"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.
- 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.
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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