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Collapse of emergency healthcare in England may be costing 500 lives every week

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Re: Collapse of emergency healthcare in England may be costing 500 lives every week

#301
post #224

Earlier quoted context omitted.

It's the opposite of what you'd be doing if you wanted the system to function correctly... But what if you didn't? Because you wanted to replace it, but it was dangerous to say that out loud? The Conservatives (and to some extent some Liberals as well) have been playing a long game -- since the 70s when it was introduced -- to get rid of medicare. It's incredibly popular with Canadians as a whole, but if you take con…

I'm still an outsider (recent immigrant to Canada) but my impression of right vs left politicians here reminds me very much of Dems vs Reps in the US. When the right obtains power, they incrementally and consistently put the pieces in place to ensure that the quality of gov-provided services decreases over time. Then when the left obtains power, they simply maintain status quo, never improving or fixing the problems…

> When the right obtains power, they incrementally and consistently put the pieces in place to ensure that the quality of gov-provided services decreases over time.

My favourite was when one promised 'fiscal restraint' and no deficits, so they sold off a 99y lease on a tolled highway to plug their deficit. They promised prices wouldn't go up more than 30% in 15 years, but they went up 200%.

https://www.thespec.com/news/canada/2019/09/03/birth-of-a-fi...

While the public highways are gridlocked, there have been at least 2 aircraft landings on the tolled highway without injury:

https://www.cbc.ca/news/canada/toronto/plane-makes-emergency...

https://www.cbc.ca/news/canada/toronto/plane-highway-407-mar...

Re: Collapse of emergency healthcare in England may be costing 500 lives every week

#302
post #42

Earlier quoted context omitted.

Family member recently received emergency care in northern NY. Several of the nurses were Canadian coming over the bridge for better pay.

Nurses are leaving a ton of places in the US for better pay elsewhere, too.

They're not leaving the US, they're re-allocating themselves internally.

Re: Collapse of emergency healthcare in England may be costing 500 lives every week

#303
post #181

Earlier quoted context omitted.

As always, it very much depends. We just went to the emergency room and experienced less than 30 minutes of wait time.

Certainly it does, but one can guarantee more than 30min wait time at some emergency rooms coming up as they are closing outright due to staffing issues. https://bc.ctvnews.ca/8-more-overnight-closures-on-the-way-f... It's a real problem, and not just in BC. Some have argued this is a politically manufactured issue to force more talk of private care ... regardless, people are suffering in the mean time.

Most larger places publish these numbers in real-time. But the info can be very limited. Some things can wait, other things can't, and they don't publish the bucketed numbers:

Ontario: https://www.hqontario.ca/System-Performance/Time-Spent-in-Em...

Winnipeg: https://wrha.mb.ca/wait-times/ (7-8h for an initial assessment is pretty terrible)

BC: http://www.edwaittimes.ca/WaitTimes.aspx

Alberta: https://www.albertahealthservices.ca/waittimes/waittimes.asp...

Re: Collapse of emergency healthcare in England may be costing 500 lives every week

#304

Earlier quoted context omitted.

> This isn't a collapse of emergency healthcare, it's a very predicted collapse of community social care: hospitals can't discharge if they need a care home place that doesn't exist. Without inpatient bed availability, ERs and AMUs can't admit to specialties and everything gums up at the front door. How does that manifest as ambulance wait times? Do you think ambulance drivers are sitting around for an hour before re…

If you come to our local DGH's A&E in an ambulance and you're not a trauma or cardiac or stroke, you face seven to twenty hour wait in the carpark. You will see multiple paramedics as they change shifts in situ. In fairness the ambulance service has scaled amazingly well given most of their staff are now pegged in hospital carparks, but yes, waiting times for critical calls are extended, people are dying because ambu…

On top of that, it's also now significantly harder to get a GP appointment vs 2-3 years ago so more people are ending up in A&E instead. My own GP surgery has gone from offering "turn up and wait for an appointment" at set times 4 days a week (and call to book a day ahead otherwise) to "you can't do anything without booking in the online system and then the GP will call you at a totally unpredictable time 3 days later when you're not available" because they think its "better" (which I suspect means because it has cut GP workload).

Re: Collapse of emergency healthcare in England may be costing 500 lives every week

#305
post #224

Earlier quoted context omitted.

It's the opposite of what you'd be doing if you wanted the system to function correctly... But what if you didn't? Because you wanted to replace it, but it was dangerous to say that out loud? The Conservatives (and to some extent some Liberals as well) have been playing a long game -- since the 70s when it was introduced -- to get rid of medicare. It's incredibly popular with Canadians as a whole, but if you take con…

I'm still an outsider (recent immigrant to Canada) but my impression of right vs left politicians here reminds me very much of Dems vs Reps in the US. When the right obtains power, they incrementally and consistently put the pieces in place to ensure that the quality of gov-provided services decreases over time. Then when the left obtains power, they simply maintain status quo, never improving or fixing the problems…

I think you're giving a lot more benefit of the doubt to the Liberals (and US Democrats) than you should.

You're assuming they have wildly different aims. But I don't think history has borne that out. If you want to know why they're so tepid and inept in their opposition to the right and far right, it's because there's not enough of a substantial difference in fundamental direction and policy. (And liberals are on the whole conceptually unable to mobilize in a populist way because they distrust mass politics.)

Yes, on the cultural issues front there's substantial disagreement. Though less so in Canada where there's more of a socially liberal consensus.

But on the economic and political side of things, it's not clear to me that there's a strong ideological dividing line here.

Both are roughly in favour of the same neo-liberal economics. Private sector == good, low corporate taxes == good. Essentially supply side conformity.

But both are responsive to different bases.

The Liberals in Canada cannot move against social programs at this time, or cut social spending broadly -- but they absolutely have done so in the past. The Chretien Liberals enacted the most brutal austerity initiative in Canadian history, and in fact one of the most drastic in the entire G7.

At this point, the Liberals broadly support a kind of neo-Keynesian aggressive social spending. But I'd argue that this is not based on fundamental principles, but based on their need to acquire votes and to squeeze out the NDP. With inflation and various budget indicators being what they are, I am pretty sure the Liberals are prone to leaning back into an austerity direction ... if the NDP vote were to collapse completely, like it did in 1993 (down to 9 seats its worst performance ever), you can pretty much bet the LPC would be back to massive budget cuts. And I think Singh is taking the NDP in that direction, so.

I think you'll have a hard time seeing a strong economic policy differentiation between Harper's Conservatives and Trudeau's Liberals. (Or McGuinty/Wynne and Ford) Both responded with intensive social "stimulus" spending in economic crisis (2008 & 2020 respectively). Both used debt as a tool in a massive way. Neither side showed serious fiscal restraint. Both sides have kept a massively low corporate tax rate (one of the lowest in the western world and drastically lower than the "right wing" USA) Both favoured policies that pumped up the real estate market. Both had aggressive immigration and temporary foreign worker programs. etc etc.

... And both directed their spending at their respective voting bases in a way that verged on corruption (Harper threw money at Alberta in a huge way, Trudeau more in central Canada).

The basic fundamental difference between the two at this point boils down to which sector of Canadian capitalism they represent. The Conservatives are 100% aligned on the energy sector and its demands, and the ideological banners erected in its name in Alberta (along with all the climate change pseudo-denial/defeatism that goes with that). The Liberals represent different interests, some regional to QC, some of it sector-based (real estate & manufacturing). None of it altruistic, or principled, and none of it truly pan-Canadian.

And so here we are.

Re: Collapse of emergency healthcare in England may be costing 500 lives every week

#306
post #287

Earlier quoted context omitted.

>and I think 1% of GDP is woefully inadequate. You spend about 4% of GDP just on Medicare alone. That all depends on the spending ROI. If the first 1% of GDP gets you 90% of the benefit and is universal, it may be just fine.

The problem is I don’t think it would. That logic just doesn’t scale. If one tenth of spending gave 90 of the benefit, then one hundredth of the spending should give you 90% of that, or about 80% of the benefit. That’s not how skilled labour intensive service costs work though. It’s probably more like one tenth of the spending would get you about 20% of the benefits. That’s certainly more efficient, but it’s just not…

I think my example was extreme but is closer to the truth than yours. My realistic estimate would be perhaps 25% of the cost covers 90% of the benefit. Preventative medicine is cheap as is ending broken bones in children. What is really expensive is open heart surgery and three rounds of chemo for an elderly patient.

Cost x years of benefit really favors the easy interventions in the young.

Re: Collapse of emergency healthcare in England may be costing 500 lives every week

#307

Earlier quoted context omitted.

NHS has been underfunded for years. These issues are, in a way, not new. But it just kept getting worse and worse, COVID added burnout and a huge backlog of treatments and missed diagnoses. It probably doesn't help that a lot of the medical staff were from the EU and just before COVID were PTFO. I'm still waiting for those hospitals to be built by all the money saved by Brexit.

How do you know the problem is in fact underfunding? The UK seems to spend as much on healthcare as many other first world countries, but with worse results.

UK seems to be at the lower end of the wealthy/expensive first world countries:

https://data.oecd.org/healthres/health-spending.htm

Re: Collapse of emergency healthcare in England may be costing 500 lives every week

#308

Earlier quoted context omitted.

It's the opposite of what you'd be doing if you wanted the system to function correctly... But what if you didn't? Because you wanted to replace it, but it was dangerous to say that out loud? The Conservatives (and to some extent some Liberals as well) have been playing a long game -- since the 70s when it was introduced -- to get rid of medicare. It's incredibly popular with Canadians as a whole, but if you take con…

Hey, if you object to privatizing healthcare, why do you hate the free market? Don't you think that private healthcare and insurance companies should be able to skim billions of dollars off the top of all health-related spending? Are you some kind of commie?

In reality what we have in Canada is already like that to some extent. Doctor's clinics are private businesses. And they bill the government. Yes the terms of that are fixed (and continually under dispute.) But the profit taking and skimming absolutely happens. Just that, unlike the US, there's a single public payer of it.

It ain't socialism. Parts of it may look like it, but most parts do not (unless your definition of socialism is "guvernm'nt does stuff", which is silly).

It's also not working particularly well right now.

Re: Collapse of emergency healthcare in England may be costing 500 lives every week

#309

Earlier quoted context omitted.

It is too bad that corrupt government officials keep systemically defunding Social Health programs with the objective of pushing private for-profit healthcare (which just doesn't make sense). Then they point to the deficient healthcare and blame the "socialized" aspect of it for the issues. Here in Mexico we've seen it all play out: We had an amazing social healthcare system (in the form of the IMSS) in the 70s and 8…

>with the objective of pushing private for-profit healthcare (which just doesn't make sense) Maybe it doesn't make sense for you, but it makes their buddies in the private sector a lot of money. And that's the game in capitalism, making a lot of money. The government competing with affordable options for everyone against the private sector is "bad for business".

> And that's the game in capitalism, making a lot of money.

yeah, but in real capitalism, this is done by consumers voluntarily choosing a product. What we are seeing here is crony capitalism play out.

Re: Collapse of emergency healthcare in England may be costing 500 lives every week

#310

Earlier quoted context omitted.

> Nearly two-thirds of adults in England are overweight or obese. That means the issue is systemic and one needs to look at things outside of individual control. Yes, often systemic issue can be overcome by individuals - by the top quartile kind of individuals with more luck, better genes, better education (including what they picked up at home while growing up), more money, more suitable lives than the majority, or…

You can both blame people and society. Modern living makes it easy to be fat, but plenty of us don’t succumb to the temptation of easy meals and overeating. I’m not sure how you’d even change modern life to get around this, save maybe for incredibly large sin taxes on everything from soda to every restaurant. I’m sure we’ll just end up with a pill sometime soon. Semaglutide comes close.

> Semaglutide comes close

Until we can mass manufacture that, can we all start taking metformin?

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