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Healthcare in Canada

25/12/2013 Leave a comment

Over the break I’ve finally had time to (get close to) finishing Jeffrey Simpson’s newish book, Chronic Condition. Basically, Canada’s healthcare system is headed for crisis, but it’s a “political third rail”, a reference to the rail carrying power for electric trains – touch it, even with the best of intentions, and you die. The book is a brilliant look at how medicare happened, how it works in Canada and other countries, how it’s broken, and how to fix it.

What it boils down to is that between 1975 and 2006, we see:

  • 75.4% growth in GDP per capita
  • 51% growth in expenditures on hospitals
  • 98% growth in expenditures on physicians
  • 338% growth in expenditures on drugs outside of hospitals

(All figures adjusted for inflation)

This might be okay if our outcomes were enough to justify our spending, but by OECD standards they are decidedly mediocre. Moreover, this spending will likely continue to grow faster than the economy. Eventually, there will be a crunch on government budgets since taxes can’t rise indefinitely. In Simpson’s words:

The first and most important lesson about health care is that simple solutions to complicated problems are invariably wrong or deeply suspect… The decade ahead will feature slower economic growth in Canada and the rest of the Western world… Choices will be inescapable and hard.

Some of his proposed solutions:

  • constrain wage growth of healthcare professionals – doctors’ salaries alone represent 14% of healthcare spending (hospitals and drugs make up 29% and 16% respectively). “Unless physicians and nurses show more flexibility in how they work, and unless they accept that their remuneration cannot continue to outstrip governments’ revenue growth, it will be very hard to improve medicare’s challenges of quality, access, and cost.”
  • “dehospitalize” medicare by emphasizing home care, long-term care sites, nursing homes, and family and specialist clinics
  • institute regional health authorities where they don’t already exist and give them control over budgets
  • make physicians and nurses accountable to these regional authorities instead of the provincial government
  • encourage private delivery of publicly-paid services where costs are lower for equivalent services
  • encourage delivery of services by lower-cost providers, such as nurse-practitioners
  • allow hospitals to use operating rooms for privately-paid surgeries when not in use for other procedures
  • allot hospital budgets according to some base amount plus an additional sum for each patient treated instead of lump sums – make patients sources of revenue and not costs
  • lower drug costs through a national drug scheme
  • institute user fees to discourage overuse and offset or waive them for lower-income people
  • reduce social inequality – statistically, poor people have more health problems

Ironically, inequality is the most likely of these challenges to be addressed. Healthcare reform is politically unfeasible, hence Simpson’s ‘third rail’ moniker.

What makes healthcare the ‘third rail’ of Canadian politics? As Canadians, we have built our national identity around our healthcare system. Needed reforms threaten the interests of people working in healthcare – and these powerful groups know that by raising the scary spectre of private, Americanized healthcare, they can elicit a knee-jerk emotional reaction from the public that will prevent any changes.

Healthcare is part of a larger complex of social problems that really frustrates me. Regarding healthcare specifically, my generation is going to be on the hook for a host of cost increases and it’s going to be the quality of our healthcare that suffers as a result. Another example is the environment – the boomer and post-boomer generations are receiving all of the job and wage benefits but will not live to see the costs.

And we have to put up with all of this while the traditional media and the rest of the population tell us that we’re lazy, entitled, ungrateful, and socially dysfunctional. Right.

More “Old  Economy Steve” memes here.

LOL,

Tim

PS – Also, this:

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The 5-Second Rule

22/05/2013 Leave a comment

Another TED video I found interesting.

Mrs. Robbins’ point is simple: you are never going to “feel like it.” This mirrors what I’ve been telling myself for the past few months: “The time will never be ‘right’ – just do it.”

We all have what she calls an “inner snooze button.” For most people, myself included, the first thing we do every morning is hit our alarm’s snooze button. Our bed is warm and comfortable, the room is cold. We do the exact same things with our ideas and desires for change: “I don’t feel like doing that right now, I’ll do it later.” Making changes is like getting up in the morning. The room is cold, the snooze button is seductive, “it’s only 5 minutes.”

But we don’t have 5 minutes, we have 5 seconds. If we don’t act on an impulse within 5 seconds, our brain hits the snooze button and we’ve missed our chance.

It can be small: write it down, send yourself a text. But we have to do it, or we’ll snooze the time away.

LOL,

Tim

Happiness and Productivity

04/11/2012 Leave a comment

I thought this TEDTalk by Shawn Achor was really quite good. Happy workers are more productive – that seems pretty intuitive. What I found really interesting were the methods he describes for making people happier:

  • 3 gratitudes – a daily listing of three new things for which you are grateful, for 21 days
  • journaling – specifically, writing down 1 positive experience from the past day
  • meditation
  • “random acts of kindness” – even something as small as writing one positive email every day

Videos like this are awesome. By showing people they can make themselves happier, they encourage people to “own” their happiness – as opposed to falling into the all-too-common trap of letting the world dictate their feelings.

LOL,

Tim

Coffee and the Enlightenment

25/11/2011 Leave a comment

An interesting article in the Vancouver Sun, which I can’t seem to find, linked the Enlightenment with coffee. (The Enlightenment was an 18th century movement based in France, led by noted philosophers such as Locke, Spinoza, and Voltaire. It called for the use of reason to reform society and knowledge)

Apparently, the standard “cuppa joe” in the mornings was a boozy one – until coffee was introduced to Europeans and became popular. People thereafter started their days chipper and alert, ready to pursue the kinds of intellectual conversation associated with the Enlightenment, as opposed to being tipsy and belligerant.

Coffee houses also played a large role in the Enlightenment as venues where the exchange of ideas could freely take place. Anybody, whether rich or poor, could sit, drink coffee, and discuss, so long as they could afford the small price of a cup.

Really makes you wonder at what café culture has evolved into, no?

LOL,

Tim

Tim Ferriss, The 4-Hour Workweek, and The 4-Hour Body

26/03/2011 Leave a comment

I’ve been quiet for a while, something I hope to remedy shortly. In the meantime, here is a rant. Feel free to tune out.

Many of you may have heard of Tim Ferriss’s two best-selling books, The 4-Hour Workweek and The 4-Hour Body. Some of you may have even read them. I’ve read both of them, and enjoyed both of them. They are both full of useful information and entertaining tidbits; I encourage you all to read both of them if you get the chance.

Now there are a lot of bloggers and other social media types who have put up posts saying things along the lines of “Tim Ferriss’s books are scams and he is a fraud; he doesn’t have any of the credentials he claims to have; he doesn’t really work only 4 hours a week; he was on steroids when he gained all that muscle; etc.”

Here comes the rant!

Most of these are ridiculous posts. Common themes include: “the books don’t come close to living up to the hype around them,”  “it’s all lies!” and “you can summarize the entire book into X and X, so you shouldn’t buy them because you just learned everything in them.”

Okay, first of all: most of these authors haven’t even read the books. Some of them took time from their busy lives to read summaries. Some of them have only seen the marketing material. I repeat, most of these authors haven’t even read the books.

Point one: It is dishonest post a “review” of a book, especially ones that personally attack the author, without having read the book. End of story.

But what about the hype around the books? Will reading the 4HWW really make you go from 9-5 slave to $40K a month entrepreneur with no effort? Will the 4HB really make you put on pounds of muscle with little gym time?

If you are willing to put in the effort and effectively use the actionable items that Ferriss provides, I say yes. To the people who use the hype around the books as a basis for calling Ferriss a scam artist, I say grow up. Name me ONE such book that lived up to all the hype around it. I dare you. Chances are, if a book has any significant amount of hype, it won’t live up to it.

Point two: Marketing hype is never lived up to. Never. Grow up and get over it – didn’t you learn that lesson when you were 10?

As for the summary argument, you can do that with every book. The entire Lord of the Rings saga can be summed up into a single sentence: Bilbo found a ring of great power and great evil and passed it down to his adopted son Frodo, who had to destroy it to save Middle Earth. Sorry to ruin it for you, but that’s exactly what happened.

The reason to buy any book is that you will enjoy reading it and hopefully learn something in the process. I did both with both of the books.

Sure, the biggest productivity secrets from the 4HWW may be outsourcing and the 20/80 principle, but the rest of the book is thought-provoking, inspiring, and entertaining. You’ll get more out of the principles if you read the entire thing, IMO.

Point three: Any book can be summarized. This does not mean they are scams, or lies, or not worth reading.

Sorry, I just had to get that out there. If you’re going to try to rip an author to shreds, at least read the damn book first, and at least use actual arguments.

LOL,

Tim

Paleo – The Way to Go. IMHO.

16/02/2011 7 comments

paleo- : combining form. Older or ancient, esp. relating to the geological past : Paleolithic | paleomagnetism.
ORIGIN from Greek palaios ‘ancient.’

The way I’ve been eating for approximately the last three months is called the paleo diet, or the Primal Blueprint (Sisson, see below), or the hunter-gatherer diet, or the Stone Age diet, or a multitude of other names.

It’s based on two ideas: a) over the course of more than 2 million years of eating a diet solely consisting of fruit, vegetables, nuts, seeds, and all parts of animals of all kinds, the human digestive system genetically evolved to process these food groups in an optimal fashion, and b) the “neolithic” foods, such as grains, legumes, added sugar, etc. have only been around since the Agricultural Revolution at the earliest – 10,000 years ago – and thus our digestive systems are not evolved to deal with these food groups.

In short, many foods that now make up much of the standard Western/North American diet are actually poisonous to us Read more…

First Experience with Intermittent Fasting

09/02/2011 2 comments

Intermittent fasting (IF) is a pretty popular concept in the paleo community (see this post on Mark’s Daily Apple for an explanation of IF and its benefits, which “include decreases in blood pressure, reduction in oxidative damage to lipids, protein and DNA, improvement in insulin sensitivity and glucose uptake, as well as decreases in fat mass.”). I tried it accidently yesterday.

Tuesday I have an 8:30am conference and usually set two alarms – one for 7am and one for 8am – just in case I pull a typical university student and sleep through one of them. Good thing I did, because yesterday I slept right through the first one!

As it takes me 15 minutes to get to the class, I only had time to wash my face and brush my teeth before running out the door and grabbing a coffee on the way. No breakfast. (Conventional wisdom disapproves!)

As I walked to class I started to think about all the reading I’d done on IF and decided to try it, just out of curiousity.

Wow. Just wow. Read more…