Last week on CBC Marketplace

Last week on CBC Marketplace there was a program about the lack of cleaniness in our hospitals and how 250,000 Canadians pick up secondary infections INSIDE, resulting in serious life threatening illness for an otherwise basic medical procedure such as childbirth or a knee operation. The main cause - health care workers, including doctors failing to wash their hands! If you are a patient in any hospital become your own health advocate and be sure, no matter how tough this may sound as we tend to treat our doctors like Gods, you get your health care provider to wash up. Put some antibacterial soap on your desk! As a doctor mentions - "funny" how when someone comes into emergency with an acute life threatening ailment the system responds and yet there is a lack of vigilance on this simple hygienic procedure. See the video here http://www.cbc.ca/marketplace/2007/01/dirty_docs.html#video In Holland they have virtually eliminated antibiotic resistant pathogens inside their hospitals/clinics through a seriously enforced "wash your hands" program for their workers and by isolating Dutch patients who are transferred from the adjacent countries where secondary illness is more common - like the UK. By introducing the same rigorous yet low tech and inexpensive control procedures as the Dutch we can make the public system work more efficiently and save millions.

Makes Business Sense

Any business outside the delivery of healthcare could not possibly want pivate, for profit, healthcare. Look what the rising costs have done to GM! The only ones that are bent on pursuing private are those that want to profit from it, or those with the deep pockets that want to be able to jump in front of the poor, sick kid when they get sick.

Tracking health spending

The HEU is hosting its own "health clock" at www.bchealthconversation.ca where the provincial government spending on health care is tracked on an individual basis.

It's not as dramatic as the BoT clock, and it provides a comparison of the value of universal public insurance to the largely private system south of the border where 46 million Americans have no health insurance at all.

Pity poor Campbell.....NOT!

Campbell is a deal maker and health-care reform is a major item for deals, secret deals and side deals.

Campbell is a cheap *expletive deleted* and sees BC nothing more as a bunch of rubes, easy pickins for his huckster friends. Hey, he gave away BC Rail, possibly illegally, and no one gave a damn. Desperate baby boomer's will pay anything to live another 2 minutes longer!

bpither1

Good comments, thanks.

I think the genesis of modern health care 100's of years ago was the connection made by scientists/physicians with (i)sanitation / cleanliness and (ii) infection.

What is a hospital really, and ironically , but an area of concentration of people in compromised health, which can be from physical injury all the way to infectious and contagious diseases, and everything in between. Thus, as a consequence,..one will risk a greater exposure and hence place one's own health (and others)at greater risk by the very fact one has set foot in the hospital.

It was proven 100's of years ago that the patients tend to "live" and /or "live longer" if the Physicians and Nurses and other Health Care workers washed and sanitized such thngs as surgical instruments and washed hand between surgery or any other patient care...However is the modern health care system slipping and regressing , but should now revisit and also place higher priority on these good "olde" habits?

We were recently visiting a family member in Intensive Care, and were a bit lost in finding the room, thus we transversed much of the hospital...including the Emergency area. As we wandered around the Hospital , I didn't see any of the horror stories of what some seem to imply is a nouveau norm ie we saw no unclean floors ,nor filth , nor poor general maintenance. The hospital appeared quite clean, certainly on par with what I recall the standards were in the past.

What?

I couldn't believe the first '100s' wasn't a mistake but then you did it again.

Do you have any real knowledge that you haven't picked up in a coffee shop or PAC meeting somewhere?

Antiseptic practice in medicine began as a result of Lister's studies on the cause of suppuration around the time of Canadian confederation.

Modern medical education was a collaborative work but some of the most important conributions to it came from a Canadian, William Osler, who wrote the first great textbook of modern medicine, The Principles and Practice of Medicine.

If competition is good...

... then more competition must be better. With the simple introduction of competition everything can be improved!

How about: Privatize all municipal roads. The initial auctioning of the roads will create an immediate one-time boost to city coffers (who's going to argue against that?). Potholes will be a thing of the past with multiple Independent Road Operators competing for drivers' business. A reward program like Frequent Driver Miles would be hugely popular in this town.

Privatize the elevators in office buildings. Why should the office building have control over all of the elevators it contains? Should workers in these buildings really expect to use the elevators for free? Competition will give elevator operators incentives to create efficiencies and reduce waiting times. User fees will introduce some much needed moral hazard theory into the equation.

The old saying goes: If the only tool you have is a hammer then everything starts to look like a nail. Well I say that lots of stuff kind of looks like a nail anyway so who are you to tell me that I can't hit it with a hammer? Hmmmm?

Lost, confused, worried ... hospital looked good to maestro

Jeez, G -- give Ol' maestro a break! He was lost ... confused ... worried about his rel in Intensive Care!

So his hospital inspection wasn't perfect. He did his best, so as to report back to us. Now you've gone and upset him with facts, dates, and logic.

He couldn't find any dirt, see. He couldn't find Intensive Care, either.

G West

I didn't want to bore people with expanded detail like the advent of Optics and the creators of the Microscope, apparently developed in the Netherlands in the 1600's ie 400 years ago ie " 100's of years ago".

Seem to recall that lead to awareness of previously invisible micro - organisms, many of which compromise human health, and thus branched off in greater understandings and developments in the field of Medicine.

That said, You don't know if your own ass is drilled or bored....and your F'n " know -it- all " attitude is becoming a B-O-R-E.

You are more and more into a spin, and a spin cycle ad -nauseum , and becoming repetitive with not much new to add....and much of what you do provide is blinkered subjective rhetoric you try and sell /scam as THE TRUTH .

Trade deadline is coming up...I'd rather trade and have COYOTE back. Take the next flight to Cuba and send Post Cards... maybe one every 100 years?

PS Where can we donate?, .....you are simply a one- man political party/parody...I am sure we can use the funds as a tax deduction.

BC Mary

Didn't you see me walk past you and say Hi...that was you foaming at the mouth in Emergency with the rope burns from practicing with the noose, wasn't it ?

Luckily your rope burns qualified as a Work - Related injury from your Kangaroo Court Ltd./ Private JUSTICE System Ltd. and thus you were able to bypass the nasty Public line-ups and thus have access to Private Health Care.

Good thing you thought a-head ,way to go BC Mary. While you were in there, what other coupons did you use?
Just curious.

One of the big mysteries

One of the big mysteries about the mess medicine was in before antiseptic practice was the curious phenomena of the patient surviving the surgery or the childbirth and then dying anyway. This was still going on in Victorian times - when most 'scientists' believed that contagion was spread by foul odours. You might want to research the story of the cholera epidemic and the construction of the London sewers.

Proper antiseptic practices are the result of a rigorous coordinated effort by a health care team who are committed to achieving excellent results. You get that from a team approach fashioned of dedicate people who are paying attention to the health of their patients and not the bottom line. The profitization and privatization of health care cleaning teams has been a disaster - as audits of the situation in major hospitals have shown.

You just keep on spouting like a disaffected 10 year old in the school yard. With luck, when someone from your family goes to hospital they'll actually get safe and competent care. But if the current conversation on health care goes the way Carole Taylor has presaged it, you'd better keep your fingers crossed - and use lots of that alcohol rub they have in every hallway throughout the hospital.

1944-64

What is happening to health care in Canada, and this is by no means a problem unique to BC, is being decided by civil servants, analysts and to a limited degree politicians.

There is presently a bulge in health care demands as the baby boom gets sick and dies. It is only going to get worse for the next ten to fifteen years. By then, enough will have croaked to ease the burden on the system.

The government, of course, knows this and they do not want to build a pile of facilities that will no longer needed in twenty years. It is therefore going to contract out its projected needs at a set price and pay for the proceedures. It is happening in every province in Canada and you'll see more of it, too.

Everybody knows that just MSP does not cut it because it does not cover so many things. That is why people need private insurance and willingly pay for it. I know, I pay for it and it is worth every penny.

These decisons are made now. In Canada, the policy will be to keep seniors at home and healthy as long as possible so they will not spend much time in the system before they die. The problems we have now will work themselves out demographically. It is all a matter of rescorces. Throwing billion of dollars are 80 year olds doesn't make sense economically or emotionally.

Unless you happen to be a rich 80 year old

Unless you happen to be a rich 80 year old in a private/public system who, because he has lots of money, can tie up all sorts of resources that should or could be used for other purposes. In a purely public system he can’t do that – in a private/public one, he’s encouraged to.

You also fail to address other unnecessary services that are always being performed in private practices, not to mention much poorer quality control in contracted diagnostics in areas like radiology. Thing like annual full body scans, for example.

Check the error rates for private radiological work in the United States with that of public facilities here in Canada.

There is a crisis in chronic care and an over emphasis upon building facilities which are more about empires than they are about medicine though. In many cases in medicine - small and local are better than big and centralized.

As for the people who're making the bad decisions. The deputy minister of health, Penny Ballam, in this province recently resigned because management of health care here was not being handled properly by the 'business' people and corporate klingons that the current government has put in positions of authority even though they have no professional experience or expertise in the field.

Some people maintain the Campbell Government is in the process of deliberately destroying medicine in this province. I’m beginning to think they are correct. Along with everything else in gordoworld, if you can’t make money out of it - forget it. If you can’t reward your friends and sneer at your enemies and people with no power or money – it’s no fun.

Quit deflecting G West

Sorry G West;

It was likely your WASP-y Imperialistic ancestors that besides royally screwing the First Nations,and fattening themselves on the plundering, probably introduced all the societal ills, man- made and natural( ie infectious diseases ) and yet you still have the audacity to claim its someone else's fault.

Nice Try...but as per usual , you L-O-S-E...AGAIN .

Sign it all over back to them ASAP.... SVP. Quit being such a free-loader...a typical Leftie.

Spoken from Experience

This is a very complicated subject and a true story. I was in New Orleans about 7 months ago.

First time i've been hurt in years, but my business partner shut the door on my hand, broke two of my fingers. I went to bed thinking I was fine, but woke up in the morning is pretty serious pain.

I went to the hospital. It was nice, clean, the nurses and doctors were wonderful. I didn't have to wait one second. I travel frequently to the US, so I have limited private health coverage. I gave my insurer information and left. I left thinking that health-care in the US is awesome!!

3 weeks later I get a bill. This hospital charged me about $2,400 for my 45 minutes and some casting. They charged me nearly $400 just to be entered into emergency and $110 just for the bandage. A few hundred more for the casting, a few hundred more for the pain-killers and around $300 for the dr.'s time.

My health insurer refused to cover 1/2 of it. So, I was out of pocket $1,200 for 45 minutes of time.

US Healthcare sucks!

What I have learned is that there has to be a balance. In the U.S. - the service was unbelievable. It truly was. However, to charge $110 for bandages that cost about $1.50 at shoppers is price gouging. I'm all for mark-up and margins, but that is exploiting people basic essential needs.

I can afford the $1,200, but there are millions of people that have a tough time. The hospital has to accept these people, but they get stuck with a big bill. If they can't pay it, they have a collection agency all over them.

Now, there are public hospitals which are free. I just went to the closest one because i had an early morning meeting.

However - we had a system with impeccible service - yet very costly and out of control. In Canada, we have a costly out of control system with terrible service.

We must find balance between the two.

maestro

Have you lost all touch with reality?

What in the world are you writing about?

I think you should seek professional help, and soon - before the privateers from gordoworld completely screw up the system.

I guess, as Stump pointed out months ago, you really are suffering from some kind of breakdown or debilitating syndrome.

If you want to talk about balance, cappy, it helps to swear off the sauce for a few weeks. It'll make a world of difference.

Guess you didn't pick the right 'private' insurer eh?

Working Man

The odd time a voice of reason (oh no)and even worse a party with intimate knowldege with the system( again oh no ) steps forward and puts things in their proper perspective.

One such person was a BC Doctor on the issue of health care and budgets.

He stated that almost 80 -90 % of the per person Health Care Budget is spent during the last 2 -3 years of the person's life. This would imply parties who are senior citizens in need of long term extended care in their remaining years, or who have major health problems etc. .

This would further imply that up until then most(but not all) people are not at all a major burden to the health care.
system.

A person has rights and in my view should have the right to access health care. Idelaistically it would be fully funded by Gov't..using the old Canadian model.

The reality, at least more and more, is that this right is a right in theory, but less a right in practicality. To bridge the two...options are needed, and currently that involves the private sector.

The usual Leftie ideological idiots who rant on and on and on would rather an individual suffer, if not simply die, to be a sacrifice to the religion of Left Wing ideology...and that individual may be say your child, your elderly parent...your spouse...etc. etc. ANYONE else...should have either (i) Public Health care or (ii)ZERO Health care.

Lefties try to be coy and package this as " in our best interests" ...not knowing that Lefties are often not in our best interests via the free ride they often crave. Of course they do NOT want options...that may de-rail the gravy train...they fear that...yet they BS society with all sorts of illogical and idealogical fear - mongering.

Usual way one can pick out a Leftie is Yes or No , but want 100% control on the issue...yet with NO reason nor rationale.

Maybe the Lefties should have a Leftie health care plan , why not... that would be more fair and ideologically equitable right? No? Why? ...Oh I see...I get it....

Maybe the issue really boils down to something a Vet should look at , " The Gored Ox theory" " who's Ox is being Gored. Do you remember, a few years ago, a group of BC Doctors , as an Xmas present to society , were willng to work for FREE= NO CHARGE and operate on some patients so as to help them and also reduce line-ups? It appeared it was a " go " till the nurses union complained, given nurses were needed...and this " gift " was cancelled. Whose the money grubber/power hungry group ?

Look at G West (and BC Mary's) usual in- denial rant about my recent experience. He/She wasn't there, I WAS, the hospital has a very maze -like layout with all the renovations and restricted areas...but my unavoidable mini tour didn't indicate anything near the usual Leftie sky is falling BS . Our families have been using this hospital for 40 + years. Can't see much change .

G West was not there and yet doesn't want to believe what I saw... so they are effectively call me a liar, yet spinning their frontal lobes and wonder what credibility, if any, they have left and why we say their heads are so far up the ying yang,it's both amusing and pathetic.

Guiding light?

GW, the Romanow report still your guiding light in the Health Care discussion?

Gordon Campbell = 3rd best

Gordon Campbell = 3rd best premier after W.A.C. and his son.

G West: Take off back to

G West:

Take off back to Leftie -Land/ Planet ..... the rest of us will have to " soldier on without you " .

Probability of success: 110%

Like " W " said in essence ...walk the walk , so start walking on the old H20...see how your self - deification holds up. glug - glug -glug .

It's obvious you (or your monkeys ) are digging into old TYEE posts , you are so bereft of anything useful or original .

Quit flatlining ...YOU are the one who needs help.....join the Leftie - induced MSP line-up.

Gavin and his Ilk

There is no doubt about this. It is Gavin and his Ilk that has been holding us back for decades. This band of protesting whiners does nothing but increase our taxes, decrease our efficiency and waste our time!

By the way, did anybody see that good ole' Goldcorp was up 3.5% today! This fast money paradigm that the Tyee creates....it is funny, everytime they write an article slamming a great canadian company - their stock jumps - I simply profit!

maestro

Where did I call you a liar?

I simply pointed out that recent audits in many hospitals have shown serious deficits in housekeeping standards that were not the case before these services were privatized.

The only people who have benefited are the owners of the companies doing the contracting and services, standards, and staff morale are all down.

Two weeks ago, I spent from 6:30 pm till 1:30 am on Friday and from 12 noon until 9:30 pm in the emergency department of a major urban hospital with two different family members for two separate emergency situations.

None of the situations I encountered and witnessed, in addition to the ones I observed directly, had anything to do with chronic care problems or long term outcomes. Even so, although the medical staff did an exemplary job, the obvious shortcomings and faults in the system were - almost all of them at the triage, diagnosis and intake levels - clearly obvious.

The management of these places, run as they are by ceos with no professional experience or qualifications other than having impressed Gordon Campbell (and his relatives no doubt), is one of the main problems with health care in this province.

At one of the intake windows, when, after about 20 individuals had been waiting for more than five hours for a single new patient to be admitted, someone eventually complained. The poor frustrated clerk, who was doing her best, then came into the waiting area to explain that there were just no open examining areas available; that everyone was doing the best the could and that, if people had complaints, they should write minister Abbott or their MLA. Most of this because beds in the wards had been closed to cut costs and lower staff levels – all while overtime costs are going through the roof.

I think I'll have them write you and cappy too. Because Gordo's 'reforms' aren't working - they are making things worse. Far worse.

I'm glad to see you enjoy making profits out of theft and greed and the undemocratic treatment of the people of Guatemala cappy.

I expect you'll be donating all the extra dough you've made to an NGO that's working in Central America to ameliorate the damage Goldcorp is doing to the environment down there.

O, and for your information, This

This:
Sorry G West;

Nice Try...but as per usual , you L-O-S-E...AGAIN .

Sign it all over back to them ASAP.... SVP. Quit being such a free-loader...a typical Leftie.

is what I was talking about when I wrote the following:

What in the world are you writing about?

You really ought to pay more attention.

Cap:

Some saw it earlier...and pointed it out.

Leftie , especially G ster, Uber - denialists to dead , tired , " tried and convicted " ideology. Borderline psychotic...irrational and illogical.

It's getting even beyond " When did you stop beating your ___" type -of-entrapment Leftie "logic".

Perhaps a delayed epiphany...but an epiphany nonetheless.

Simply a cult-ilk of condescending " believe -us -or -else " pseudo - intellectuals . Their loss, but most certainly not ours.

So I'll repeat it.

Ubiquitous thinks you have the capacity for abstract thought, Cappy not so much.

I'd say, keep up with this sort of thing and you may lose ubiquitous too:

Leftie , especially G ster, Uber - denialists to dead , tired , " tried and convicted " ideology. Borderline psychotic...irrational and illogical.

It's getting even beyond " When did you stop beating your ___" type -of-entrapment Leftie "logic".

Perhaps a delayed epiphany...but an epiphany nonetheless.

Simply a cult-ilk of condescending " believe -us -or -else " pseudo - intellectuals . Their loss, but most certainly not ours.

Now I know why you were at the hospital, evidently.

maestro

Maestro, Have you been ill?

"Cappy not so much"

I think that Cappy is one of the few guys in here that doesn't dilute himself. He is a libertarian and doesn't believe in government.

As far as running and hiding. He never does that! He doesn't take the time to read a bunch of the crap posted on this site, about him or other matters. Other times, he decides not to respond because it is flat out a waste of his time!

Gavin believes he is trying to educate folks at the tyee. Speaking of delusional and belonging in a hospital.

Alci believes he is the second coming of Ghandi. Gavin believes he is the second coming of Nostradamus. Both of them belong in a hospital!

You don't have to dilute yourself

You're already diluted.

By the way. The BCSC has opened a file on Goldcorp.

Just thought you'd like to know.

Good article, Tyee.

Good article, Tyee.

CAPPY'S HAND INJURY!!

Sorry to hear about your hand. Since reading your posts I'm sure it was your right hand as it would appear that you fear leading with anything that might put you in a leftist position. Was it an accident or was your partner tired of hearing your illconcieved babbling?

recent experience with "the system"

My number of posts has gone down considerably in the last while. One of the reasons, as some of you know, is that one of my brothers was diagnosed with Mesothelioma. He is undergoing chemo and doing better than anticipated. His treatment has been top notch at every level of the system, including the WCB and other peripheral agencies. Naturally this means nothing on a provincial scale but that was my first reason to be thankful.

My second was last weekend. A bus driver decided that hitting our legally parked car was within the bounds of good driving and he hammered the back corner, knocking the car aside, before hitting the driver side door. The door had been in my wife's hand as she stood next to the car. I was on the passenger side and she disappeared from my sight as the bus roared by.

I thought she was dead. I dropped what I was holding and ran around the car to find her crumpled with her head on the door sill. There was no blood and she was soon responsive to voice but groggy. I had barely time to start pulling a blanket out of the car to put on her when 2 women came up and said they were nurses. Soon after a doctor came running out of the crowd and the three of them did what they could to make her comfortable during a brief wait for the ambulance. Two more nurses appeared with a quilt and it was pretty crowded with medical help.

By the time we were on the way to the hospital things were looking a lot better: the doctor and paramedics were confident that she didn't have any broken bones or internal injuries. We arrived at VGH on a Saturday evening...and it was near empty. She was examined while I did the paperwork and I was told I would be able to see her in a few minutes. There were 2 people in the sitting area waiting to see family or friends in emerg, but there was nobody else.

My wife was examined and by the time I saw her the doctor had said she could go home. We live nearby, and her only complaint was a diminishing headache. She had a concussion, but no other symptoms until the stiffness set in the following day. The time from the accident to getting home was just over 2 hours. Everything went comparatively well following the impact, the fact that she is alive has made us consider this a "lucky" event. The response from all the members of the medical and emergency response community made them come out looking like giants in our eyes.

Glad to hear that Gerhardius

Both about your brother and your wife.

I wouldn't want anyone to think that I was complaining in my piece above here about the medical care my family members received; once past the wall of admitting everything was efficient, precise, careful, caring and otherwise exemplary.

In one case an internal medicine specialist was brought in to do a complicated endoscopy procedure on very short notice. The staff professionals were, in every respect, thoroughly professional even though the environment, shortages and crowded conditions made their jobs far more taxing than they ought to have been.

DELETED DUE TO VULGARITY - TYEE EDITOR

Too many things we have to deal with are controlled by government.
Being a libertarian, I think government should only be involved in immigration, human rights, justice, tax collection, home security and that's about it.
Certainly not what we have here.
Govt. selling liquor, Govt. selling auto insurance, Govt. involved with combining ICBC with Motor Vehicles Dept., birth certificates, marriages, Govt. selling pension plans, Govt. providing medical care. You get my drift.
Privatize everything possible, including Transit, water dispensing, medical and auto insurence.
They are unelected, appointed beaurocrats with a self serving mission.
Give back power to the people.
Get Govt. out of our lives.

Back to basics

Usually the health care subject generates a lot of good debate, but this has just been a thread of name-calling and sheer bullsh*t from nearly one end to the other.

EVERYBODY SETTLE DOWN AND GET BACK TO FACTS!

The most egregious one was the one about the unnamed BC doctor who said that 90% of the health care budget cares for people in the last 3 years of their life. It's crap, and that I know because one of the business case analysts at Providence told me so a couple of years ago when that topic came up.

In their organization, the median age cost of spending was 51 years. As much money was spent on people below that age as above, when all costs, from doctors fees to labour to supplies were factored in. Given average life expectancy in Canada is 80 years for men and women combined, I think that should put that one to rest quite nicely now.

I'm on the board of an extended care home where we are expected to care for chronic patients who survive for 20-30 years on $136 per day (now - until mid 2005, it was $108 per day). Just try to get a hotel room alone for that, never mind get your diaper changed, a shower once a week, physio, rehab, recreation or decent food that satisfies your ethnic background. There's a good story in this one, given that the charities that run about 50% of the ECU homes in BC do it on 10-30% fewer funds than nearly all of the private care operators.

More bullsh*t

Are hospitals filthy? Not like a few years ago. There was a serious problem when the private contractors (Crothall, Sodexho, Aramark, etc) took over and refused to hire most of the workers previously employed, or if they did, moved them to new sites. Dumbest thing they ever did, and it was done solely to avoid reunionization, which obviously didn't work. The real complainers didn’t bother applying, and the good ones often didn’t get jobs if they showed any initiative at all. The replacement staff hired off the street had little or no training beyond the 5-week BSW course (sometimes not even that) and the training of them substantially fell on those housekeepers who had previous hospital experience, or on nurses, care aides and nursing managers.

Audits were performed of housekeeping at every facility I was at, and routinely for the first year or two, the contractors failed abysmally, but showed improvement by throwing more and more staff at the site. So now, if you talk to floor staff who have knowledge of these audits, they will honestly admit there is little if any difference in cleanliness before privatisation and after.

Don't forget, cleanliness isn't about paper on the floor or dust on top of doorframes in hallways. It's about the dirt you can't see that harms people - the rooms that are not properly "bombed" after the TB patient leaves because the housekeeper has been given only 24 minutes to do the work by the call-centre, which reports her "statistics" to her manager, who then follows up to find out why she isn't as fast as the stats say she should be.

However, the contractors are not making money. They lost so much money in the first two years that there is doubt they will be able to recoup it in the balance of their ten year contract. Nobody's sure. A number of things have led to this. The contractors are paying more for labour, partly due to unionization but mostly because they seriously underestimated the amount of work involved. They are also experiencing higher assessments for everything from WCB to benefits. Added to that, their turnover in employees was approximately 40% per year
(this figure from an HEU staffer of my acquaintance) so they are constantly spending on retraining.

So it appears they are resorting to other value-added ways of getting more money out of the facilities - supplies charges, higher bids for final cleanings after renovations, etc. It simply hasn't turned out to be the profit centre that they had hoped, here or in Ontario.

And unfortunately, the hospitals themselves have taken an extra hit financially, in that the quality control has effectively been downloaded onto hospital staff such as nurse managers, who have had to keep these housekeeping audit committees going continuously. With no extra money of course.

But some of these problems existed prior to privatisation. There were training problems, quality issues, and wide variation in how various employees did their work. Training and management oversight could have been better. Employers made no effort to address a restrictive union contract with qualifications and experience. And money made no difference - after pay equity kicked in to level "female" and "male" jobs, there was no difference in quality of work afterward.

As I found long ago, higher pay is no guarantee of getting good workers. It's all in the attitude of both manager and employee. There were a few crappy housekeeping aides before at $18.32/hour, and there are a few now at $8.96-13.50/hour. The majority have always been decent workers. The truly stellar ones are still not being rewarded commensurate with their skill or experience under either system.

BPither...

... is quite right. Handwashing is an issue and I am aware of several people actively studying it. Y'all might have noticed this year has not been a "Norwalk" year. But there's still a long way to go. Routinely you find visitors using toilets specifically designated for patients only, either because they can't read or because they don't want to go find a public one. The cross-contamination here alone is suspected to lead to all sorts of nosocomial infections including MRSA and VRE, only senior staff are having trouble gathering information.

We may have to rethink how we "do" hospital in many ways that we have not even suspected up until now. In the future the public might not be allowed to visit a loved one unless they agree to a lengthy list of conditions and take a course.... ;>)

You're not a libertarian now are you Ron

Last time it was conservative; before that you were a Socred loyalist - then you said you were GOP. Now a libertarian. You must be from Alberta.

Government liquor store prices are about 20% lower than in the private stores - even though the Campbell gang refuses to discipline the private stores for selling to minors and gives them special breaks on prices.

ICBC has better coverage and cheaper than anywhere else in Canada - even the idiots in power now and the former socred hacks knew that Ron - why do you think they didn't change things?

The only thing I'd like to see privatized is you.

You are the most ignorant person I've ever encountered - about as informative and original as a recorded message.

I call bs on you Ron, you're not even a real person. You’re just a caricature. Right?

So it appears that one of

So it appears that one of the posters got lost in a hospital . Lucky he didn't wander into an operting room.

Most people if they can't find their way or don't follow signs ask somebody. Each time I go into such a place I look where I'm going and read the darn signs. Some hospitals have names of units and are colour coded with a srip of paint even those of us with no sense of direction can end up where they intened to end up.

But what this post of mine or the number of ones by a earlier poster has to do with Gordo and his conversation is pretty minimal. He appears to want to privatize, and most of don't agree with him.

For the folks who figure the hospitals are dirty, or the food is basic. It's simple. write the Minister of Health. George will tell you it's all the previous government's fault.

The staff who clean and feed folks were in HEU until Gordo tore up their contract.
A lot of the cleaneruppers are paid very little and possibly their training isn't up to standard. who to blame? Well look a bit higher up the power chain.

And like other Canadians who ended up going south for business or pleasure our family has learned to make sure we have extended health care because as one fellow said, there is no waiting but the cost for anything will blow you out of your socks. There is no waiting because over 40 million US citizens have no medical plan coverage at all. They get sick, well tough as the free enterprise system couldn't care less. If we care it's time to start talking to the present government not trash the folks some call lefties, whatever that is supposed to mean

Zalm

Certainly won't disagree with your remarks about hand-washing and cross contamination by the public. The audits I referred to above were the early ones you've quoted...On the other hand, the first stint I spent waiting in Emerg with a family member on a Friday night a couple of weeks ago was maybe a bad night, but...
There were two washrooms for the public, also being used by patients waiting to be admitted. One toilet was plugged, as was one sink - both with vomit. I advised the volunteer (a student) who was on duty of the situation as soon as I observed it. He called housekeeping immediately.

This happened around 7 pm that night and when we finally got out of there - 1:00am - the bathroom had not been cleaned and was still not available.

I realize this is anecdotal and may not be at all typical. When I arrived at the same Emergency suite less than 48 hours later for another marathon session (9.5 hrs) the washroom had been cleaned.

G West

I won't disagree with your experience - I know these things happen with all-too-common regularity in hospitals. Have for years, even when I first started in '88.

One mindset that has never been erased at the top or middle levels of management is the 5-day work-week. Patient care staff know the job is 24/7. Middle management's sole response (IMHO based on 19 years of either employment or association with them) has been "Just get through the weekend and we'll deal with it on Monday."

Unfortunately, that sometimes affects the lower ranks. Neither illness nor plugged toilets wait for no man. It shouldn't happen. But if the toilet was truly plugged, then a maintenance guy or engineer should be by to unplug it before housekeeping tries to clean up, or the next person in (ie you) will flush the floor a whole new Code Brown. And in larger places, that sometimes happens as everyone pushes responsibility somewhere else.

Unfortunately, the 5-day week syndrome is one thing the CEOs of the health authorities have never attempted to deal with at any level, whether OR usage, energy conservation, or, most shockingly, with disaster plans. Every disaster plan at every facility I've looked at relies on a charge nurse to run the whole hospital on nights, weekends, and holidays until a senior manager can be located and brought in to take over. Could be 20 minutes. Could be 2 days.

I thnk you said you were at VGH. I've seen it happen at half-a-dozen hospitals, but it's especially bad at inner-city hospitals. I've got some thoughts about that, but I'll leave them for another thread.

Gordo and maestro

Can't believe the Board of Trade would allow anyone to say anything that Gordo didn't like. I assume they'll be privatized now?

Geez maestro, you have the worst case of ADD that I have ever seen. Focus buddy.

Ron Erwin

Ron Erwin said:

Oh man that's funny stuff. "Public" means the "people" own it Ron. If you privatize it it means the "people" no longer own it. Only a few will and they probably won't even be Canadian.

So basically you want to see Canadian public services taken over by foreign business interests and you actually think service will get better and cheaper? I love those ideological blinders buddy, why the Tyee has never given you your own column is beyond me.

children

If it weren't for a very few posts by people lke Zalm, this thread would have to qualify as the most childish display of name-calling, kindergarten behaviour I've seen to date on Tyee.

Zalm's comments...

Keep talking Zalm. Some might learn something.

Cap to Gavin

This is only because the private stores buy from the government - at a significantly higher price than BCL charges. Private liquor stores are at a competitive disadvantage. It comes down to supply and demand. People will still go to private liquor store for convenience - we have about 2 BCLs in North Vancouver - and hours. The Liquor stores are open longer hours. In Alberta, booze is cheaper. It is because there is zero government intervention there.

Wrong again. Private insurers charge good, safe drivers significantly less. However, they slam the bad drivers. In BC, the good driver vastly subsidizes the bad driver. While it is true that the average driver in BC pays less - this is because a bad driver in Alberta with several accidents and speeding tickets - pays $7K a year, whereas the safe driver pay $1K.

Doesn't it make sense that those that cause the costs - pay for them????

Sorry Cap, but

When I was living in Alberta back in the early 80's my insurance rate went from $215 a year in Sask to over $1500 in Alberta even though I had had no accidents. The problem was that I was deemed high-risk because of my age.

Private insurance didn't get rich by being fair, they hammer you even if you're a safe driver in a bad demographic.

Health care

When I saw this topic I thought there'd be lineups of right-wingers wanting to throw in their 2 cents on the "conversation on health".

No wild claims of unaffordability? No regurgitation of Carole Taylor truisms?

C'mon guys I'm truly disappointed in all of you. And I'm especially looking at you Cap what with your New Orleans example. You sound like Tommy Douglas.

I guess I'll just have to accept that the "conversation" on health will boil down to left and right agreeing to complain about the system 24/7 but please god don't take it away.

Quote:Private insurance

I agree - the discriminate by demographics. Though, only until 25. I am not sure about senior citizens though. The bottom line is that drivers under 25 are responsible for a very large % of total accidents.

I'm not saying it is perfect - nothing is. Though for the vast majority of drivers between 25 - 65, all that matters is your driving record.

Frank

I would hardly call myself Tommy Douglas, though I can say that I've witnessed failure in Canada - and I've witnessed failure in the US.

I have always said I am a libertarian - and agree with IAMC's post above. However, government plays a vital role in protecting its citizens basic essential needs. I believe healthcare to be one of those needs.

When a US hospital will charge you $2,500 for 45 minutes and a cast, you have problems. The reason why health-care is different is simple. Supply and Demand is out the window, because demand is inelastic. When people need to go to the hospital, they need to go to the hospital! It doesn't matter if it is $2,500 or $50. If you have a broken hand, somebody needs to fix it!!

So, people walk into a hospital - the administrators see $$$ signs. This should be the way.

I am not a health-care specialist. I will say the Canadian healthcare system is unacceptable, but so is the U.S. system. If the U.S. can provided far superior services at far superior the individual cost to the sick and needy - can't Canada be somewhere in between????

This is entirely different than auto insurance, banking, liquor stores, telephone and cable services. People have the time and capacity to choose between competitors. Competition is the best regulation of them all.

Telus is bound by the CRTC and has to scrap with Bell, Rogers, Virgin for your mobile coverage. Prices have trended down for the past several years....

ICBC

Then don't you agree that the ICBC direction to penalize bad drivers more is fair? The problem for me with private insurance is you're penalized before the fact.

ICBC's approach of making proven bad drivers pay more is fine with me.

Health care

We've had reports from Kirby and Romanow among others, we can look at best practices in places like France who have the highest rated system, the problem is we live beside the USA and that's where those who dislike the system look for inspiration (in spite of its bad rating) not to France or Scandinavia.

I'm all for reforms, but they have to be what's best for patients, not governments and business.

Let's look to countries that do it better, not to countries that do it worse.

Frank

I have no problem with ICBC's directive. However, I do have a problem with the government forcing us to use ICBC.

If the citizens wish ICBC to remain as a crown, so be it. However, let State Farm, Progressive, etc. provide coverage too. If you prefer to use ICBC, go ahead. However, we are forced to use it.

Either privatize it - or allow others to business in this province.

There's a very interesting column in the NYTimes this morning

On the disaster of health care in the US.

It's behind the firewall so I'll post it in for you.

By the way Cappy, your comments about insurance rates in AB are wrong. BC, Sask and Manitoba are the low rate providers in this country. You can look it up. As for the situation relative to having a private liquor store on every corner in AB - well, they have the disintegrating social structure and community standards that go along with it too. You're not the only one who's lived there. I notice no one dealt with the anomaly of non-enforcement for selling to minors and drunks in Prince George either. You may think of yourself as a libertarian, I think you’re simply someone who has only a passing familiarity with the truth.

Anyway, here's the piece from the TIMES:

Edwards Gets It Right
By PAUL KRUGMAN

What a difference two years makes! At this point in 2005, the only question seemed to be how much of America’s social insurance system — the triumvirate of Social Security, Medicare and Medicaid — the Bush administration would manage to dismantle. Now almost all prominent Democrats and quite a few Republicans pay at least lip service to calls for a major expansion of social insurance, in the form of universal health care.

But fine words, by themselves, mean nothing. Remember “compassionate conservatism?” I won’t trust presidential candidates on health care unless they provide enough specifics to show both that they understand the issues, and that they’re willing to face up to hard choices when necessary.

And former Senator John Edwards has just set a fine example.

At first glance, the Edwards health care plan looks similar to several other proposals out there, including one recently unveiled by Arnold Schwarzenegger in California. But a closer look reveals extra features in the Edwards plan that take it a lot closer to what the country really needs.

Like Mr. Schwarzenegger, Mr. Edwards sets out to cover the uninsured with a combination of regulation and financial aid. Right now, many people are uninsured because, as the Edwards press release puts it, insurance companies “game the system to cover only healthy people.” So the Edwards plan, like Schwarzenegger’s, imposes “community rating” on insurers, basically requiring them to sell insurance to everyone at the same price.

Many other people are uninsured because they simply can’t afford the cost. So the Edwards plan, again like other proposals, offers financial aid to help lower-income families buy insurance. To pay for this aid, he proposes rolling back tax cuts for households with incomes over $200,000 a year.

Finally, some people try to save money by going without coverage, so if they get sick they end up in emergency rooms at public expense. Like other plans, the Edwards plan would “require all American residents to get insurance,” and would require that all employers either provide insurance to their workers or pay a percentage of their payrolls into a government fund used to buy insurance.

But Mr. Edwards goes two steps further.

People who don’t get insurance from their employers wouldn’t have to deal individually with insurance companies: they’d purchase insurance through “Health Markets”: government-run bodies negotiating with insurance companies on the public’s behalf. People would, in effect, be buying insurance from the government, with only the business of paying medical bills — not the function of granting insurance in the first place — outsourced to private insurers.

Why is this such a good idea? As the Edwards press release points out, marketing and underwriting — the process of screening out high-risk clients — are responsible for two-thirds of insurance companies’ overhead. With insurers selling to government-run Health Markets, not directly to individuals, most of these expenses should go away, making insurance considerably cheaper.

Better still, “Health Markets,” the press release says, “will offer a choice between private insurers and a public insurance plan modeled after Medicare.” This would offer a crucial degree of competition. The public insurance plan would almost certainly be cheaper than anything the private sector offers right now — after all, Medicare has very low overhead. Private insurers would either have to match the public plan’s low premiums, or lose the competition.

And Mr. Edwards is O.K. with that. “Over time,” the press release says, “the system may evolve toward a single-payer approach if individuals and businesses prefer the public plan.”

So this is a smart, serious proposal. It addresses both the problem of the uninsured and the waste and inefficiency of our fragmented insurance system. And every candidate should be pressed to come up with something comparable.

Yes, that includes Barack Obama and Hillary Clinton. So far, all we have from Mr. Obama is inspiring rhetoric about universal care — that’s great, but how do we get there? And how do we know whether Mrs. Clinton, who says that she’s “not ready to be specific,” and that she wants to “build the consensus first,” will really be willing to take on this issue again?

To be fair, these are still early days. But America’s crumbling health care system is our most important domestic issue, and I think we have a right to know what those who would be president propose to do about it.

Frank - Well Put

As much as I hate the whining pathetic Frenchmen - if their system is better, let's do it!

I agree - the problem is that we are ride beside America. Everytime health care reform is discussed, you have commies like Gavin and Alci up and arms pointing to America. The anti-america card is the only card that works - and they play it - all in.

Like I said, health care does not operate under the supply/demand/cometitive constraints - because Demand is inelastic. Same with Hydro, Power, etc. - these are monopolies and very difficult to enter - that is why government needs to establish arms-length, politically unbiased regulators and commissions.

The problem is that in Canada - they are politically biased, because it is the politicians that appoint them. For example, why won't the CRTC allow Telus flexibility in its pricing. All it wants to do is bundle its services - and why on earth did the Alcan deal get turned down????

Private iunsurance

What about that private insurance company that keeps advertising with their silly "found money" bit?

Anyway, ICBC-like socialist spreading of the costs and benefits only works if you're sharing both. When you allow private companies to "cream off" the safe drivers it would destroy ICBC just as it would destroy any insurance company that had all the bad drivers and none of the good ones.

We simply don't need private insurers here.

Mr. Gordon Campbell

I wish the Tyee had a little more tact. It is very rude and unprofessional to call the Premier, hate him or love him, "Gordo".

Call him Campbell, the Premier, Mr. Campbell, whatever. However, enough people voted for this guy to govern our province, and represent our people.

It is fine to be critical, but please have some respect.

Respect is earned

When Campbell starts behaving in a way that's worthy of respect, he'll get it.

Don't hold your breath.

Bill Bennett is more worthy of respect - because he at least recognizes that he's played fast and loose with the public trust.

'Premier' Campbell, not so much.

His current oleaginous status as the defender of native rights, while selling off BC's public assets to the highest bidder - in many cases for nothing (net of tax) is no more worthy of respect than ...well, you are.

Start believing in something besides yourself and caring for something besides your own pocket book - all the while being far more sexist than Coyote ever was ( I noticed your bolded 'male' reference to yourself in the third person - that really is a problem for you, isn't it?) and I'll even accord you a little respect Cappy.

Premier Campbell also might want to think back about all the promises he’s explicitly broken if he really wants to understand why no one ‘respects’ him.

Just my views.

And, by the way, when it comes to name calling

And lack of respect, cappy, I don't think you can teach anyone anything.

Look at what I just found:

I guess you put Arnold and Paul Krugman and Senator Edwards in that category too.

What a phony. Being called a commie by someone like you is a badge of honour.

Vive la France

Capitalism:

Wow. You are a fu*king idiot. Your trolling is bad enough, and now this? Instead of spending all your time posting garbage on this site, how about getting a job?

Cappy whine

If you don't like the reporting by the Tyee, why do you continue to read it? Seems to me that an intelligent man would ignore what he does not like or in your case understand. Please think before you post. Your schizophrenic nature as shared by all neocons is getting in the way of real social progress.

Sorry Jimmy

This comment has been removed because it contained offensive and hateful content.

Please refer to our commenting rules of conduct: http://thetyee.ca/Comments/FAQ/#7

-- Tyee Site Manager

Vive la france

Sorry, Cappy, Canadians are not the bigots that you portray them to be. You are a member of a very exclusive club, shrinking with the annual decrement of the population.

Your comments add nothing to any debate, except perhaps as an example raised in one which seeks to delineate the limits of freedom of speech. Ethnic prejudice is always unwelcome. It is time for you to go home.

BC Mary & Settebello & Jimmy for that matter

Maybe I went a little overboard. Though, I hear many on this board spit hatred for all things American. I don't see much of a difference other than it is socially acceptable to bash America, but unacceptable to bash any other country....

I'm not sure how this is any different. I think France is really losing out in this world because of the culture of entitlement that exists there. Furthermore, they have been very uncooperative on the world stage....

Believe me - I am not hateful!

And that mark about Americans

I know a lot of folks around here don't much like some of the things our American cousins do, or say, but I haven't heard many left wingers and commies (your term) around here spout pure ad hominem 'hate' about them either.

You have to go to members of Gordon Campbell's neocon cabinet to find those kinds of references.

Maybe you're just emulating one of your heroes Cappy. In fact, if memory serves you actually posted something complementary about Bennett around here the other day.

Do you actually know what you think?

* Our government does not "…bow to the almighty dollar and face east to Wall Street each day…", but we do recognize a fool when we come across one. How do you think you are representing the interests of your members when you insult the BC hunter's strongest advocate, yours truly. I have spent an inordinate amount of time trying to sort out this allocation file. It is complex, something that you obviously have enormous difficulty with. You don't know who your friends are, which makes you dumb.

* Don't lecture me about "listening to the wishes of my constituents". As someone who has spent the past six years working my ass off for my constituents, I am not about to take that kind of bullshit from someone who, for all I know, is up here as an American spy who is actually interested in helping the US create a park in the Flathead.

Call a spade a spade

Regarding Capitalist's request to have some respect for "Mr. Campbell". I do not automatically respect a person by virtue of their social position, credentials or how much money they make, no matter who they are. I respect a person by virtue of their behavior, e.g., whether they are kind, honest,compassionate, etc. That having been said, when "Mr. Campbell" earns my respect, I will give it to him.

In the meantime, even "Gordo" is more respectful than he deserves, based on his behavior. In my opinion.

Attention David Beers

Dear David Beers:

I wish to bring the following post to your attention.

It comes from the 'Gordo's conversation' commentary on Tyee..

If appears to fall afoul of your posting guidelines.

If you have been paying any attention to this contributor you will know that this is far from the first time he/she has made similar comments and used as offensive, or nearly so, references to other participants on the web site. This poster has done this both as IAMC and as someone called Ron Erwin.

You've recently banned, apparently permanently, a contributor, Coyote, who has often (although sometimes at excessive length) made contributions that are both stimulating and thought provoking, as well as sometimes being troubling and rude. Coyote, despite his warts, was always an asset to the Tyee. The person quoted above has never been. If he/she is allowed to continue to post - after the latest of his many violations of your rules - the situation with respect to Coyote's banishment will be put into even sharper perspective.

If Coyote needed to be banned, and I am not convinced that he did and if IAMC is permitted to continue to post this kind of thing, which is typical of his/her input over the months I have been reading Tyee, then the whole operation will be placed into serious disrepute, in my opinion.

I support what you are doing David. I know it's difficult and I appreciate the difficulties under which you operate.

Even so, in my opinion, the integrity of your effort is being compromised by this situation. I am going to post this letter to the site in the hope that you'll deal with the offending commenter quickly and appropriately, and in some kind of a balanced way relative to what you have done to Coyote. I think it's also important for other participants in this forum ot know what's going on here.

Thank you for your attention.

Yours very truly,

G West

Aha!

Welcome back, blonde pitbull. Been waiting for you to weigh in. You've got lots to say too - let's hear it.

nobody has a better system...

... of evaluating various health-care systems from different countries. There are problems with all of them. My favourite way of measuring outcomes in the most general terms is by life expectancy, at least for OECD coutries.
http://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy

Note, these figures are actually 2005.

And a new measurement developed by WHO is catching my eye, although I'm still uncertain as to the implications of public health vs. medical care.
http://www.irdes.fr/ecosante/OCDE/59.html

One of my favourite sites for stripping away the BS is the one from the OECD. Here it's easy to see how Gordo has been manipulating the conversation. Mind you, you may have to open an Excel document to get all the detail, and I understand that's a bit too much work for one or two of you - you like your BS like Caligula liked his grapes - hand-fed.
http://www.oecd.org/document/16/0,2340,en_2825_495642_2085200_1_1_1_1,00.html

You can compare individual countries more easily here
http://www.oecd.org/document/46/0,2340,en_2825_495642_34971438_1_1_1_1,00.html

Let's have a real conversation on health sometime....

I'd rather not go near anything that weighs me lol...

So what would you like to talk about?

whatever

Just lend a hand - the education process gets tedious with some of these types who know how to fix everything in ten minutes.

Dear brother David

May I make so bold as to suggest that the plain spoken Coyote was, while he was present here, a very effective foil to all these mean spirited posters who seem to have been taking over your nice magazine.

These conversations tended to be much more interesting.

I told you I thought you'd miss him. Can we have him back soon please?

Whatever? hmmm....

Privatized hospital cleaners...well, I glad to know that the quality audits are improving but I still see way too many new faces on a constant basis. I see too many rookie mistakes and I see waterless hand cleaner every where whereas a few years ago it was only used in a handful of areas and situations. (I'm curious how much my facility now spends on this stuff as compared to pre privatizing). You are right that the private companies are spending too much on constant retraining, and yet they are constantly "short" on staff. Most of their staff have second jobs because they can't meet their financial obligations (by that I mean "have to haves" NOT "wants" ).
Having said this I must also say that I agree with you that wages don't necessarily guarantee good workers but it does bring a wide(er) choice of applicants to you. It is managements' job to sift through... You were bang on when you say the relationship between management and employees is the best way of gauranteeing quality careful work...You say that the outside contractors aren't making money , that they seriously underestimated the work load to care for the facilities, (I'm struggling here to dreg up some sympathy), well, they were suppose to be experts but my opinion is if this is true then they were fed inaccurate info from inept management. My apologies to the "suits" out there who actually know/care what they are talking about.

Quick fixes....

Simple minds need ...well they need to go back to play in their own little sand box is the nicest way to say it that I can think of. Or maybe they could sit down and focus on learning....

On hospital cleaners

The Hospital Employees Union a few years ago published a leaked letter from Gordon Campbell to the head of Accenture confirming that he (Gordo)was absolutely tickled pink and somewhat weak in the knees at the chance to work with somebody of that quality. Trouble was that I don't know for sure that Accenture had yet been granted the name change from Enron by the US courts. It was right about that time.

Gord was ticked. A while later he fired flat out ten thousand HEU union cleaners and replaced them with a hotel outfit, which hired untrained cleaners who no longer worked for or answered to the actual hospital at $9.50. However, they charged us about the same rate as the $17.00 plus workers cost.

This preceded the current surge of superbug infections that nurses lay at the door of these new cleaners.

From the standpoint of the hotel outfit the trick is to persuade untrained people to come to work where they risk fatal infections every day for so little money that they often lose staff to the fast food industry.

One of their strategies has apparently been whenever possible to hire foreign staff with poor language skills. That took a while for them to learn of the risk they and their families are in.

The problem has little to do with money. I'm given to understand that the hotel cleaners cost a little bit more than the union workers did overall, but without the union there is a whole layer of training, professionalism, and oversight that's just gone.

Not to mention support. I have heard some of the new cleaners are beginning to rejoin the HEU, even though this doesn't automatically raise their poor wage levels.

Most if not all have rejoined HEU, Bailey

When the private companies "won" these contracts they set up a deal with an IWA union local pre hiring of any actual staff. So,in fact, they started off as "union" just not a union that had any practical knowledge of what they were talking about. This union had no qualms about demanding $20+ p/hr for sawmill workers to "clean up" but thought that less than $10 p/hr for hospital cleaners was fine- then they had the nerve to take union dues off of the workers in essence making their wages as low as minimum wage if not lower. They did little to deal with the workers concerns about workload and such that rapidly surfaced. The HEU began actively re organize them . This IWA union and companies involved spent significant time and lots of cash fighting this worker wanted change. So did HEU. The LRB sided with the HEU/workers . The companies continued to appeal(?) challenge(?) for a couple of years, but eventually lost out. As far as I know they are all now HEU members, now I could be wrong about that but I don't think so as I never heard of any site voting to keep IWA.

Gordo's conversation....

I actually do think/hope that this 10 million dollar exercise COULD bring forth some proactive ideas however, I don't believe that it will. I, like others on this site, think that the ideas that don't fit the preconceived destinations will never see the light of day let alone be proposed or persued.
Just my veiws.

Check Raesides cartoon today

Check Raesides cartoon today regarding the conversation. Gordo and friinds at the head table. A fellow from "the crowd" gets up to speak. He names a number of folks who can't make it. One stuck on a stretcher in a hospital hallway, one stuck at home waiting for a hip operation. The crowd was he alone. But no matter, Gordon has decided what he wants as as long as he runs things, that's the way it's going to be. Even when a Health Authority director quits and writes why, parts of the letter get removed before the public sees it. The FOI chap is looking to see why such shady stuff happens. The words shifty, sleazy come to mind

Too Busy

I have been too busy to respond to G West but here is my two cents worth.

I agree with you. The public system is bloated, inefficient and plagued with people who do not provide health services. For an organisation that has this many accounts and paper pushers, I don't buy their mumbo-jumbo about not knowing how much a proceedure costs. They know their annual cost of carpet tacs. They just don't want to release that information because as soon as they did, private clinics would sprout up all over the place to provide the service.

That does not fit the agenda at all. The fact the private sector could easily provide all the services the public does at the same or lower prices has nothing to do with the debate. The health care monster is Canada last Great Socialist Experiment, right up there with Candu (oops) and the Sprung Greenhouse.

For, in that huge, money gobbling monster is a culture that does not really deliver services very well, especially when one sees the kind of spending going on. Romanov saw this and commented on it but I can't believe a system as entrenched as our "health" system can do much to reform itself.

Health care spending in BC grew at more than 7% and we will continue to see more spending. It is inevitable because of the demographics of the province.

What you are seeing now is more people using private plans to get the proceedures they need. My workers use their plans all the time and I am glad to pay the premiums. If they have any work related ailment, I send them straight to a private hospital for treatment. Most are back on the job the next day.

Changes, they are a happenin'

WM, got time for me?

After reading your comment I got lots of comments for you but since you're so busy I've whittled it down.

So here goes:

Just how bad is your safety record?

Where is this private hospital that you send your workers to?

Be careful what you wish for you might just get it....

Foot in Mouth Award!

Capitalism stated the following earliar: "Doesn't it make sense that those that cause the costs - pay for them????"

Seems to me one of the foundations of capitalism is that many costs are externalized (e.g. mortgaging the future), so I suppose Capitalism does not support capitalism!!!!!!!!!!!!!!!!!!!

Zalm the oced links

Hey, you provided some great links to fact based info. While I haven't had the chance to spend alot of time on them this weekend I definitely will asap. The one where you need Excel to open it is my biggest problem my old clunker of a computer is not up to speed so I need to snag my daughters' laptop and probably need some coaching from her as well. I am honestly way behind most folks on this site on computer saviness but I can learn.
So if you're still out there, Zalm, and you'd converse with me about it ...I'll be back...

Hey BPB - sorry I've been

Hey BPB - sorry I've been AWOL - my own sister has been experiencing her trials with the health care system and coming out pretty well.

On the OECD excel sheet I'm going to try to split off the current (real) figures from the estimated ones and just post the last of the figures in each category. The problem is some figures are from 2006, some from 2005, some from 2004....

Although the history is useful, especially when we see the GDP-to-health-spending ratio over the last 30 years, I think people could use single-year snapshots to answer most arguments.

More when I get it done

Bailey

It wasn't quite Gordo that fired the cleaners. Hansen was actually responsible for putting together the contract with IWA that allowed private contractors to fulfill the requirements to bid on hospital work.

And not just any IWA local, but the one run by Sonny Ghag, part owner of a non-union cedar mill in the Fraser Valley with his family, a thug with a sordid history you can look up in any newspaper archives, the one who was finally dumped by the IWA/Steelworkers a couple of years ago for egregious expenditures of union funds, among them on his own private boat. I find it hard to believe Hansen found this clown all on his own - eh, GWest & BC Mary?

Then Hansen told the health authorities that they would be permitted to fire the cleaners and the province would pick up the bill for retraining (limited, I believe, to $44 million) so that they didn't look like ogres. Last, the government told the health authorities to make public to all the private bidders the cost of hospital cleaning so that they could find out what they were bidding on, and specified the terms of the RFP to be 10 years.

The private contractors submitted their bids, ensuring they were lower than the hosptial's bids (by a total of $36 million over 10 years in VCHA's case) so that savings could be boasted of. Then began the demonization of the housekeepers in Canwest rags and everywhere else one could think of.

It's hard to blame the private contractors. They bought a pig in a poke. Campbell & Hansen & the boys set them up, and now they're trying hard to fulfill the contract. It's gonna be hard.

But the choice was left up to each employer, each hospital. And a few did NOT fire their cleaners - they continue to be employed at union scale by HEU. They managed to make the savings in other ways, either by deferring maintenance and replacment, or by (in one case I know of) dumping a manager. Incidentally, many of these are the small charity-run extended-care facilities that are getting low dollars per patient for care.

So this is a clue (once again) that for many aspects of our health care system, that smaller is better.

And...

Linen was another example. Tilbury Laundry was a purpose-built laundry, I think owned (certainly operated) by the ministry dealing solely with hospital laundry, with all the machines etc needed to run eficiently. It was so efficient that even running with HEU employees at their scale, the competition, (mostly K-Bro) was unable to come up with a competitive bid.

Gordo wanted to dump hospital laundries all over the place. But nobody would bid. Tilbury's books showed the costs (and hence margins) were too low. Plus, nobody wanted the laundry from the smaller facilities, especially ones that had patient laundry from chronic care homes. Something had to be done.

So Tilbury was banned from bidding. Think about that Cappy and IAMC. The cheapest bidder was banned from bidding on a contract becuase it was union and socialistic. We now have to spend more money on hospital laundry services in order to make it worthwhile for K-Bro to set up a plant here to service our hospitals at higher cost.

I don't know why Gordo didn't just give the Tilbury plant to Halliburton....

Other wacky stuff...

Just going over this thread and laughing at some of the crap...

Elliott thinks

Wacky the socialist? Who nationalized BC Electric and other power producers to create BC Hydro? Who nationalized a variety of ferries to creat BC Ferries? Who assembled BC Rail out of a variety of ramshackle lines and created the transport system that allowed BC pulp and lumber mills to dominate North American markets for 30 years?

Any other superhero costumes in your closet, Elliott? You closet commie, you....

And Ron Erwin (IAMC) thinks that government should only run

Yeah, right, Ron. You believe nothing of the kind. The government does a great job of immigration now, don't they? You like it? And you're always praising the Human Rights tribunals aren't you. And home security? You mean, AlarmForce isn't protecting your valuables good enough, you want the government to do it?

I'ms surprised you didn't mention education. That's the one I'd be tempted to privatise, given what lousy results they've produced in you....

Honestly, Ron, Li'l Green Footballs... http://littlegreenfootballs.com/weblog/ That's the blog for you. You're an embarrassment to the libertarian and conservative bunch here. You'll be much happier over there.

Health care distress; slashed by politicians, choked by unions

If you want good health care, here is one good rule to follow. No hospital or health care facility should be allowed to expand to more than 500 beds. If you need an explanation, you haven't worked in the health care system for 20 years. you haven't seen how large hospitals take on a life of their own, where the larger the hospital, the less the patient figures in the equation.

Large hospitals do have certain efficiencies but they have nothing to do with patient care. What BC needs is more small facilities in the rural areas, and the complete rethinking of the big-city juggernauts. Some of them are totally unmanageable.

>Where is this private

>Where is this private hospital that you send your workers to?>

The WCB actually does the referrals to their hospital at Cambie and Ash. Remember, the one the NDP allowed built?

>Just how bad is your safety record?

Far below the average for my industry, actually.

>Be careful what you wish for you might just get it....

We already have it. Cambie Surgical clinic opened in 1998 and False Creek is going great guns.

The WCB actually does the referrals...

Which is not quite you sending them straight there. Cambie and Ash? Is this in Vancouver or Richmond? I know that the WCB has a facility in Richmond that is quite extensive but I didn't know they took injured workers straight from the streets. Or are you referring to the recently opened Urgent Care Centre? The one that started off saying they were going to charge a couple of hundred dollars to walk through the door then they backed up a bit saying they'd just bill the gov't at the according fee schedule?(You see there is a itemized fee schedule; I guess either those interveiwed are ignorant of it or they don't think spitting out numbers is significant/ relevant for the situation) That only lasted a few weeks if I remember correctly.
As for your safety record being lower than most , well, since I don't know what is your field of business I'll take your word for it, but instead of bragging rights on what great plans and services that you pay for and use why don't you go for the bragging rights of eliminating the need to use these plans instead?

Fish counter

I'd say closer to 200 beds for acute care and 300 for extended care would be much more efficient than 500...

Action taken and noted

Thank you David.

Zalm, are you out there?

I was wondering whether you knew of any sites that list the services provided by the various countries health care public dollar? I mean healthcare has a pretty broad range of implications and I'd like to know.

Accident Free?

why don't you go for the bragging rights of eliminating the need to use these plans instead?>>>

Unfortunately, Blonde, in the construction business there are mishaps. The majority are skinned knuckles and the like but they still have to be reported. Luckily, I have never had a serious accident on any of my work sites(keep fingers crossed)but one of my employees was killed in a traffic accident on the way home from work a few years ago.

WCB is paid for, 100%, by employers. Have a few accidents caused by a violation of their codes and see what happens to your premimums.

Mis-statement perhaps

I think Working Man, unless you are bragging about an unsafe workplace, that you mean your safety record is far 'above' the average. Is that right?

Statistics

In busines and WCB terms, work place accidents are based on the number of occurrances per 1000 person hours. This can range from a bruised thumb to a death. Thus, if your stats are lower than average, so is your premium.

So, my incidents per 1000 person hours are far below average for the construction industry. It makes financial sense to me to keep my workplace as safe as possible.

You missed my point

The apparently correct answer to: How bad is your safety record?

Is not:

Lower than average, but 'better' than average. The question needed a better/worse answer, not higher/lower.

Otherwise, according to what you wrote, your safety record is lower (i.e. worse) than average and I don't think that's what you meant and I doubt you'd be proclaiming it too loudly either.

WM, uuhh, you're not following me...

You know, you seem to have missed where I was going in that your intial post was that you pay for your plans and your workers use your plans all the time that for anything work related you send'em straight over to the private facility for treatment and they're usually back the next day. Which is like very expensive in the WCB system so I didn't think it would be for the bruised knuckles.

Huh?

Blonde, I really do not follow what you are saying. If you could break your post up into individual sentences it would make things a lot clearer.

Semantics

Stump, you are into sematics. Go have a look at the Worksafe BC site and how they do their stats will be clear to you.

The way WCB measures workplace safety is incidents per 1000 person hours.

My incindents are lower than average. For example, in my industry, the accident rate runs about 5 per 1000 hours worked. That is any reportable incident and any incident that happens mustno matter how minor it might be. The premiums a company pays for WCB is based on the industry average and you then get a safe workplace discount, much like on your car insurance.

My incident rate (and I just sent in the payment) was 1.92 per 1000 person hours in 2006. It is therefore lower than average and my premimum, altough still a big whallop, is adjusted to reflect my greater workplace safety.

sorry..

Okay I'll try again. Your initial post said that you workers used your private plans all the time. You also said that if an "ailment" occurred you sent your workers straight over to the private hospital.

The private plans that are available in B.C. cover dental and extended health(prescriptions, orthotics, glasses, etc.) they don't cover hospital/emerg visits per se except in some plans they pay for a semi or private room if hospitalized.

So I thought you were saying that WCB was paying which, as you were saying, gets you pretty hefty premiums pretty d*mn quick, so I thought that if your workers were using it that often they must be relatively injured. I'm sure that as adults both you and your men are fairly proficient at minor wound care and evaluation. Which is why I asked how bad your record was. Any clearer?

Quote:Your initial post said

Yes, of course my company has extra insurance for all our employees that covers drugs and things not covered my MSP. We even pay 100% of it, as well as 100% of employee MSP premiums.Many people in BC have it. The largest of these plans is Blue Cross but since their card does not work like a credit card, we use Manulife. My employees use this plan for prescriptions, eye glasses, massage and the like. We also carry income continuance insurance for workers who, unfortunately, may become chronically ill. It is rather expensive but well worth it and part of the cost of doing business and retaining employees.

Not true. ANY incident, no matter how minor, must be reported. It may not even be an injury per se, it can be a sore back or shoulder, for example. This is pretty common on older workers but their experience more than makes up for a few days off to rest up. At this point, the worker can choose to go the WCB route or the MSP-Manulife route.

WCB is a completely different case. If a worker is injured at their work place, the jurisdiction is theirs and the patient, after their initial treatment at a hospital, is taken into the WCB system.

Actually, the law is very, very clear. Any incident, even if it is a skinned knuckle, ABSOLUTELY MUST be reported ASAP. The form is filled out by the IFA and then forwarded by HIM/HER to Worksafe. He must forward that report BY LAW. I then get a copy in the mail so I cannot interfere.

These incidents, no matter how minor, are calculated towards your workplace safety index (incidents per 1000 person hours)and directly affect your premiums. For example, a skinned knuckle can be caused by an employee not wearing gloves when he/she is supposed to and is therefore preventable. Raising the attention given to workplace safety is the goal here, one I whole heartledly support.

In 2006 my incident rate was 1.92 per 1000 person hours vs an industry average if 5 per 1000 hours

Who really pays

Would it not be more accurate to say that the money for these services aren't paid for by the employer so much as the money comes from that pool of cash allocated for employee remuneration... and would also include pension and rrsp contributions as well as wages and extended health care payments?

Okay

There is a big difference between reporting an incident and sending your workers to a private hospital for any ailment. Which is what you said. The WCB regulations that you speak of are relevant at my place of work and I have similar forms to fill out which are quite detailed too. Anyways, I'm done dancing with you. Later.

That is not how business works, stump

>much as the money comes from that pool of cash allocated for employee remuneration>

Maybe that is how government works, stump, but in a company like mine, everything from paper clips to MSP premiums comes straight off the bottom line. In my business it is pretty difficult to exactly peg how much will be paid in wages annually as many factors such as overtime, extra projects, cancelled projects, changes in specs can affect that cost. It is not a fixed cost.

If my company has a $100,000 gross profit and I add a fixed cost of $1000 a year for every employee for a new benefit and I have 100 employees, my profit, and my salary, BTW, is gone uless I can raise an an additional $100,000 in revenue

for every dollar you earn

for every dollar you earn working for an employer, you earn that employer five dollars. Management never hurts, they just say that.

Blonde Pitbull

Sorry about the AWOL.

No, I'm not aware of any sites that responsibly compare health care. All sorts of studies have been done by various universities, and what I noticed is that they all refer at last in part to UN studies, but there is no coordinating body for health care. It all comes under social development, for which there are five regional bodies, each doing their own thing:
http://www.uneca.org/ for Africa
http://www.unece.org/ for Europe
http://www.eclac.org/ for Latin America
http://www.unescap.org/ for Asia - Pacific
and http://www.escwa.org.lb/ for West Asia.

In most studies (OECD and others) Western Europe is generally held to be comparable to North America in terms of resources, outcomes and processes, except for Germany, which is held apart because of the heavy preponderance of private health insurers who keep information secret as a trade practice.

It's very difficult to directly compare when treatment modalities are so different in each country. It's also difficult when expectations of health care vary widely from historic notions of prevention in France, Germany and Switzerland to wellness-targeted processes in Scandinavia, to high-tech solutions for health problems left to fester in North America. Imagine trying to come up with a study to account for all that! Never mind organizing, operating or funding it.

My wife and I have relatives all over Europe - Germany, Switzerland, England, Poland, Montenegro, - and the conversations we have with people there give us perspective on our own health care problems here at home. As many people as possible should be doing that, if they want to help out. Not just health professionals (as my wife is) but ordinary citizens. It's all valuable, as long as it's solid anecdotal information, and not doctrinaire theory from some economic think-tank.

Zalm

You're busy. No biggie. So I guess I'm going to have to find gov't websites for some countries to see what services and how they are provided by the public purse. Thanks.

blonde pitbull

Send me an email if you have a moment

Enhanced HEALTH CARE?

What does it mean? Its all enhanced now my doctor was just telling me she will be charging an additional fee for making an appointment to see her($30-$40)and if not just go to the walk-in-clinic. What do you get when you get the ENHANCED package from your employer YOU CAN make A doctor's appointment in their offices usually within a 24hr period, YOU CAN get surgery within a timely manner, YOU CAN receive other treatment when necessary. Its the health care services I grew up with and it used to be there for all Canadian citizens but not now its all ENHANCED. Your ENHANCED health care coverage is only there as long as you are with the employer who is providing you with the ENHANCED HEALTH CARE. What happens if you leave and find yourself unemployed? What then? Remember the ENHANCED MODEL is really are health care system disguised in a new name ENHANCED HEALTH CARE. Welcome to the USA health care system but just don't tell anyone just call it ENHANCED because Canadian citizens will never figure it out.