How Successive Governments Have Weakened the Foundation of All Canadian's Social and Economic Security At some point you will find yourself lying in a hospital bed. There is a good chance that your bed will be a firm, rubber pad held secure between two rails and parked along a corridor in a busy emergency department. Moans of “Nurse!” will echo from the beds ahead of you in line. Those pleas will fall largely on deaf ears. Your hospital is underfunded and understaffed. Welcome to the current reality of Medicare in the 21st century. Using searing analogies and first-hand accounts, Dr. Whatley makes the argument that the current Medicare system is unsustainable and unless critical choices and changes are made soon, the publicly funded, single-payer system in Canada will implode. Successive governments, regardless of political stripe, know all too well that Canada's system of health care is one of the defining characteristics of “being a Canadian”, and any changes deemed harmful will have them thrown out of power. Thus, decades of cuts around the margins, centralized control, federal/provincial infighting, and government oversight has left doctors and hospitals with little input on how your health dollars are allocated and spent. Citizens are being left to languish in pain for months, sometimes years, because the current cost and delivery system is programmed for the benefit of governments staying in power. That was not what was intended. Medicare should be about delivering high-quality and timely healthcare value for Canadians. This is not an easy fix. Treatment starts with a serious look at the disease, and Dr. Whatley pulls no punches. But what sounds like a radical new approach is neither new nor radical. He is not arguing for the end of Medicare per se but is making the case to let medical professionals — those providing the services — become equal partners in its design, implementation and delivery.

How Successive Governments Have Weakened the Foundation of All Canadian's Social and Economic Security At some point, you will find yourself lying in a hospital bed. There is a good chance that your bed will be a firm, rubber pad held secure between two rails and parked along a corridor in a busy emergency department. Moans of "Nurse!" will echo from the beds ahead of you in line. Those pleas will fall largely on deaf ears. Your hospital is underfunded and understaffed. Welcome to the current reality of Medicare in the 21st century. Using searing analogies and first-hand accounts, Dr. Whatley makes the argument that the current Medicare system is unsustainable and unless critical choices and changes are made soon, the publicly funded, single-payer system in Canada will implode. Successive governments, regardless of political stripe, know all too well that Canada's system of health care is one of the defining characteristics of "being a Canadian", and any changes deemed harmful will have them thrown out of power. Thus, decades of cuts around the margins, centralized control, federal/provincial infighting, and government oversight has left doctors and hospitals with little input on how your health dollars are allocated and spent. Citizens are being left to languish in pain for months, sometimes years, because the current cost and delivery system is programmed for the benefit of governments staying in power. That was not what was intended. Medicare should be about delivering high-quality and timely healthcare value for Canadians. This is not an easy fix. Treatment starts with a serious look at the disease, and Dr. Whatley pulls no punches. But what sounds like a radical new approach is neither new nor radical. He is not arguing for the end of Medicare per se but is making the case to let medical professionals - those providing the services - become equal partners in its design, implementation and delivery. Praise for When Politics Comes Before Patients "In Canada, socialized medicine has been exalted to the status of a sacrament, and to criticize it, either in theory or in practice, is tantamount to heresy. Dr. Whatley dares to do both, and with such clarity of argument and abundance of evidence, that no reasonable or fair-minded person could fail to be convinced. What Dr. Whatley has demonstrated, in this beautifully written and engaging volume, is that socialized medicine fails to meet the most fundamental moral obligation of health care: to place the patient's interests above all else." Dr. Harley Price, University of Toronto "Whatley... insists that our focus should be on the patients, the people the system is supposed to serve but whose interests are too easily sacrificed in the name of some pretty but ineffectual or even destructive bureaucratic theory. I have been thinking about the health care system for thirty years yet I found Whatley's book packed with new insights and courageous thinking. A cure for what ails us." Brian Lee Crowley, Managing Director, the Macdonald-Laurier Institute "When you are getting a diagnosis from your doctor, you want the truth. If you want a truthful diagnosis of our health care system, you must read this book. With precision, wisdom, and verve, Dr. Shawn Whatley has fearlessly dissected the rot that plagues Canadian socialized medicine. Can you handle the truth?" Bruce Pardy, Professor of Law, Queen's University

The complaints that patients bring to their doctors often have roots in social issues that involve work, family life, gender roles and sexuality, aging, substance use; or other problems of nonmedical origin. In this book, physician/sociologist Howard Waitzkin examines interactions between patients and doctors to show how physicians' focus on physical complaints often fails to address patients' underlying concerns and also reinforces the societal problems that cause or aggravate these maladies. A progressive doctor-patient relationship, Waitzkin argues, fosters social change. Waitzkin provides a pathbreaking analysis of medical encounters, applying perspectives from structuralism, post-structuralism, and critical literary theory to transcripts of recorded conversations between doctors and patients. He demonstrates how doctors unintentionally maintain dominance in their dealings with patients, encourage conforming social behavior and attitudes, and marginalize patients' concerns with social problems. Waitzkin urges physicians to attend to the social as well as the medical problems that emerge from patients' narratives and suggests ways to restructure the manner in which patients and doctors communicate with each other. Physicians and patients, for example, should work together to demystify medical discourse, should refrain from medicalizing social problems through medications or reassurances that dull socially caused pain, and should be prepared to call on advocacy organizations seeking to change the social conditions that create personal distress. This book will influence and challenge physicians scholars, and students in the social sciences and humanities, as well as anyone concerned about the present problems and future direction of medicine.

Are they truly independent organizations or have they been 'colonized' by the big vested interests in health? Are they a signal of a more assertive patient or consumer? Do they actually influence what health care people receive?" "This study will be important reading for scholars, students and professionals and, in particular, for those involved in running patient organizations."--Jacket.

Essential reading for every American who must navigate the US health care system. Why was the Obama health plan so controversial and difficult to understand? In this readable, entertaining, and substantive book, Stuart Altman—internationally recognized expert in health policy and adviser to five US presidents—and fellow health care specialist David Shactman explain not only the Obama health plan but also many of the intriguing stories in the hundred-year saga leading up to the landmark 2010 legislation. Blending political intrigue, policy substance, and good old-fashioned storytelling, this is the first book to place the Obama health plan within a historical perspective. The authors describe the sometimes haphazard, piece-by-piece construction of the nation’s health care system, from the early efforts of Franklin Roosevelt and Harry Truman to the later additions of Ronald Reagan and George W. Bush. In each case, they examine the factors that led to success or failure, often by illuminating little-known political maneuvers that brought about immense shifts in policy or thwarted herculean efforts at reform. The authors look at key moments in health care history: the Hill–Burton Act in 1946, in which one determined poverty lawyer secured the rights of the uninsured poor to get hospital care; the "three-layer cake" strategy of powerful House Ways and Means Committee Chairman Wilbur Mills to enact Medicare and Medicaid under Lyndon Johnson in 1965; the odd story of how Medicare catastrophic insurance was passed by Ronald Reagan in 1988 and then repealed because of public anger in 1989; and the fact that the largest and most expensive expansion of Medicare was enacted by George W. Bush in 2003. President Barack Obama is the protagonist in the climactic chapter, learning from the successes and failures chronicled throughout the narrative. The authors relate how, in the midst of a worldwide financial meltdown, Obama overcame seemingly impossible obstacles to accomplish what other presidents had tried and failed to achieve for nearly one hundred years.

Drawing on the work of the Roundtable on Evidence-Based Medicine, the 2007 IOM Annual Meeting assessed some of the rapidly occurring changes in health care related to new diagnostic and treatment tools, emerging genetic insights, the developments in information technology, and healthcare costs, and discussed the need for a stronger focus on evidence to ensure that the promise of scientific discovery and technological innovation is efficiently captured to provide the right care for the right patient at the right time. As new discoveries continue to expand the universe of medical interventions, treatments, and methods of care, the need for a more systematic approach to evidence development and application becomes increasingly critical. Without better information about the effectiveness of different treatment options, the resulting uncertainty can lead to the delivery of services that may be unnecessary, unproven, or even harmful. Improving the evidence-base for medicine holds great potential to increase the quality and efficiency of medical care. The Annual Meeting, held on October 8, 2007, brought together many of the nation's leading authorities on various aspects of the issues - both challenges and opportunities - to present their perspectives and engage in discussion with the IOM membership.