Pen as Sword - Social Commentary, Politics and Economics

Breath in … Breath out …

“plus ça change, plus c’est la même chose”

Pay close attention America. This is where your leadership has decided that your healthcare system has got to go.  It doesn’t take a seer or a Ouija board to predict what will happen when the gov’mint takes over a system that is ten times the size of ours here in Canadian fly-over country. I know a little about what is going on in health finance. I spent a happy five years running the payroll and accounting systems for a major prairie health care region.

I got the job back when Y2K was the next big “Sky-is-Falling!” crisis. I was one of a rare breed of ancient mariners who cut their teeth programming in COBOL. Remember COBOL?  All gov’mint and corporate legacy business systems are coded in COBOL, only now they call it “Object” COBOL. Ha! But, just like janitors, the programmers are invisible, even though they are handling the real numbers all the time. Senior management dream on about security and secrecy and all the time the peons know everything that matters because without the peons the whole system comes to a grinding halt.

Here in Redmonton, the last couple of days saw the gov’mint announcing amidst the usual flurry of fanfare that they had decided, yet again, to improve the health care system in the province. They were going to do this by creating about 10 new regional health authorities or “districts”.  Seven years after the Province collapsed its health regions and centralized care in an attempt to save money and improve outcomes, it is moving back in the other direction.

Our Premier said Wednesday that decentralization of health care is the way to go, despite earlier decisions by previous Progressive Conservative governments. “I’m not going to defend what happened in the past. I wasn’t the premier at the time,” the Premier told reporters. (Well, golly, gee, that just makes it all OK then. Why don’t you go ahead and set up a final solution while your at it. After all, you weren’t the Fuhrer at the time either) 

The announcement followed the release of a government report into reforming rural care (I’m sure this isn’t really good grammar, but what the hey, our readers ARE ignoramuses otherwise they wouldn’t be reading our crap anyway) . Mr. Premier said the government heard a lot from residents “who have felt disenfranchised by the way the system has been operating.” The Health Minister said the province will set up eight to 10 new health districts by July 1. Each will be responsible for meeting performance targets and delivering health services. Each district will receive advice from a local advisory council.

The Minister said the districts will be different from the nine health regions that were consolidated into the Alberta Health Services superboard in the spring of 2008. A senior bureaucrat in Alberta Health Services, said big decisions such as new hospitals, technology improvements and other health infrastructure will still be co-ordinated through Alberta Health Services. “We’re also going to keep overall functions in finance and human resources and communications fairly centralized,”  Any costs associated with the transition are expected to be handled within existing resources (in spite of a 7 billion dollar shortfall, hmmm, does this add up?).

It’s another step in what has been a tortured and twisted path for AHS (understatement of the century – total cluster f_ _ k would be closer to the truth), which has been responsible for delivering front-line care province wide. Since 2008, multiple CEOs have been hired and left, and in 2013 the entire governing board was fired by then-health minister Fred Horne in a dispute over bonuses. It has yet to be replaced. There have been headlines on wasteful spending and large severance payouts to executives (when an “executive” screws up he doesn’t get punished because then folks would ask who was responsible for letting him or her screw up? So they just get a major 6 figure golden parachute and are moved on to another jurisdiction so they can screw up again.), intimidation of staff and doctors (that must have been a mistake – intimidating a doctor? Wow!), organizational chaos (ever hear of SNAFU?),  administrative turf wars and long lines for surgery and emergency room care (normal, normal, normal for ANY gov’mint operation). There have already been previous attempts to reintroduce local governance by dividing the province into five zones to go with 12 other health advisory councils.

Opposition leaders said the latest reorganization is stark proof of Tory administrative bungling, with Provincial taxpayers paying the price. Another opposition leader said she is hopeful, but cynical, that true change will emerge.  “While we are hopeful these new districts will lead to the badly needed improvements in rural care, they sound like another rewrite of a broken script. “The reality is the core of the problem facing health care in our province remains the same today as it was yesterday: a centralized health model with all the power remaining in Edmonton.”

NOO!!!!  I want my deck chair nearer the stern!!!  WAAAHHHH!!!

No one, and no group of no ones, and no superboard of no ones, and no politician, or manager, or minister, will ever, EVER! be able to fix health care in our fair land simply because no one in the entire system has been, is now, or will ever be, held accountable for anything. They are ALL dancing around in one great Rainbow daisy chain, each with a hand in the next guys pocket and the other hand over their ass in one colossal circle jerk, with the taxpayers paying for everything. Healthcare in this fair land is spelled “T-R-O-U-G-H”.

And what feeds at troughs?  Of course, HOGS! HOGS in suits! And each Hog is so totally fixated on making sure that it gets it’s share of the slops that not ONE little piggy gives a rip about anything else happening around it. If some of them get unruly then the senior hogs simply consolidate and shuffle the chairs. A little while later – usually after another election cycle or two, they re-cycle the chairs again. And so on ad infinitum.

Ahhhh! it is so reassuring to know that we are living in such a rich land that we can easily afford all this squealing and pushing and corruption (that would be pig shit by the smell from here,  and whatever changes it ALWAYS costs millions more than they promise).

Cheers

Joe

CSR

Police…

 Two policemen call the station on the radio. “Hello. Is that you Sarge?”

“Yes?”

“We have a case here. A woman has shot her husband for stepping on the floor she had just mopped clean.”

“Have you arrested the woman?”

“No sir. The floor is still wet.”

Standard

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