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Squandering Billions - Health Care in Canada

The Issue

"The management of our health care system is so inefficient that we not only fail to put patients in the hands of those professionals most qualified to give the best treatment, we actually ensure that the most expensive and least qualified person provides the care. . . . the structure of health management makes the squandering of billions unavoidable." - Pran Manga, Ph.D., M.Phil., an internationally renowned health economist and a principal author of Canada's universal health care.

Squandering Billions is a brutally frank indictment of health spending. The book demonstrates that the absolute power of medical doctors, pharmaceutical companies, health bureaucrats, Health Management Organizations and hospital administrators, enshrines mediocrity at the expense of patients. Mistakes, inefficiency and malpractice in both American and Canadian health systems may cause ten times or more unnecessary deaths a year than the toll from traffic accidents and crime. Some acute care hospitals seem to have become disease factories. Why do health care tragedies not face the scrutiny typically focused upon other accidental and wrongful death?

Health insurance - government and private sector - was designed to insure the patient, not the practitioner. Why, then, are governments and HMOs permitted to establish rules to disqualify so many people (US) or to restrict coverage to medical doctors and hospitals exempted from competition (Canada)? Evidence shows conclusively that expanded use of community health centres, nurse practitioners, doctors of chiropractic and others can be more effective and less expensive within their area of expertise.

Americans are alarmed by the size of the uninsured populations, and reduced or more restricted coverage for everybody else; Canadians are shocked to see health costs soar past 40 per cent of gross provincial (i.e. State) budgets, with no end in sight and the public clamouring for more coverage.

This book goes where official commissions have been afraid to travel.

Why this Canadian book has both startled and impressed
so many American health practitioners:

  • Most of the authoritative data with respect to adverse events, the malfeasance of pharmaceutical marketing, media manipulation and distorted research comes from unimpeachable American sources.
  • It exposes as a "red herring" the controversy of a mixed for-profit and limited publicly-funded health insurance system, as in the U.S., in comparison to the universal health care in the rest of the democratic world. The real issue is one word: monopolies. Corporate power and selectivity devastates U.S. health care, while Canada suffocates under the weight of bureaucracy, pharmaceutical companies and the medical establishment.
  • The big money in health care comes from invasive procedures: if you cannot cut, burn or drug a patient, there is unlikely much net profit to be had.
  • It may be the most comprehensive history yet written of the success of the chiropractic profession against unspeakable bias and discrimination.

Canadians are very concerned too

In brutally frank, provocative, entertaining and well-researched fashion, the book demonstrates how poor management wastes fortunes and mistreats millions of patients:

  • Mistakes, inefficiency and malpractice in the Canadian health system may be causing 50,000 unnecessary deaths a year, compared to 3,000 highway fatalities and about 500 from crime.
  • Spending on drugs has doubled from $10 billion to $26 billion in seven years with no measurable public benefit, and, in fact, contributing to alarming numbers of adverse events.
  • Monopolistic behavior by the health establishment continues to distort the intent of the Canada Health Act, conspiring against the expanded use of community health centres, nurse practitioners, Doctors of Chiropractic and other services, demonstrably more effective and less expensive within their area of expertise.
  • The text is sharply critical of health politics but not “anti-doctor.” The best of medical science is applauded in the context of multidisciplinary respect, proposing renewed efforts to place all patients into the most effective hands as quickly as possible.

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