take what the media reports and dig deeper ourselves to determine the full, real story.
 
I think comparing the numbers provided is like comparing apples and oranges.

Physicians bill OHIP separately, public or private, as stated in the article, so not a factor. It's important to note that there are no new additional physicians doing these procedures. In theory, an increase in private clinics means physicians are electing to work there to generate more OHIP fees and this might negatively impact their availability in public hospitals. On the other hand, limited public hospital operating room availability may very well mean physicians have excess volume capacity and private clinic work adds to the total number of procedures performed.

The other factor is that many physicians own or have an equity position in private clinics, so they get the OHIP fee and also a share of clinic revenue, so their gross and net income is higher. Also, many clinics do a hard sell on certain medical devices (think lenses) and they make significant fees on upselling from OHIP covered implants.

The private sector number is an all in turnkey fee that includes office space, operating room space and all OR equipment, all instrumentation, decontamination and sterilization equipment and all labour costs.

I have no confidence that the public hospital number is 100% accurate. Hospitals are globally and procedure funded so making direct comparisons to a turnkey private sector number vs a represented public system number many not be 100% accurate. Knowing your costs is critical because hospital infracture is Ontario is massive, paid for, and in many respects is underutilutilized. Existing, all in fixed and variable cost for a procedure might be $3,000, but the variable cost of additional procedures within a relevant range is a very different, lower number.

I think the government does not know the existing and incremental all in cost of specific hospital procedures, so how they arrived at a suitable private clinic rate is unclear to me.
 
ReSTored said:
I think comparing the numbers provided is like comparing apples and oranges.

Physicians bill OHIP separately, public or private, as stated in the article, so not a factor. It's important to note that there are no new additional physicians doing these procedures. In theory, an increase in private clinics means physicians are electing to work there to generate more OHIP fees and this might negatively impact their availability in public hospitals. On the other hand, limited public hospital operating room availability may very well mean physicians have excess volume capacity and private clinic work adds to the total number of procedures performed.
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I’m guessing private clinics are more efficient, which would allow surgeons and facilities to perform more procedures. If costs are the same, reduced wait time is the benefit.
ReSTored said:
The other factor is that many physicians own or have an equity position in private clinics, so they get the OHIP fee and also a share of clinic revenue, so their gross and net income is higher.
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I would think that too adds to efficiencies.
ReSTored said:
Also, many clinics do a hard sell on certain medical devices (think lenses) and they make significant fees on upselling from OHIP covered implants.
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I don’t see that as a problem. More choice is good.
ReSTored said:
The private sector number is an all in turnkey fee that includes office space, operating room space and all OR equipment, all instrumentation, decontamination and sterilization equipment and all labour costs.

I have no confidence that the public hospital number is 100% accurate. Hospitals are globally and procedure funded so making direct comparisons to a turnkey private sector number vs a represented public system number many not be 100% accurate. Knowing your costs is critical because hospital infracture is Ontario is massive, paid for, and in many respects is underutilutilized. Existing, all in fixed and variable cost for a procedure might be $3,000, but the variable cost of additional procedures within a relevant range is a very different, lower number.

I think the government does not know the existing and incremental all in cost of specific hospital procedures, so how they arrived at a suitable private clinic rate is unclear to me.
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I agree it’s not possible to boil down costs to the procedural level in a public hospital. Hospital networks are very large operations with high volumes of procedures, that does make it somewhat easier as you can compare using funding ratios.

I don’t think it’s coincidental that the private funding is almost exactly the same as the public. model using the 60:40 direct:procedure costs in the public system.
 
If private care brings some accountability and competition, I'm in. Had a horrendous ear infection this week. Family doc said no appointments at all this week. Walkin clinic flubbed diagnosis and gave me antibiotics but not strong enough. Went to hospital and infection had spread to bones and was dangerously closed to becoming meningitis (triaged as 1B). Care at the hospital wasn't quick but it was thorough. Emergency surgery and some iv drugs and I'm home and pain level has decreased.

That walkin clinic should ideally not be in operation. It only exists as the system sucks so bad that doc can make tons of money with marginal care. Same for my family doc. No competition so she can suck and make the same money.
 
GreyGhost said:
If private care brings some accountability and competition, I'm in. Had a horrendous ear infection this week. Family doc said no appointments at all this week. Walkin clinic flubbed diagnosis and gave me antibiotics but not strong enough. Went to hospital and infection had spread to bones and was dangerously closed to becoming meningitis (triaged as 1B). Care at the hospital wasn't quick but it was thorough. Emergency surgery and some iv drugs and I'm home and pain level has decreased.

That walkin clinic should ideally not be in operation. It only exists as the system sucks so bad that doc can make tons of money with marginal care. Same for my family doc. No competition so she can suck and make the same money.
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Ditto on my experience with walk in clinics. All they can do is basic tests one can do at home with a hundred dollars worth of equipment. I was told to buy an over the counter cream that wasn't for my age group.

If you're a senior it gets worse.
 
GreyGhost said:
If private care brings some accountability and competition, I'm in. Had a horrendous ear infection this week. Family doc said no appointments at all this week. Walkin clinic flubbed diagnosis and gave me antibiotics but not strong enough. Went to hospital and infection had spread to bones and was dangerously closed to becoming meningitis (triaged as 1B). Care at the hospital wasn't quick but it was thorough. Emergency surgery and some iv drugs and I'm home and pain level has decreased.

That walkin clinic should ideally not be in operation. It only exists as the system sucks so bad that doc can make tons of money with marginal care. Same for my family doc. No competition so she can suck and make the same money.
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Having lived in the US for a long time, two of the benefits I always enjoyed was speed and specialization. Hospitals did the big work (acute) while their affiliated clinics did the day to day doctoring.

My clinics were 24/7. Family physicians did the primary stuff like physicals, sniffles, you saw a specialist for anything else.

Over a decade, I can't recall waiting ever.

In your case, you'd drop in, see a primary physician, if it was out of her/his scope, you'd get marched down the hall to an ear/nose/throat specialist for treatment. Pharmaceuticals, if necessary, dispensed on the spot.

Maybe 2 hours in & out.
 
GreyGhost said:
If private care brings some accountability and competition, I'm in. Had a horrendous ear infection this week. Family doc said no appointments at all this week. Walkin clinic flubbed diagnosis and gave me antibiotics but not strong enough. Went to hospital and infection had spread to bones and was dangerously closed to becoming meningitis (triaged as 1B). Care at the hospital wasn't quick but it was thorough. Emergency surgery and some iv drugs and I'm home and pain level has decreased.

That walkin clinic should ideally not be in operation. It only exists as the system sucks so bad that doc can make tons of money with marginal care. Same for my family doc. No competition so she can suck and make the same money.
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The thing is, we now pay more taxes than ever before, but we get less in return. OHIP coverage is dropping, health care systems are all understaffed, and our tax money is going to China, Ukraine, foreign workers, and the pockets of politicians and their friends (at a much higher rate than ever before). Trudeau is even spending money on marketing in other countries to entice immigrants, telling them we have a surplus of over 1,000,000 jobs.
 
Australia has a mixed private/public system and the private acts for overflow when the public is jammed.
Walkins are everywhere but not all bill the public health rate.

The Canadian system treated me very well a decade back
Walkin to check a small lump on a testicle on Thursday in Feb
Doc did not like it, sonoscan same day and bloods.
Onco apptment on Friday, operation on Tuesday after long weekend.
Chemo every three weeks plus spinal chemo 3 x and 17 times radiation.
Declared cancer free in the summer
Biggest cost to me was parking.

Mcycle accident also was satsifactory,
Trauma center at Sunnybrook.
Leg operated on and in cast the next day...shoulder injury with sling.
Few days in Sunnybrook then transfer to Rehab center for 90 days.
Paid either by OHIP or the insurance company.

In either case concern over costs of treatment never crossed my mind. I don't think the US is like that tho Australia is.
Aviva policy will cover my physio related to the accident for 5 years at OHIP pay rates. They covered all else, walker purchase, wheelchair rental, all accommodation, food and drugs and sent me to Aus with 1 month drug supply.

Now this is a GTA viewpoint...I suggest the further away from major centers, the more the issues arise.
I'd be fine with a mixed system like Australia, not the unmitgated money pit the US has with 25% admin fees, horror stories about coverage and poorer outcomes than public systems.

Staffing shortages are NOT going to be fixed with a private system.
 
So...interesting experience today with this. But will see.

In August had some trouble with my abdomen where I had a dull pain. Got a few urgent emails from concerned GTAMers (thank you) to go see the doctor, which I did.

Had the ultrasound, and all they found was a 0.5cm kidney stone which COULD be causing the pain...but not conclusive. So they sent me to a gastro doctor, which happened today.

Roto rooter appointment for March 25 booked at time of visit for Credit Valley hospital. By the time I got home got a call from the receptionist that there is an option for an earlier appointment (Jan 11) at a private clinic the doctor has her practice at, and if I'm interested in the earlier date that they'll cancel the hospital one.

'Do I have to pay anything?'
'Nope, all covered by OHIP but 2 months sooner'
'Ok sounds good. Sign me up.'

If this is the result...may not be a bad thing at all.
 
There are lots of gaps in hospital and fillings by clinics , that are staffed by the same Doctors . Take the appointment and be happy your being seen.

This biggest thing I’ll miss with wifey retired from the hospital network , and the contacts should last yrs . Son needed to see a urologist, could be 5 months , nope next day. Daughter had girl issues , gyno visit same day. My Labrador needed heart meds, he was under the care of a cardiologist. The two tier system has been assume for us .


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crankcall said:
There are lots of gaps in hospital and fillings by clinics , that are staffed by the same Doctors . Take the appointment and be happy your being seen.

This biggest thing I’ll miss with wifey retired from the hospital network , and the contacts should last yrs . Son needed to see a urologist, could be 5 months , nope next day. Daughter had girl issues , gyno visit same day. My Labrador needed heart meds, he was under the care of a cardiologist. The two tier system has been assume for us .


Sent from my iPhone using GTAMotorcycle.com
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Well in your case the two-tier system was only because you had an in. If your wife wasn't involved in the hospital / medical field you'd be stuck with the rest of us suckers.

But I agree, it's always been there. Hell in Poland it's simple...'you can have an appointment in 6 months, or pay me 500PLZ (about $200) and I'll see you next week'.

It's always been there, and always will be.
 
I had a spot of cancer taken off my face a year or two back. It was done at a private clinic and the service was great.

The other side of the coin: I asked one of the nurses how she liked working there and the reply was she loved it. A far cry from what I hear about burnt out hospital nurses.
 
Had my first taste of this new public / private yesterday with a colonoscopy.

Original hospital visit was scheduled for late March, and then the doctor works at a clinic and offered an earlier date yesterday.

Fantastic. In and out within 2hrs. Clean, efficient, and run like a proper business. 5-6 beds of patients wheeled in and out like an efficient machine.

Appointment was about 10min later than planned, 15min prep, 20min procedure, 15min recovery.

In and out (literally and figuratively).

I was pleasantly surprised. Only lost 3lbs during my 36h fast and cleansing...
 
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