Sacred Cows. . . a Rick Merceresque rant….
– the bottom line: change is required, some sacred cows need to be turned into hamburgers and the politicians are going to have to put some skin in the game with unions, communities and professions (read: electorate).
Some of the sacred cows:
OHIP has to stop being the accounts payable department of the OMA and become a REAL insurance company
We have to spend money on IT and much of the initial spend will be sunk costs
We need to integrate to have fewer organizations managing the patient journey, not more
We need a robust and accountable primary care system focused on reducing the burden of chronic disease and aging and incentives / rewards to reducing frequency, severity and duration of hospital stays
To move workers from downsized hospitals to upsized community models, we need new approaches to collective bargaining, job transfers, pay equity, and more, or all of the above is compromised
We need hospices
…and we need the professions to collaborate better (end the sovereignty), to stop medicalizing everything with drugs, procedures and tests (end fee-for-service and introduce co-pays)
Health links is a start but the pace of change there is somewhere between glacial and tectonic and there is absolutely no incentive for primary care to play – upward pressure on accountability and downward pressure on revenue, upward pressure on time for patients and downward pressure on productivity….
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