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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. Praise for When Politics Comes Before Patients "In Canada, socialized medicine has been exalted to the status of a sacrament, and to criticize it, either in theory or in practice, is tantamount to heresy. Dr. Whatley dares to do both, and with such clarity of argument and abundance of evidence, that no reasonable or fair-minded person could fail to be convinced. What Dr. Whatley has demonstrated, in this beautifully written and engaging volume, is that socialized medicine fails to meet the most fundamental moral obligation of health care: to place the patient's interests above all else." Dr. Harley Price, University of Toronto "Whatley... insists that our focus should be on the patients, the people the system is supposed to serve but whose interests are too easily sacrificed in the name of some pretty but ineffectual or even destructive bureaucratic theory. I have been thinking about the health care system for thirty years yet I found Whatley's book packed with new insights and courageous thinking. A cure for what ails us." Brian Lee Crowley, Managing Director, the Macdonald-Laurier Institute "When you are getting a diagnosis from your doctor, you want the truth. If you want a truthful diagnosis of our health care system, you must read this book. With precision, wisdom, and verve, Dr. Shawn Whatley has fearlessly dissected the rot that plagues Canadian socialized medicine. Can you handle the truth?" Bruce Pardy, Professor of Law, Queen's University
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.
Describes the power that can be imposed, and the misery that is caused, especially for the poor, by the simple act of waiting. This title also describes a variety of different situations, including waiting for national identity cards, for welfare agencies, and the endless waiting for relocation from the slums.
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. 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. This critically important book 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." Now with a new preface by the authors, Unhealthy Politics offers vital insights into the limits of science, expertise, and professionalism in American politics.
Each year, hospital-acquired infections, prescribing and treatment errors, lost documents and test reports, communication failures, and other problems have caused thousands of deaths in the United States, added millions of days to patients' hospital stays, and cost Americans tens of billions of dollars. Despite (and sometimes because of) new medical information technology and numerous well-intentioned initiatives to address these problems, threats to patient safety remain, and in some areas are on the rise. In First, Do Less Harm, twelve health care professionals and researchers plus two former patients look at patient safety from a variety of perspectives, finding many of the proposed solutions to be inadequate or impractical. Several contributors to this book attribute the failure to confront patient safety concerns to the influence of the "market model" on medicine and emphasize the need for hospital-wide teamwork and greater involvement from frontline workers (from janitors and aides to nurses and physicians) in planning, implementing, and evaluating effective safety initiatives. Several chapters in First, Do Less Harm focus on the critical role of interprofessional and occupational practice in patient safety. Rather than focusing on the usual suspects-physicians, safety champions, or high level management-these chapters expand the list of "stakeholders" and patient safety advocates to include nurses, patient care assistants, and other staff, as well as the health care unions that may represent them. First, Do Less Harm also highlights workplace issues that negatively affect safety: including sleeplessness, excessive workloads, outsourcing of hospital cleaning, and lack of teamwork between physicians and other health care staff. In two chapters, experts explain why the promise of health care information technology to fix safety problems remains unrealized, with examples that are at once humorous and frightening. A book that will be required reading for physicians, nurses, hospital administrators, public health officers, quality and risk managers, healthcare educators, economists, and policymakers, First, Do Less Harm concludes with a list of twenty-seven paradoxes and challenges facing everyone interested in making care safe for both patients and those who care for them.
Essential reading for every American who must navigate the US health care system. Why was the Obama health plan so controversial and difficult to understand? In this readable, entertaining, and substantive book, Stuart Altman—internationally recognized expert in health policy and adviser to five US presidents—and fellow health care specialist David Shactman explain not only the Obama health plan but also many of the intriguing stories in the hundred-year saga leading up to the landmark 2010 legislation. Blending political intrigue, policy substance, and good old-fashioned storytelling, this is the first book to place the Obama health plan within a historical perspective. The authors describe the sometimes haphazard, piece-by-piece construction of the nation’s health care system, from the early efforts of Franklin Roosevelt and Harry Truman to the later additions of Ronald Reagan and George W. Bush. In each case, they examine the factors that led to success or failure, often by illuminating little-known political maneuvers that brought about immense shifts in policy or thwarted herculean efforts at reform. The authors look at key moments in health care history: the Hill–Burton Act in 1946, in which one determined poverty lawyer secured the rights of the uninsured poor to get hospital care; the "three-layer cake" strategy of powerful House Ways and Means Committee Chairman Wilbur Mills to enact Medicare and Medicaid under Lyndon Johnson in 1965; the odd story of how Medicare catastrophic insurance was passed by Ronald Reagan in 1988 and then repealed because of public anger in 1989; and the fact that the largest and most expensive expansion of Medicare was enacted by George W. Bush in 2003. President Barack Obama is the protagonist in the climactic chapter, learning from the successes and failures chronicled throughout the narrative. The authors relate how, in the midst of a worldwide financial meltdown, Obama overcame seemingly impossible obstacles to accomplish what other presidents had tried and failed to achieve for nearly one hundred years.
Introduction -- Defining the public interest in the US and European patent systems -- Confronting the questions of life-form patentability -- Commodification, animal dignity, and patent-system publics -- Forging new patent politics through the human embryonic stem cell debates -- Human genes, plants, and the distributive implications of patents -- Conclusion
In 1965, the United States government enacted legislation to provide low-income individuals with quality health care and related services. Initially viewed as the friendless stepchild of Medicare, Medicaid has grown exponentially since its inception, becoming a formidable force of its own. Funded jointly by the national government and each of the fifty states, the program is now the fourth most expensive item in the federal budget and the second largest category of spending for almost every state. Now, under the new, historic health care reform legislation, Medicaid is scheduled to include sixteen million more people. Laura Katz Olson, an expert on health, aging, and long-term care policy, unravels the multifaceted and perplexing puzzle of Medicaid with respect to those who invest in and benefit from the program. Assessing the social, political, and economic dynamics that have shaped Medicaid for almost half a century, she helps readers of all backgrounds understand the entrenched and powerful interests woven into the system that have been instrumental in swelling costs and holding elected officials hostage. Addressing such fundamental questions as whether patients receive good care and whether Medicaid meets the needs of the low-income population it is supposed to serve, Olson evaluates the extent to which the program is an appropriate foundation for health care reform.
In a democracy, we generally assume that voters know the policies they prefer and elect like-minded officials who are responsible for carrying them out. We also assume that voters consider candidates' competence, honesty, and other performance-related traits. But does this actually happen? Do voters consider candidates’ policy positions when deciding for whom to vote? And how do politicians’ performances in office factor into the voting decision? In Follow the Leader?, Gabriel S. Lenz sheds light on these central questions of democratic thought. Lenz looks at citizens’ views of candidates both before and after periods of political upheaval, including campaigns, wars, natural disasters, and episodes of economic boom and bust. Noting important shifts in voters’ knowledge and preferences as a result of these events, he finds that, while citizens do assess politicians based on their performance, their policy positions actually matter much less. Even when a policy issue becomes highly prominent, voters rarely shift their votes to the politician whose position best agrees with their own. In fact, Lenz shows, the reverse often takes place: citizens first pick a politician and then adopt that politician’s policy views. In other words, they follow the leader. Based on data drawn from multiple countries, Follow the Leader? is the most definitive treatment to date of when and why policy and performance matter at the voting booth, and it will break new ground in the debates about democracy.
The amazing tale of “County” is the story of one of America’s oldest and most unusual urban hospitals. From its inception as a “poor house” dispensing free medical care to indigents, Chicago’s Cook County Hospital has been renowned as a teaching hospital and the healthcare provider of last resort for the city’s uninsured. Ansell covers more than thirty years of its history, beginning in the late 1970s when the author began his internship, to the “Final Rounds” when the enormous iconic Victorian hospital building was replaced. Ansell writes of the hundreds of doctors who underwent rigorous training with him. He writes of politics, from contentious union strikes to battles against “patient dumping,” and public health, depicting the AIDS crisis and the Out of Printening of County’s HIV/AIDS clinic, the first in the city. And finally it is a coming-of-age story for a young doctor set against a backdrOut of Print of race, segregation, and poverty. This is a riveting account.