Michael Rachlis MD

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At the University of Toronto with the Globe's Jeffrey Simpson

9 February 2013, 8:50 PM

I was on a panel at Hart House University of Toronto on Thursday February 7th with the Globe and Mail’s National Columnist Jeffrey Simpson — the topic was the sustainability of the Ontario health care system. My slide presentation available at the Publications page, concludes that health care spending is not “wildly out of control” and we need very little new money to ensure we hardly wait at all for needed health care. You can also find a picture at the publications page.

Mr. Simpson’s new book Condition Critical outlines the problems with our health system — long waits, mediocre quality, relatively high costs. His main recommendation is more for profit competition within our public financed system.

In general, Simpson toes pretty close to the conventional centre/right line:

      *     Health Care costs are wildly out of control

      *     The baby boomers will really deep six Medicare
      *     The only alternatives are to either cut real services or use more private care and finance
      *     We need an “adult conversation” to reduce our expectations and make us see the need for private involvement

Even when confronted with examples of how we could eliminate waits for care — patient co-production, high functioning teams, shared care with specialized services — Mr. Simpson doesn’t believe these really could be the norm. He doesn’t think providers, especially doctors will change the way they do their work.

I understand Mr. Simpson’s skepticism. We’ve known about these innovations for a long time. Change is hard anywhere at anytime. But, it’s been really hard to change Canada’s health care delivery system. But, I like to think that Canada could have a world class health care system if we wanted one.

I found Mr. Simpson reminded me of John Ralston Saul’s descriptions of Canada’s elite in his 2008 book “The Fair Country”. Saul refers to the “Colonial Mind” — that the Canadian elites tend to have a colonial view of insignificance within the Empire (British originally, US now) and to be focussed on the outside world for validation. I find folks like Jeffrey Simpson to have a cynical view of the Canadian potential. He can’t or doesn’t want to clarify whether he is saying we can’t do something — like eliminating wait lists with process improvement — or rather that up until recently there has been little effective implementation of these innovations.

Perhaps he is correct. But I don’t like the way he dismisses the notion that we should aspire to health care excellence with a quick knowing shrug, “tried that, too hard, let’s move on (to private care).” Let’s all prove him wrong.

Speech to Quebec Medical Association Annual Meeting April 20

23 April 2012, 12:05 AM

You can read Montrael Gazette articles prior to and after my speech to the QMA annual meeting in Montreal. You can also get a copy of my presentation here (MS PowerPoint, 3.89MB).

Canada's Health System needs Innovation

19 April 2012, 12:50 PM

Read an article in today’s Montreal Gazette about my presentation tomorrow at the Quebec Medical Association annual meeting.

Primary Health Care Meeting in Southey, SK

6 March 2010, 5:00 AM

On March 3rd, I had the delight of speaking at a meeting on primary health care in Southey Saskatchewan. Southey is located about 80 km north of Regina. Despite a blizzard on the way from Regina to Southey, there were 160 people there from as far away as Yorkton (230 km East) and Maple Creek (460 km West). Here is my presentation from that day. And, here is a picture of me with some of the organizers. Well done all!

From left: Fiona Bishop VP Saskatchewan Federation of Union Retirees, Betty Pickering President Saskatchewan Federation of Union retirees, Holly Schick, executive director Saskatchewan Seniors Mechanism, me


Filed under Meetings, Presentations, Travel

It's the Wild Rose West: My week in Alberta

19 October 2009, 1:48 AM

I got back Saturday (the 17th) after a fun week in Alberta. I spoke to a number of events organized by Alberta Friends of Medicare. There were over 500 people who attended a raucous public meeting at the Polish Hall in Edmonton on Tuesday night. See the coverage in the Edmonton Journal. Kudos to Dave Eggen Friends of Medicare coordinator, Della Drury his campaign worker, economist Diana Gibson, research director at the University of Alberta’s Parkland Institute who also spoke, and dozens of other folks who helped organize the meeting.

On Wednesday morning Dave Eggen and I flew to Calgary but our plane to Medicine Hat was cancelled because of snow so we rented a car and started our southern Alberta road trip. We had a wonderful crowd of 150 that night. Thanks so much to Jan Bunney chair of the Medicine Hat Chapter of Friends. It’s an amazing group of folks. Amongst other things they participate in Medicare Mondays where they go to places like Tim Horton’s and talk to people about health care in their community. Here’s a picture of Dave Eggen, Jan Bunney, and me.

Then it was on to Lethbridge where Michael Cormican and his chapter organized a terrific meeting Thursday night at Southminster Church.

We drove to Calgary on Friday morning where I talked to a meeting of the Health Sciences Association of Alberta.

I will be writing up my analysis of my Alberta trip in the next few days but you can read the op ed I wrote before the trip here. It is quite frightening how quickly Alberta seems to be eroding the public system.

Filed under Meetings, Presentations, Travel

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