My body starts convulsing; my blood pressure continues to drop. I’m exhausted and weak. This is it I think to myself. I’m not going to make it. There’s a call for help and a doctor rushes into the room. Her voice booms orders as she takes control of the situation, “OK guys, ABCs,” she says as she proceeds to direct the medical resident and the nurse to start an oxygen mask and IV. A hot air mattress appears and quickly covers me. Another person enters the room and takes a poke of blood from my foot. I hear them talking about crossmatching and a blood transfusion. I turn my head to the side and look across the room at my husband holding our new baby and think – there is the family that I’ve always dreamed of having and now I’m not going to live to enjoy them. The doctor starts asking me questions, “What are you going to name your baby? Are you cold?” A wave of tiredness consumes my body and my mind. It’s a strange type of tiredness, one that I’ve never felt before and that causes me to fully expect death to follow. Yet, each time this doctor speaks her voice is like a lifeline. It’s unlike the other voices, the one that denied my requests for my doctor, the ones that left my care in the hands of a medical resident and a nurse seemingly borrowed from another floor. This doctor’s voice exudes a confidence that comes from critical thinking and skill. It owns a competence that can only be acquired from years of education and training, years of experience and dedication. The voice belongs to an anesthesiologist.

A stillborn death at Victoria General Hospital last August brought public attention to the issues surrounding hospital anesthesia services for expectant mothers in British Columbia. Following months of failed contract negotiations over fees and workloads, a few anesthesiologists spoke openly about their concerns over the death. In December 2011 the president of the BC Anesthesiologists’ Society announced their intention to withdraw services starting April 1, 2012. Both the BC health minister and the British Columbia Medical Association (BCMA) scolded them for trying to bargain outside of the box and for shaking up the confidence in our public health care system. The government and the BCMA worked quickly to reach a deal that would help prevent the strike.

When contract negotiations with government are not going well the focus often shifts to patient safety concerns which then continue to grow in silence after the contracts are signed. In November 2010 failing contract negotiations in Newfoundland and Labrador spurred its medical association to hold lengthy press conferences about the resignation of more than a dozen specialist doctors and its impact on patient safety. When they finally settled the dispute all but one of the resignations were rescinded as part of the deal.

Is it about money or patient safety? It’s about money, patient safety, doctors and patients. It’s about the realities of a government monopoly on health care that stifles performance, competition and innovation. It’s about a government-run health care system that breeds the type of incompetence that ultimately jeopardizes the safety of every patient. One of the most telling paragraphs from the Vancouver Island Health Authority’s review of the stillborn death in August 2011 at Victoria General Hospital is this one:

“Finally, neither the patient-focused review nor this system-focused review were conducted with the purpose of evaluating the performance of any of the healthcare providers or administrators; to do so would be inappropriate and not in accordance with the philosophy of systems analysis.  Any decisions about conducting performance reviews are left with VIHA.  Furthermore this review will make no comment on whether or not any type of performance review is necessary.” p.3

This is just another report following another review following more committee meetings resulting only in more recommendations and guidelines. It’s a pattern replicated throughout the Canadian health care system. In the meantime, are expectant mothers waiting for anesthesia services in hospitals in British Columbia any safer today than they were yesterday? Will they be any safer tomorrow than they are today?

Despite what supporters of the status quo tell us, a publicly-funded universal health care system based on need is a fallacy. Reality shows us that our system is neither universal nor based on need. Reality shows us that it’s time to put Medicare to sleep and usher in a new health care system that promotes and protects the medical freedoms of patients and doctors.

A special boy from British Columbia named Walid is now recovering from surgery in a hospital south of the border. It’s a surgery he could not access in the Canadian health care system because of waiting lists that are two or more years. Walid’s mother Debbie, who is also a nurse, worked tirelessly to bring attention to his case before making the decision to leave the country to seek medical care. You can help break the waiting list silence by watching Walid’s story and passing on its message “No more waiting”.

Romanow’s staunch defence of a universal, government-run health care system includes the die-hard notions that Medicare is a social good, a necessity for national unity and a part of our Canadian identity.

Perhaps he should ask the patients receiving hallway medicine in his home province of Saskatchewan if they agree that it’s just part of their Canadian identity.

Do you think hallway medicine is part of our Canadian identity?

As part of its harm reduction program the Vancouver Coastal Health Authority is now handing out crack pipe kits to drug addicts in Vancouver. This is in addition to funding and operating a supervised injection facility for drug addicts. Insite costs around $3 million a year and provides drug addicts with clean needles and other supplies for injecting their drugs all under the guise of a harm reduction program aimed at – you guessed it – improving population health and minimizing public health care costs.

Supporters of Insite claim it reduces the number of deaths by drug overdose and the transmission of certain diseases. That may sound good for population health statistics, but what about the individual health of these drug addicts? Prolonged drug use impacts the brain and body and can lead to various chronic conditions, heart disease, strokes and organ failure. I wonder what family members and former employers of these individuals have to say about the impacts of prolonged drug use on quality of life?

How did such a place come to be? In 2003 the facility received an exemption from Canada’s federal drug law, the Controlled Drugs and Substances Act, for the purpose of scientific research. Drug addicts serving as research subjects explains the avid support Insite receives from the academic and research community.

Supporters of Insite say that we must take care of the needs of the most vulnerable in our society. A line often used to try and guilt us into embracing ideas like this one that serves to transfer all personal responsibility for using drugs from the drug addicts themselves on to the rest of us. If the family members or friends of a drug addict were providing them with needles for injecting drugs or pipes for smoking crack wouldn’t they be called enablers?

Since drug addicts face no legal consequences for their drug use at Insite and no financial consequences for the services provided to them at this facility they really have no incentive to stop using drugs. How can a drug addict get clean without quitting drugs? How many drug addicts have been cured of their drug addiction through Insite?

Last September a decision by the Supreme Court of Canada mandated Insite’s continued exemption from the federal drug law. However, the original exemption only allows for injecting drugs not inhaling them so Insite’s new inhalation room for crack addicts will have to stay empty for now.

What’s next? Will the government start providing the drugs to drug addicts as part of its harm reduction model? It’s already happening under the banner of scientific research. Enrollment for the latest study started on December 19, 2011.

A few weeks ago the public health director in Montreal and the provincial minister of health put out the call for new safe injection sites in Quebec as a harm reduction measure aimed at improving population health and minimizing public health care costs.

Another danger of socialized medicine is that it makes all of us more vulnerable. I’d like to recommend a harm reduction measure for the law-abiding, taxpaying citizens footing the bills for safe injection sites and crack pipe kits – just say NO!

A much bigger barrier to health care is patient waiting lists for access to diagnostic tests, specialists and surgery. Is waiting on government imposed lists for medical care fair to patients?

If hospitals don’t charge for parking then where will the money for maintaining the parking lots come from? As a patient, I’m willing to pay for access to a hospital parking lot because patient-centred care doesn’t require free parking. There is no such thing as free parking just as there is no such thing as free health care.

The information raises a number of important questions including: How many health care bureaucrats does it take to run a health region? How does the Winnipeg Regional Health Authority compare to other health regions of similar size? How well do regional health authorities perform when it comes to efficiency and effectiveness?

More information is needed for us to better understand how much our health care bureaucracy is truly costing us as taxpayers. With health care spending now consuming close to half of our provincial budgets it’s time for us to start asking the right questions.

In today’s video clips Charles Cruden talks about the bureaucracy in the Winnipeg Regional Health Authority in Manitoba.

In today’s video clips Leslie Worthington and Val Lee talk about the bureaucracy of regional health authorities in the Canadian health care system. You can read more about their story here.

In today’s video clip Alice Little talks about transparency and accountability in Canadian health care. You can read more about her story here.

I recently travelled to Manitoba to meet with individuals whose experiences with our health care system have united them on a path for driving change and making improvements that will help other patients and their families.

Keep watching the site for new videos from patient safety advocates among us.

Today’s video clips feature Leslie Worthington and her sister Val Lee providing some tips for patients and families affected by medical error. You can read more about their story here .