Politics Before Patients

How Successive Governments Have Weakened the Foundation of All Canadian's Social and Economic Security At some point you will find yourself lying in a hospital bed. There is a good chance that your bed will be a firm, rubber pad held secure between two rails and parked along a corridor in a busy emergency department. Moans of “Nurse!” will echo from the beds ahead of you in line. Those pleas will fall largely on deaf ears. Your hospital is underfunded and understaffed. Welcome to the current reality of Medicare in the 21st century. Using searing analogies and first-hand accounts, Dr. Whatley makes the argument that the current Medicare system is unsustainable and unless critical choices and changes are made soon, the publicly funded, single-payer system in Canada will implode. Successive governments, regardless of political stripe, know all too well that Canada's system of health care is one of the defining characteristics of “being a Canadian”, and any changes deemed harmful will have them thrown out of power. Thus, decades of cuts around the margins, centralized control, federal/provincial infighting, and government oversight has left doctors and hospitals with little input on how your health dollars are allocated and spent. Citizens are being left to languish in pain for months, sometimes years, because the current cost and delivery system is programmed for the benefit of governments staying in power. That was not what was intended. Medicare should be about delivering high-quality and timely healthcare value for Canadians. This is not an easy fix. Treatment starts with a serious look at the disease, and Dr. Whatley pulls no punches. But what sounds like a radical new approach is neither new nor radical. He is not arguing for the end of Medicare per se but is making the case to let medical professionals — those providing the services — become equal partners in its design, implementation and delivery.

How Successive Governments Have Weakened the Foundation of All Canadian's Social and Economic Security At some point you will find yourself lying in a hospital bed. There is a good chance that your bed will be a firm, rubber pad held secure between two rails and parked along a corridor in a busy emergency department. Moans of "Nurse!" will echo from the beds ahead of you in line. Those pleas will fall largely on deaf ears. Your hospital is underfunded and understaffed. Welcome to the current reality of Medicare in the 21st century. Using searing analogies and first-hand accounts, Dr. Whatley makes the argument that the current Medicare system is unsustainable and unless critical choices and changes are made soon, the publicly funded, single-payer system in Canada will implode. Successive governments, regardless of political stripe, know all too well that Canada's system of health care is one of the defining characteristics of "being a Canadian", and any changes deemed harmful will have them thrown out of power. Thus, decades of cuts around the margins, centralized control, federal/provincial infighting, and government oversight has left doctors and hospitals with little input on how your health dollars are allocated and spent. Citizens are being left to languish in pain for months, sometimes years, because the current cost and delivery system is programmed for the benefit of governments staying in power. That was not what was intended. Medicare should be about delivering high-quality and timely healthcare value for Canadians. This is not an easy fix. Treatment starts with a serious look at the disease, and Dr. Whatley pulls no punches. But what sounds like a radical new approach is neither new nor radical. He is not arguing for the end of Medicare per se but is making the case to let medical professionals - those providing the services - become equal partners in its design, implementation and delivery.

The 1989 White Paper "Working for Patients" was the watershed of the Conservative government's policymaking for the future of the British National Health Service. This text examines the political and historical background to the document, its proposals and the reactions to which it gave rise.

Making an original contribution to debates on health policy, this accessible and engaging book critically examines the future of health care and public health policy from the perspective of users and citizens. Consumerism, partnerships with patients and user involvement are seen as key to future health care and healthy public policies. The book outlines how individuals as patients, healthy people and research subjects relate to health services and how the public, as citizens, influence health care and public policies at local, national and international levels.

Two towering figures in the field of health care policy analysis, Theodore R. Marmor and Rudolf Klein, reflect on a lifetime of thought in this wide-ranging collection of essays published in the wake of President Obama’s health care reform. Presented as a kind of dialogue between the two, the book offers their recent writings on the future of Medicare; universal health insurance; conflicts of interest among physicians, regulators, and patients; and many other topics.

How partisanship, polarization, and medical authority stand in the way of evidence-based medicine The U.S. medical system is touted as the most advanced in the world, yet many common treatments are not based on sound science. Treatments can go into widespread use before they are rigorously evaluated, and every year patients are harmed because they receive too many procedures—and too few treatments that really work. Unhealthy Politics sheds new light on why the government’s response to this troubling situation has been so inadequate, and why efforts to improve the evidence base of U.S. medicine continue to cause so much political controversy and public trepidation. This critically important book draws on public opinion surveys, physician surveys, case studies, and political science models to explain how political incentives, polarization, and the misuse of professional authority have undermined efforts to tackle the medical evidence problem and curb wasteful spending. It paints a portrait of a medical industry with vast influence over which procedures and treatments get adopted, and a public burdened by the rising costs of health care yet fearful of going against “doctor’s orders.” The book shows how the government’s efforts to promote evidence-based medicine have become mired in partisan debates. It also proposes sensible solutions that can lead to better, more efficient health care for all of us. Unhealthy Politics offers vital insights not only into health policy but also into the limits of science, expertise, and professionalism as political foundations for pragmatic problem solving in American democracy.

`The author presents a plethora of infomation on users as individuals, their communities, research, healthcare markets and health service myths - old and new. It′s a cool academic appraisal of where the power lies and how more might be shared with the patient′ - Health Service Journal `Anything that helps us to understand the complexities of healthcare provision and what issues are important to users is therefore helpful. I welcome Christine Hogg′s excellent summary of the issues raised by users about healthcare services. It clearly informs readers of the debates that need to take place and of the issues that healthcare practitioners should address in order to better serve their users.... So read the book to gain a better understanding of some of the issues that users feel strongly about′ - British Medical Journal Making an original contribution to debates on health policy, this accessible and engaging book critically examines the future of health care and public health policy from the perspective of users and citizens. Consumerism, partnerships with patients and user involvement are seen as key to future health care and healthy public policies. The book outlines how individuals as patients, healthy people and research subjects relate to health services and how the public, as citizens, influence health care and public policies at local, national and international levels.

In 1964 the Senate Committee on Aging reported that “once admitted to an institution ... the veteran begins ... to show signs of social and physical degeneration,” a phenomenon that has not escapted the attention of clinicians, social scientists, veterans, and other chronic-care patients. Assuming that social withdrawal in the institutional setting was avoidable ad that a strictly medical model of chronic care was inappropriate, Lella and his collaborators established a patient-government project designed to give thirty elderly men in a large veterans’ hospital, who suffered from various degrees of social withdrawal, an opportunity to express their individuality and independence and to shape institutional decisions. The Perils of Patient Government goes well beyond a description and analysis of the projects’ successful side—a general improvement in the lives of the veterans on Ward 23; it also exposes and analyzes the project’s failures, portraying negotiation and conflict among change-oriented and conservative staff of varying professional identities, ideologies, and career strategies. While struggling over the idea and practice of patient self-government, nurses, and other professionals did make progress but also set severe limits on what patients could achieve for themselves. As well, Lella’s study tackles the larger question of how change affects organizations and institutions. Lively and well-written, this is an enlightening work for students of gerontology and geriactics, for professionals and para-professionals, administrators, and policy-makers involved in chronic care, and for researchers probing the fields of medical sociology and institutional organization.