How universal is universal?

I have long wondered how universal our universal health care system really is.

Residents in various communities around Nova Scotia have to pay for public services that those in other parts of their health authority don’t. For example, if you need blood drawn in downtown Halifax you go to the VG and it’s done. If you live in Tantallon, you pay a fee for that. If you live in Caledonia you pay for having blood drawn, but not if you are in Shelburne, Liverpool or Bridgewater. Likewise Kentville residents who go to Valley Regional Hospital to have their blood drawn don’t pay, while people in Canning will pay for a private person to draw their blood. Why are the individuals paying for this and not the health authority?

We do have some private clinics. And then there are various headlines about medications or surgeries not paid for by the system. How often do we read about families and friends who have to organize community fundraisers to be able to afford a life-saving drug that isn’t covered by Nova Scotia’s system, but is acceptable in other provinces? Or to raise money to pay for transportation to another province where a type of surgery is available? I wonder how we are not in violation of the Canada Health Act?

This week I learned that a former executive of a non-profit organization, a woman who has a national reputation, is now stocking shelves. Why? Because this private employer has a great benefits package which pays the $90,000 annual cost for the drug which is keeping her husband alive. This is the type of mean-spirited hardship situation we expect to hear from the United States, not Canada.

Sadly, this couple’s situation isn’t as rare as we would like to believe.

And while people talk about the economic pressure our system is under I suggest that’s bullshit. In Nova Scotia we spend $6.1 billion on health care. If that’s not enough, how much is?

Our system affords whatever those in the executive suite want it to afford. Like maintaining 10 separate health authority bureaucracies. And then there are all the poor choices this army of health executives make. Little things add up. The Yarmouth Regional Hospital, for example, uses disposable cutlery in their cafeteria. That doesn’t seem to make sense. Not only isn’t it environmentally responsible, it seems to be an unnecessary cost. This is a hospital, they wash and sterilize all kinds of things, why not cutlery? Surely they have dishwashers?

I’ve heard that in the weeks leading up to Christmas four female managers at Annapolis Valley Health were treated to having their colours done. That’s four salaries, plus travel, and the cost of the colours program – whether it’s materials they paid for or a consultant. This is the type of thing that gets buried in a budget under human resources development, education or staff training. The health authority also had staff from Middleton drive to Kentville to decorate the executive cafeteria for Christmas. That’s paid staff time, plus mileage. Traditionally, the food services staff responsible for on-site executive catering decorate the cafeteria, but not this year.

I’ve also heard that in November the health authority had an issue with two staffers, but rather than speak to the people involved, they required 40 people in that department to come to a four-hour meeting with Human Resources staff in the executive bunker in the Kentville Industrial Park. There was no concept of the HR staff actually going to the hospital’s cafeteria, which was closed at the time of the meeting, for this session. That would have been cheaper and more convenient. That’s 40 people times four hours’ pay, plus mileage, plus the HR staff. I have no idea if it was catered. On the topic of budget expenses, has the Province set guidelines for hiring live-in lovers or spousal equivalents of executives for positions paid for by the public purse?

Now, multiply these examples across 10 health authorities and we can see where a lot of money is pissed away by questionable management practices. That is why there is pressure on health care budgets and why people who would otherwise be retired are stacking shelves or organizing fundraisers for those they love.

Universal health care doesn’t just mean everyone pays, it means everyone is cared for.

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4 Responses to How universal is universal?

  1. Mary says:

    Until we demand a truly open system, with complete accountability for all spending, we will continue to face such wasteful spending (such as taxpayers footing the bill for staff to have their “colours done”). A friend of our works for the Federal government and recently told us they all (several hundred staff at his location) had personality profiles completed, primarily to “boost staff morale”. By my estimate, costs for this evaluation (Myers Briggs) would exceed $500 per person, maybe even as high as $1000 each.

    There is no possible way we need 10 separate health authorities in this small province. Someone needs to step in and evaluate the “big picture”. At a recent Chamber Dinner it was interesting to hear the perspective of a visiting health economist, who took one of our health regions to task for IT spending, and inconsistencies across each region that costs taxpayers millions of dollars.

    The big question is, how do we effect such change?

    • We effect change by contacting politicians. It’s important to let them know it is safe for them to challenge the status quo. For too long the public has bought into the idea that more money is the solution to our problems. It obviously isn’t. We have poured money into the system and the same old problems persist. We have tinkered with every part of health care except for how it is managed. Therein lives the problem.

      Let your MLA know what you think. And copy the health critics from the other parties and the leaders. The politicians will follow the public’s lead. Thanks for writing.

  2. Of course it isn’t universal. But any government run system will always end up rationing what it will and won’t pay for. Same for private insurance companies. Same for pay-directly-from-your-own-pocket.

    I have experienced (directly) the healthcare systems in 4 countries. For example: Australia has both public and private healthcare systems. The most fundamental difference between Canada and Australia is that in Canada the public system gets to impose itself as a monopoly for those healthcare services that it feels inclined to provide.

    The abuses to which your article points are probably linked to the discrepancy between our healthcare myth and our healthcare reality… I like the fairytale version but I just can’t bring myself to believe it.

  3. The January 8th comments by Louise under the Contact Us page addresses some of the disconnect between the executive suite and front line. It is a disturbing summary of the situation.

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