Is the rising cost of healthcare related to rising level of bureaucracy?

Community Health Aug 12, 2011 at 11:11 am

By Dr. Garrett Foley

The cost of healthcare in Ontario is increasing and there is more and more scrutiny on healthcare expenses, from doctors’ fees to nurses’ salaries to hospital costs. While it is crucial that we examine these costs, it is also crucial that we examine the cost of the bureaucracy that has evolved to manage our healthcare system.

How much money is being spent in the system before one patient is treated? How much of our healthcare budget is what I call ‘pre-patient care’ dollars? In other words, how much money does the system consume before one patient is treated in a doctor’s office, clinic or hospital?

How much money is the government spending to advertise ‘free’ healthcare? How much of that advertising is hidden political advertising?

How much money is the government spending on the salaries and benefits of the ever-increasing army of bureaucrats required to run the system?

How much money is being wasted pursuing untested programs that are ultimately abandoned due to their failure? If family doctors had the same failure rate with patient care as the system has with its own programs, patients would rightly be outraged and demanding action be taken. Perhaps some drastic action needs to be taken with the system itself.

The problem, as I see it, is that we have a healthcare system designed primarily by bureaucrats with little, if any, experience in the delivery of frontline healthcare.

Bureaucrats are administrators and obviously healthcare needs them. What healthcare does not need is increasing bureaucratic functions at the expense of the actual delivery of patient care, which is exactly what I am seeing happen in my practice.

Now that we have an approaching election, the rhetoric on healthcare is increasing dramatically. Each candidate and party will want to convince you that they put healthcare first and foremost and that they are the right ones to trust. The only reason that each party will champion healthcare is that they know from opinion polls it is the most important social program to you; you, the voter. You, the patient.

The reality is that healthcare challenges will not be solved by one political party over another. In reality, it would likely take bipartisan efforts to intelligently and effectively address many of the issues confronting Ontario healthcare. How likely do you think that is to happen? How likely do you think it would be for a Liberal MPP to embrace a PC MPP’s idea if it were a sound one? Or an NDP’s idea? Not likely at all. That’s political reality.

Family doctors may not always agree with each other on answers to some of healthcare’s changes. But one thing is certain: a patient’s best interest is a family doctor’s primary motivator. Not votes.


Dr. Foley is a family physician practicing in Cornwall. He and many involved family physicians share their views and concerns with patients on