Monday, 13 July 2009

Case-Cost Studies & Healthcare

Case-Cost Studies
(How To Take The Care Out Of Healthcare)

As mentioned in a previous post, in a a rather misguided move to save my hospital money, the management closed the 'self-pay' outpatient physiotherapy service (which brought outside money into the hospital) and moved me over to the OHIP(1) or government funded physiotherapy service which is funded by the Ontario taxpayer. In other words, in an attempt to save the Ontario taxpayer money, they switched me from private insurance covered therapy to Ontario taxpayer funded therapy. Go figure!!

I'm sure the Ontario government (or Health Canada) did numerous studies requiring numerous consultants putting in numerous hours of overtime crunching numbers in order to develop cost-case data. These cost-case studies refer to the nature of patient treatment, number of hours of therapy, length of hospital stay and maximum number of hours to be invested etc. in any particular ailment, injury or disease encountered by the appropriate health care facility and it's personnel.

If, say you had a stroke, you would be entitled to x-hours of therapy, only a, b and possibly c drugs, and, oh, 4.76 days of inpatient hospital stay followed by no more than 'y' weeks of outpatient physiotherapy. No more..... but possibly less!

The algorithm has been established by highly paid bean counters, number crunchers and paper pushers in order to establish "appropriate therapy" for the "average patient".

But is there an "average patient"? We are all different with different levels of initial health, different prognoses and responses to therapeutic drugs as well and other therapy. Should each patient not be followed carefully, observing their response to treatment an have it adjusted accordingly, even if some therapy may be unconventional? Should therapy on a non-responsive patient be terminated sooner or should therapy be modified or perhaps extended. Should it not be the goal of any health care facility and the government funded care to restore a person to as close to a healthy and productive state as possible, rather than cut them loose after, say, a hypothetical 12.23 weeks of treatment? Should a patient making significant progress be cut loose after those same 12.23 weeks even though additional treatment will benefit the patient further?

We citizens are not all the same, cut by the same cookie cutter mould, nor should the health care offered be cut by that same mold.

As in my case, it would seem that having me return to a state of health & mobility where I can return to work, earn a living and pay the government my taxes far preferential to having me sit at home on welfare or disability payment. My government should be encouraging health care facilities to do whatever it takes to restore me to a productive state. That would save money in the long run rather than trying to save on the administration of healthcare.

That said, OHIP allows me to receive 16 weeks (max) of physiotherapy after which time I am cut loose regardless of my needs or progress. No ifs, ands, or buts....
My 16 weeks will run out in this upcoming August after which I'll be on my own.

After my initial injury I was told at discharge from the hospital that I'd never walk again. I began receiving physiotherapy 2 to 4 times weekly which has continued for over two years now. I've progressed from having to be hoisted around on a sling to where I can walk unassisted with a walker. I am continuing to improve although the pace is slow.

Imagine if I only had our Canadian Socialized medicine to rely on as administered by OHIP? I would have been discharged as a useless immobile lump after 16 weeks. Goodbye - have a nice life! Luckily, through my workplace, I had supplemental private insurance and luckily they had stubbornly negotiated unlimited physiotherapy. It is only because of that that I have a chance of being independently ambulatory in the future.

How many of us citizens rely totally on OHIP for our healthcare? How many are rich enough to purchase whatever additional therapy we might need with our own savings? How many have supplemental private insurance through our workplace or are astute enough to purchase private insurance coverage when healthy in anticipation of something which we feel will never happen to us? Such a delicate safety net separates us from the hard reality of chronic illness or disabling injury.

Come some date in August I shall be on my own regarding my continuing recovery and progress or I can return to my private insurance for therapy at some private (for profit) clinic in my community.

We in Canada would like to believe that we are compassionate, extending healthcare to those in need, however it is measured and meted out in pre-determined doses at the discression of the government.

(1) OHIP - Ontario Health Insurance Program (Socialized Medicine)

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