March 31, 2009

Burn It All Down

Category: Life — Cranky @

As I sat in the emergency room at the University of Alberta Hospital, it became very clear to me that something has to be done. Our health care system is in terrible shape. The problem isn’t staff. There are plenty of people working in the system. It’s not a funding problem, either. Over 60 cents of every dollar collected in provincial taxes goes to health care. It’s positively brimming with cash.

The problem is that the system is a broken mess of bad processes and inefficiencies.

I watched as they routed my sister back to the emergency room after each step, making them the problem of the group that is supposed to deal with emergencies. Why they concluded that after-triage rerouting should involve emergency again is beyond me. Do you know why some people wait eight hours or more in emergency before being seen? Because it’s also filled with people who have been and gone, only to return. It makes no sense whatsoever.

I watched as my sister provided the same details to a number of different people. Duplication of effort is something most businesses manage to trim pretty early. Why is the university hospital unable to do the same? Of all hospitals you would think that one connected to an institute of learning would be the one that would embrace improvement.

The silent submission of people to process is evident everywhere. The woman who took some personal details in the emergency room was the very model of the defeated worker, marking her time, doing everything by the unassailable checklist. She didn’t want to be there, and she didn’t care.

As I sat in the radiology waiting room, I thumbed through a Business Report magazine from 2004. As my sister said, “At least they aren’t wasting money on magazine subscriptions.” I learned a little about selling houses to millionaires, and I watched the parade of bad workflow continued. It occurred to me that it’s very difficult to change how things are done within a hospital for the simple truth that people are continually making use of these facilities and processes. I’m willing to bet that less than 10 of those 60 cents per provincial tax dollar actually goes to providing health care. The rest is lost to unnecessary bureaucracy, duplication of effort, and busted process.

We could fix it in a clean, slow manner, but the resistance would be tremendous. The whole system suffers from the broken idea that just because they’ve done something one way for decades, it must be the right way to do it. It doesn’t matter, though, because it will be fixed eventually. As the population ages, the system is doomed to crash. It’s unavoidable. There’s no way it can continue in its present state as the user load increases – it’s far too busted. After it fails, we’ll pick up the pieces and find a better way.

In the end, after several doctors and lots of time, my sister was told to go to her GP, who will once again examine her before arranging surgery for her minor hernia. Of course the university hospital could have arranged that surgery, since they’ve already done everything, but there was an opportunity to waste her time, as well as more taxpayer dollars, by involving yet another doctor in another city. The next funding set shouldn’t be an increase. The overall health care budget should be cut fully in half. Maybe then they’ll embrace change.

Burning the whole thing down and starting fresh would be more emotionally satisfying.

Cranky

To Joke, Or Not To Joke?

Category: Entertainment — Cranky @

Okay, here is my dilemma.

Last night I had a thought that quickly became a full-blown article in my head. I started to write it out today, but I quickly realized that the line I was treading was very fine. It was one of my typical politically incorrect pieces where I use contrast and insinuation, and where my goal is laughter and disgust.

This one is hard, though. I’m only half done writing it, and each word has to be exactly right because it could go so very, very wrong. A smarter person might ask, “Why bother going with it at all, if it could be so offensive?”

Because it’s really, really funny, that’s why.

I laughed out loud when I heard it, and every time I think of it I laugh again. If I can walk the tightrope, this will be a gem. If I fail, everybody I know is going to ask, “What the hell is wrong with that boy?”

In the past it has never been an issue. If I find it funny, it goes on the site. This one, though, is my Mount Everest, standing before me, towering over me… challenging me. Am I Sir Edmund Hillary, successful in my attempt, or will I be one of the 199 who died on her slopes?

Any idiot can be offensive. There are lots of crappy standup comics who make their living pissing off as many people as possible. I’m aiming higher than that. My worst fear is that in an effort to walk the line I produce something that is neither funny nor disgusting. Well, I won’t let that happen. I’d rather be a weird-ass, offensive nutball if the alternative is to be boring.

Cranky

March 23, 2009

Can you pick me up some tetrahydrozoline hydrochloride while you're out?

Category: Life — Cranky @

When they think of over the counter medicine, most people think of brand names. They don’t buy diphenhydramine hydrochloride, they buy Benadryl. They aren’t shopping for acetylsalicylic acid, they’re after Aspirin. Nobody is looking for cetirizine hydrochloride. They’re asking for Reactine.

The thing to remember is that these companies are making a great deal of money off of the ignorance of the masses. Virtually every name-brand pill has a low-cost counterpart sitting right on the shelf next to it. Most of the time the retail price is less than half that of the branded variety, and yet there is no significant difference between them. Sometimes they’re made by the same company, sometimes they aren’t. In many cases the patent on the chemical has expired, and so other pharmaceutical companies have leapt into the fray.

There are tremendous savings to be had if you buy xylometazoline instead of Otrivin, or ranitidine instead of Zantac. These aren’t cheap knock-offs, they’re functional duplicates. Before they are approved by the FDA the manufacturer must demonstrate that their formulation is bioequivalent to the original. That’s not to say they are exactly the same – they might not be. Small differences in the manufacturing process might make slightly different versions of the chemical. They must, however, work the same way.

Don’t give away your hard-earned cash. If you are buying something in the pharmacy section of your local store, check for the generic box next to the name you know. It’s worth it.