Tuesday, April 03, 2007

Money Back Guarantee

Mia Rabson provides one of the most concise explanations of why wait time guarantees are the worst health policy trend to come along since provincial governments of the 1990s cut enrollment in medical and nursing schools with the view that the ageing baby boomers should actually need fewer nurses and doctors to look after them.

The Wait Time Guarantee promise by Canada's New Government was a gimmicky act by people who have no real power over health care delivery in this country except to give money to the provinces and make vague threats to Alberta about enforcing the Canada Health Act.

(Of course the previous ill-fated Martin campaign had little ground to stand on calling Harper's crew gimmicky in the policy business.)
Having politicians decide how long you should wait for your heart surgery or hip replacement has had perverse results in other jurisdictions where it's been tried - like Great Britain.

Patients who are closing in on the "guaranteed" waiting time get care before other patients who may actually have greater medical need. Waiting for cancer treatment is not the same thing as waiting in line at the deli counter. Medicare was not designed to be "first come, first served". The goal of our health care system is to get people what they need when they need it -- no matter who they are or how much money they have. And generally, we try to let nurses and doctors decide how quickly you need care based on the seriousness of your condition.
Working with health care providers to reduce wait times has actually had good results in Manitoba. As Mia points out, cancer treatment times are down to about a week -- one of the shortest waits in the country. This was achieved because the government worked with Cancer Care Manitoba to keep radiation therapists working here and replace old equipment that was constantly breaking down after the decade of neglect, otherwise known as the "Filmon Years" (see current Manitoba Nurses Union campaign). Investing in people and machines -- that's the way to shorten wait lists.
But, hey, we'll still take the money from the feds. They've been shortchanging health care for decades, while racking up massive budget surpluses. It's the least -- literally -- that they could do.