# Thank goodness for government health care.



## sags (May 15, 2010)

It has become apparent in the ebola news coming from the US, that a fragmented, privately run health care system is fraught with inherent major flaws.

The CDC........whom many assume have "control" over how hospitals operate.......can offer nothing more than "guidelines".

They have no mandate to order privately owned hospitals to do anything. The lack of authority virtually assures big differences in procedures and equipment from hospital to hospital. Privately owned hospitals weigh the cost of expensive protective clothing for their health care workers vs the cost to the bottom line. The choice is between optimal procedures and expense.....often with the result being less equipment, protection and training.

The lack of a central authority has never been made more clear than during a White House press conference yesterday, when repeated questions regarding the chain of command.........the "who is in charge question"........revealed that "everyone" and "no one" is in charge.

That is very disturbing news, and food for thought for Canadians.

Some advocate for more privatization in health care in Canada. They claim that private industry can operate more efficiently.

It may be a valid argument.....if saving dollars or earning profits are the most important goals.

But Canadians should ask themselves.......Are those the goals they want in a public health care system?

Perhaps the benefits of a publicly paid for and controlled health care system.........are worth more than the savings of privatization.

In Canada, perhaps we are fortunate that our hospitals and health care will be directed by central authorities in a crisis.

Hopefully, we will never have to find out.

In the meantime, from what has been reported, Canada's authorities have ordered hospitals to review and update their training and procedures in the event of an outbreak.

That is good news.


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## carverman (Nov 8, 2010)

Our healthcare system in Ontario at least (don't know anything about the other provinces and territories) is acceptable as far as health care standards, but by no mean perfect. 

Not sure what happened with the nurse in Texas contracting ebola from the patient that died, but
in every case there are extenuating circumstances..even in quarantined areas of a hospital. 

All it takes is one mistake of not following rigid procedures...like the hazmat suit not sealed properly
or reused for the second time.

We have had some similar cases here in Canada, the Hamilton -Burlington hospital C-difficile outbreak case comes to mind,where 91 patients DIED and many more were infected.



> A class-action lawsuit launched by patients and families after a deadly outbreak of C. difficile at Joseph Brant Memorial Hospital has been settled out of court for a proposed $9 million.
> 
> The Burlington hospital disclosed in the spring of 2008 that 91 patients infected with the virulent superbug had died, and a total of 225 had been infected, in a C. diff outbreak that was longer and deadlier than originally thought.
> 
> The case remains Ontario’s worst outbreak to date of the superbug, which overran the hospital from May 2006 to December 2007 and triggered a public uproar over patient safety. Settlement documents filed in court say that Joseph Brant Hospital “does not admit any wrongdoing or liability.”


http://www.thespec.com/news-story/2206909-jo-brant-hospital-settles-c-diff-suit-for-9-million/

Can something similar happen here in Canada before it is brought under control...what are the chances? 
All it really takes is one seriously infected patient wandering around a hospital before the patient is diagnosed
and quarantined.


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## Beaver101 (Nov 14, 2011)

carverman said:


> Our healthcare system in Ontario at least (don't know anything about the other provinces and territories) is acceptable as far as health care standards, but by no mean perfect. ....
> 
> Can something similar happen here in Canada before it is brought under control...*what are the chances*?
> All it really takes is one seriously infected patient wandering around a hospital before the patient is diagnosed
> and quarantined.


 ... 100% ... look at SARS. At least we know where ground zero is on eBola whereas it took months to figure that out with SARS in 2003 ... hasn't health officials or the experts learned anything from that/history? They should be have some concrete / air-tight plans in place waaaaay before a potential pandemic emerges ... or it can't be controlled.


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## Just a Guy (Mar 27, 2012)

In alberta, the nurses Union is suing public health because of the way they handled suspected Ebola cases...so how is this better than Texas?


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## sags (May 15, 2010)

I think one benefit is that when mistakes are made, the public health authority can mandate necessary changes and enforce compliance.

Failures that are recognized.........can be changed to effect every facility within the jurisdiction at the same time.

In the US...........changes are voluntary.........vary from hospital to hospital.........based on guidelines.

One significant change that has taken place..........is ebola patients would be transferred and treated in one facility within the Province.

It is significant because staff training can be focused, the best protection provided, the best expertise applied, and the destruction of hazardous material can be simplified. It also makes the storage of the experimental anti-virus drugs easier in one place.

It should be a much more effective system........to have regional hospital staff trained primarily to identify and transfer ebola patients, without the additional necessary training for treatment and isolation.

But you are right in that it depends on the central authority making the right decisions.


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## carverman (Nov 8, 2010)

Beaver101 said:


> ... 100% ... look at SARS. At least we know where ground zero is on eBola whereas it took months to figure that out with SARS in 2003 ... hasn't health officials or the experts learned anything from that/history? They should be have some concrete / air-tight plans in place waaaaay before a potential pandemic emerges ... or it can't be controlled.


I'm sure the hospitals and health authorities do now..with the latest outbreak in western Africa.
Not that long ago this year, several children in some Ottawa schools got exposed at school to measles, for which there was a measles vaccine developed many years ago..you would think that new cases of measles here would be non-existant at this point..but parents don't always want their children vaccinated against infectious diseases..so now these virus related diseases seem to surface when our children are exposed to other children that were exposed in some other country they travelled to and brought it back home with them.
http://www.theglobeandmail.com/life...seases-is-spreading/article17866080/?page=all


You can't control people with infectious viruses (Sars/c-difficile/ebola) until you know for sure that the person has that disease.
By the time the infected person gets isolated treatment, many people can be exposed to it. Not everyone who contract the disease..will die from it...it's one of those mysteries of our immune system, but anyone exposed has to be tested rigorously so the disease isn't spread exponentially.


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## Rusty O'Toole (Feb 1, 2012)

I hope you are right. We are better off than the US that is for sure.


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## uptoolate (Oct 9, 2011)

sags, I would say that you have made an insightful observation. The public v private debate seems to always be raging but seldom is this aspect of the difference between the two systems even mentioned. I think you are correct in your assertion as to which system is likely to respond better to the kind of threat that ebola poses. Hopefully we won't get the chance to see any potential differences demonstrated during the current challenge.


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## Berubeland (Sep 6, 2009)

I take exception to the characterization that privatization of hospital services would save money. The evidence south of the border is the opposite of your statement. I am happy to be in Canada right now, for all the talking of how great America is, that is true only for the 1% 

In any case there is already discussion of the Ebola patient's #1 dying and neglected because he was black and had no health insurance. He was sent home even thought he told them he was traveling from Africa


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## fraser (May 15, 2010)

There are certainly challenges with our health care system but I certainly would not trade it. Would like to see some changes of course, and include pharmacare, but that is par for the course

When we look south we see the largest cause of personal bancrupy is medical costs. Early retirement for many is out of the question because of insurance costs/risks. The mortality numbers are no better.


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## carverman (Nov 8, 2010)

Some more news on the Ebola outbreak...now there are* two nurses that have tested positive* and maybe even at some stage of contraction of the disease.

A former nurse at the Dallas Presbyterian Hospital ,(where the patient died) was seen on a TV interview indicating that the hospital did not follow proper protocols with the patient.

One nurse that attended him..didn't even button up her hazmat suit properly at the neck, possibly exposing
herself to the virus...and the patient was not quarantined for a while, so that all the nurses attending him, need to be checked out thoroughly themselves. 

The two nurses that apparently have caught the virus, now have to be medically evacuated in yellow hazmat suits to another hospital in Atlanta, as there isn't enough nurses still working at the hospital now to care for them
with the correct protocols.



> The day before she went to the hospital with Ebola symptoms, Amber Vinson was *flying halfway across the country on a commercial jet with 132 other people.*
> Centers for Disease Control and Prevention Director Dr said she never should have stepped foot on the flight, but another federal official told CNN that no one at the agency stopped her.





> Before flying from Cleveland to Dallas on Monday, *Vinson called the CDC to report an elevated temperature of 99.5 Fahrenheit. She informed the agency that she was getting on a plane, the official said, and she wasn't told not to board the aircraft.*


Normal temperature is 98.6. That's only about 1 degree difference, probably not a fever at that point.
The threshold is 100.4 or about 2 degrees higher than normal. 



> The CDC is now considering putting 76 health care workers at Texas Health Presbyterian Dallas hospital on the TSA's no-fly list, an official familiar with the situation said.
> The official also said the CDC is considering lowering the fever threshold that would be considered a possible sign of Ebola. T*he current threshold is 100.4 degrees *Fahrenheit.



What is the possibility of others being infected by such lax rules?


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## Just a Guy (Mar 27, 2012)

fraser said:


> When we look south we see the largest cause of personal bancrupy is medical costs. Early retirement for many is out of the question because of insurance costs/risks. The mortality numbers are no better.


When we look to the north, the largest portion of the tax bill is healthcare...are we going to bankrupt the entire country? Perhaps we need to look at the spending problem in the system...like spending all the money before the end of the year, or the budget gets cut, or people (unions) demanding pay raises every time new funds are announced...not really incentives for frugality.


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## sags (May 15, 2010)

I agree there is extra cost in the healthcare system that could be gleaned out, but we have to make choices.

The most expensive costs are at the end of life care. We can keep people alive for extended periods through medical intervention.........but should we?

That is a whole other moral debate..........but it ties in with healthcare costs.

If we lower the pay for nurses and hospital staff.............will the profession attract the best people ?

Are we willing to accept a cheaper version of healthcare...........if it means a few more dollars in our pockets ?

Valid questions........but anytime a politician has gone anywhere near the topics........they have been rejected by the voters.

It seems to me..............that it is what Canadians want it to be.

I think what Canadians would really support...........is removing wasteful spending from the system and re-investing the savings back into a better system.


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## Beaver101 (Nov 14, 2011)

Canadians are fortunate enough to have a public health care system but at the same time, the move to privatization will be inevitable when the income gap becomes greater.


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## uptoolate (Oct 9, 2011)

The belief that people who can afford to pay lots of money get 'excellent' health care is far from beyond question. My experience with US style health care is that those who can pay great amounts for healthcare do pay but don't necessarily get great care and sometimes get much worse care.


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## Beaver101 (Nov 14, 2011)

^ At least they get quicker access to medical care and in the process, perhaps increases their chances of of survival.


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## HaroldCrump (Jun 10, 2009)

The trouble with the theory that those who can pay more for better/faster health care should be allowed to do so is that it does not take long for those very same people to get tired of having to pay for the health care of the less wealthy or less fortunate.

It does not take too long to go From:

_I have the ability to pay more for better/faster care, and should be allowed to do so by the free market_
To:
_Why should I have to pay for others' health care when I pay for my own. Let them pay for their own Goddamn health care._

^ and that is what has happened in the US.


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## uptoolate (Oct 9, 2011)

Agree with that. Also, if I'm the doctor or hospital that just bought the newest, fanciest diagnostic gadget then I'm definitely going to be using it on as many people as I can and billing them a handsome sum, even if maybe I don't think they really need the test. It is only relatively recently that doctor's have begun to come to grips with the many potential harms that false positive tests can lead to. Cloaked in the mantle of 'cover your butt' medicine the person with simple ingestion winds up with a battery of tests, a liver biopsy and exploratory surgery for what is a normal anatomical variant or something totally benign. The racket is so good that the person winds up thanking the system - thank goodness I had the total body MRI and they found out that that lesion was really nothing... I'm so lucky! And yes of course there is always someone's friend's friend's second cousin who actually had something and was 'saved' - maybe.


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## rford (Aug 16, 2014)

Isn't it kind of premature to say thank goodness for government healthcare when they haven't even been tested yet with a case in Canada?


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## carverman (Nov 8, 2010)

rford said:


> Isn't it kind of *premature to say thank goodness for government healthcare when they haven't even been tested yet with a case in Canada*?


Good thing too. ^. 

In the latest CBC news, a woman suspected of ebola in a Edmonton hospital, had a blood sample taken , and it
was supposed to be sent by courier, but because it was in the middle of the night, another courier was called which took the blood ( suspected ebola) to the Air Canada depot, where it was refused to be taken on the plane due to not following 85 protocols of blood shipments ....or the pilot (captain of the plane) refusing it...big disagreement between the federal minister of health and AC on that one.

Eventually the blood sample was flown to the test labs in Winnipeg. The test determined that the patient did not have ebola.

But here is just one incident of *procedural errors that could compromise someone's risk of catching the disease.*

This time it didn't happen..(nobody got infected so far), but who's to say it can't happen if the disease is that contagious and proper protocols are not followed. Look at the panic in the US..the lastest one with a woman
getting sick in the Pentagon. She, apparently told health authorities that she had travelled to Africa and
returned..whether that was a hoax or not..they are still trying to determine. 




> It was not until midnight Sunday – nearly 36 hours after the patient first visited a hospital – that Ebola was ruled out.
> Health Canada, Air Canada disagree on cause of delay
> 
> "It is my understanding that the pilot who was going to fly the sample had some concerns ... and there was a delay in getting the sample on board and off to a lab," said Vickie Kaminski, president and CEO of Alberta Health Services.
> ...


https://ca.news.yahoo.com/ebola-outbreak-diagnosis-delayed-air-195342567.html


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## sags (May 15, 2010)

It sounds like it was a failure with Air Canada,...... not with the system in place.

One difference from what has happened in the US, is the hospital automatically assumed the patient was infected, and she was immediately placed in isolation.

There doesn't seem to be a valid reason Air Canada refused to accept the shipment.

During my days in warehousing, I have seen how bio-hazardous material is shipped, and it is very well identified and contained.

The "paperwork" for shipping can be a little cumbersome........but it is necessary for everyone's safety.

It would probably be a good thing if Alberta had a lab in the Province to provide the testing though.

As long as ebola is active in Africa.....there is no system that can provide 100% safety.

All a system can do is mitigate the damage as much as possible.

The lack of central authority in the US did the opposite. It created a lot of problems.

Hence Obama has finally appointed someone to take charge of the situation, acting as a central authority.


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## carverman (Nov 8, 2010)

sags said:


> It sounds like it was a failure with Air Canada,...... not with the system in place.
> 
> One difference from what has happened in the US, is the hospital automatically assumed the patient was infected, and she was immediately placed in isolation.
> 
> There doesn't seem to be a valid reason Air Canada refused to accept the shipment.


Maybe so, but it also depends on how the biohazard was shipped and the documentation available at the time
for that specific shipment. It was a human blood sample, and the patient from which it came was NOT
diagnosed of having ebola..only suspected... So this would be routine blood sample check..

but...
if it mentioned anywhere in the documentation that it was a suspect bio-hazard which was classified
as DGR (Dangerous Goods)...and the packaging and paperwork were not correct for it..I can see the IATA pilots refusing it. 



> 7.1.2 Air Transportation
> The air transportation of infectious substances internationally is regulated by the International Civil
> Aviation Organization (ICAO). As the majority of carriers (both passenger and courier/cargo) around the
> world are members of this organization, *anyone shipping infectious substances internationally is likely
> ...





> The ICAO requirements are based upon the United Nations Recommendations on the Transportation of
> Dangerous Goods. For further information regarding international shipping requirements, please contact
> the ICAO Canadian representative directly: Judith Code, Chief, Dangerous Goods Standards,
> Commercial and Business Aviation, Transport Canada, at (613) 990-1060 (mailing address as indicated
> ...


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## HaroldCrump (Jun 10, 2009)

sags said:


> Hence Obama has finally appointed someone to take charge of the situation, acting as a central authority.


A career bureaucrat, a fatcat with no medical background, training, or expertise, and no prior experience managing a crisis of any seriousness (other than perhaps to try and get Al Gore elected President in 2000).
But then, not surprisingly different from many other "appointments" by Obama.


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## Beaver101 (Nov 14, 2011)

HaroldCrump said:


> A career bureaucrat, a fatcat with no medical background, training, or expertise, and no prior experience managing a crisis of any seriousness (other than perhaps to try and get Al Gore elected President in 2000).
> But then, *not surprisingly different from many other "appointments" by* Obama.


 ... so how is this different from any government bureaucracy? Since we're talking about the US here, here's another example, 

http://en.wikipedia.org/wiki/Michael_D._Brown appointed by George Bush Jr. during the Katrina crisis - profession(s): lawyer, radio personality ... lots of emergency crisis experience, not. Now he probably does. :biggrin:


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## Beaver101 (Nov 14, 2011)

sags said:


> I agree there is extra cost in the healthcare system that could be gleaned out, but we have to make choices.
> 
> ....
> 
> I think what Canadians would really support...........*is removing wasteful spending from the system and re-investing the savings back into a better system*.


 ... and let's start with the fat bureaucrats from the top.


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## uptoolate (Oct 9, 2011)

I may be wrong but I think that we have far few bureaucrats and they make far less both individually and collectively. As well, our bureaucrats are more answerable to the public as opposed to shareholders and special interest groups.


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## HaroldCrump (Jun 10, 2009)

Beaver101 said:


> ... so how is this different from any government bureaucracy? Since we're talking about the US here, here's another example,


No difference at all...the aftermath of Katrina is one of the most glaring examples of govt. mismanagement - both at the Federal and State levels.
The Ebola outbreak in the US has not even begin to be the same scale as Katrina, thankfully, so far.


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## carverman (Nov 8, 2010)

Looks like the Canadian health authorities are taking ebola situation more seriously now. Halifax and Ottawa are conducting emergency measures
drills to train personnel, in case a case is discovered here as well. 

The awareness level definitely has been heightened after the situation in Dallas where two health care workers contracted it looking after the same patient. 



> The Public Health Agency of Canada has two teams of public health experts and epidemiologists on standby in case a patient tests positive for Ebola — one in Winnipeg and another in Ottawa.
> 
> Since Ottawa is closer to Belleville, that team would race to the hospital. They’d bring laboratory expertise to quickly confirm the diagnosis, and any needed supplies, such as masks, gloves and face shields.
> 
> They’d be responsible for the hands-on treatment of the patient, who would remain in quarantine.


http://thechronicleherald.ca/canada/1244920-how-canada-would-respond-if-ebola-came-here


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