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16

OCTOBER, 2016

Multinationals
Blown health budgets
Co operative for startups

According to this weekends UK Guardian, Teresa May, Prime Minister of Britain, has said she will not filling the NHS’s 22 billion budget hole. Instead of caving in to demands, the PM has told the health department to find efficiencies, like other departments such as the Home Office and the Ministry of Defence.

This suggests that the PM does not view the health industry with the same-star struck awe that the politically correct are prone to doing.

Good for her.

Contrary to popular belief, Medical Specialists are not Popes, hospitals are not Cathedrals and the health industry is not God’s sole representative on Earth. 

The fastest growing economy in the Western World – the health industry

From Pixabay

Anybody who has worked on the ground floor in the health industry has seen the staggering waste and over-servicing in modern hospitals. Sixty year olds with chronic kidney disease being started on dialysis (despite saying they’d rather go home and die peacefully). Seventy year olds in the last stages of leukaemia being given blood transfusions in Emergency Departments. Eighty year olds with extensive vascular disease being carried off to surgery for Cardiac Artery Bypass Grafts. Ninety year olds being admitted for ‘monitoring’ of a host of chronic medical conditions over the weekend, purely to give their family or nursing home a break. 

Some Emergency staff refer to this as the great granny drop off.

Meanwhile the basic unit of good healthcare, General Practice, is being squeezed. In a world where public services are increasing expected to ‘sing for their supper’, General Practice misses out. No pop star is going to donate millions to General Practice for saving her from breast cancer. No politician is going to bring millions in charity dollars to General Practice for giving him emergency bypass surgery.

General Practice is also unable to tap into the very lucrative ‘trauma’ money from motor vehicle insurers, that props up so many public hospitals. Motor vehicle insurers pay on time and pay well. Hospital helipads and trauma teams = big bags of cash.

General Practice has limited operating hours, lacks the resources big hospitals take for granted and has to fight off a growing ‘more is better’ attitudes from patients.

Some parents now demand to see a Medical Specialists about issues as minor as a child with constipation. Nobody in the entire health industry has the will or the legal authority to say “no”.

Worst of all, General Practice is increasingly drawn into a poison well of professional turf wars. Specialist Doctors, General Practitioners and Registered Nurses are increasingly arguing over the ‘right to perform’ basic health procedures, from neurological exams to pap smears and blood pressures.

At the bottom of the health funding heap, many nursing homes are often poorly run by a fragmented network of small operators. Some of the abuse that occurs there is simply appalling. Great acts of kindness and caring go unnoticed and unrewarded. Private operators get away with hiding under old fashion Commercial in Confidence laws that were never designed for modern health services. Relatives are now demanding greater public scrutiny including 24 hour CCTV monitoring. When some of their family members are dying of neglect including starvation, chronic ulcers, who can blame them?

Many Australian medical services cost less and are more effective.

Photograph from Pixabay

According to the weekend Australian paper, Neurosurgeon Paul D’Urso wants Australian health regulators to allow use of 3D printing of bespoke devices in hospitals, instead of relying on over-priced, mass produced and sometimes inferior US products.

The surgeon points out that Australian medical device manufactures who are able to provide innovative and effective products to patients, are currently being locked out of the local market. Meanwhile, US multinationals are dominating the market with the mass produced products, sold at large profits. Patients, Doctors and tax payers are missing out. Multinationals are profiting.

The problem according to Paul, is the infamous Australian health regulatory system. Like the Australian financial regulatory system, it assumes all businesses are guilty until found innocent. Instead of trial by fire, it’s trial by red tape and maze of illogical regulations that come straight out of a Russian novel. This benefits big business who can afford to hire legal firms to sweat over commas and sub sections in endless documents. It punishes small business who can’t. The financial regulatory system is so Byzantine that one law firm builds it’s cases around which particular bureaucrat is handling their case and changes it’s tack, when the department changes staff.

The Australian regulatory systems belongs in the nineteenth century. Like much of Australian infrastructure, it is run by over-powerful unions and completely out of touch with industry. It also panders to what Teresa May referred to as ‘the nasty party’ when she kicked Cameron’s Grammar school cronies out of the party. In Australia’s current regulation system, big unions, people with Grammar school contacts and big business wins. Small business and the tax payers lose.

The surgeon was quite outspoken about the down side of our dysfunctional system.

We can’t let multinationals muscle us out of our own country and rip us off to the tune of 40% premium then let that money go offshore.

Paul D’Urso runs an Australian company called Anatomics that makes 3D implants for the skull, spine, hips and shoulder. His frustration echoes the private health insurers, who have been trying to reform the Prosthesis List, which is currently allowing private hospitals to charge far more for exactly the same medical devices that public hospitals buy.

Medical devices are not the only thing Australians are paying too much for. Australia currently pays 14 times more for pharmaceuticals than other countries like the UK and New Zealand. Pressure from industry lobbyists, weak (and possibly corrupt) politicians, the regulatory bureaucracy nightmare and a lazy media are part of the problem. Few Australians realize that overpriced and uncompetitive medical products are being dumped on our shores, while local innovation is being strangled.

Australian surgeons… have to suck it up.. we… are basically at the end of the tram stop’ commended Paul. He suggested that Australian either take control of the situation or end up …’eating up the slop we have been fed, and being forced to pay a premium on that.

The most interesting article was called, It’s back to the USSR for US poor.

The US economist Joseph Stiglitz, Nobel laureate and advisor to Hilary Clinton has publicly suggests that millions of Americans face the same social and economic conditions that Russians were confronted with, during the dying days of the communist soviet republic.

At least somebody is taking the Donald Trump syndrome seriously.

During my yearly trip to America my boyfriend and I hire a car, head off into the beautiful countryside and drive through endless small country towns. Every front yard had a ‘Vote for Trump’ sign on it during our 2016 visit. We talked to locals working in motels, bars and diners. Why Trump?

Young Americans spoke about collapsed wages, closing factories, Silicon Vally outsourcing manufacturing jobs to Vietnam and illegal Mexicans undercutting basic wages. Middle aged Americans talked out the new economy of drug dealing, prostitution and permanent welfare. Older Americans worried about kids that can’t afford to ever buy a home, live in permanent debt and don’t bother getting married before they have children.

This is what ordinary people see, not just in America, but across the western world. What does Joseph suggest as a solution?

Co-operatively owned businesses. According to Joseph the top 300 co-operatives around the world generate more income than Australian and New Zealand combined. He sighted the CBH (an acronym for Co operative Grain Handling), Australians largest grain exporter as an example of a positive co operative. Joseph described co operatives as the ‘third pillar’ between public service and private enterprise. According to him, we need to do more to promote this industry. Less corporate greed, less bureaucratic red tape and more industry co operation is his message.

I discovered that Canada already has a health startup co-operative that offers resources including cloud services, research and development funding. Canada has similar problems to Australia, a vast land mass and tiny population, situated on the fringe of a massive economy with low wages and low taxes.

According to their website, CANARIE strengthens Canadian leadership in science and technology by delivering digital infrastructure to support world-class research that directly benefits all Canadians. Established in 1993, CANARIE is a non-profit corporation, with the majority of its funding provided by the Government of Canada.

Some stats. 1 million Canada’s have access to the CANARIE network, 700+ Canadian entrepreneurs have access to the CANARIE cloud service, 70 cross-disciplinary Software Services analyze big-data and support mass collaboration, 70 Canadian Universities and Colleges are currently participating in the Canadian Access Federation.

Health startups will never get into mainstream health funding unless we band together and pool our resources. Mainstream health services demand a large number of different things to be done with patients or customers, across a wide area. The specialisation of the thousands of tiny health startups keeps us all on the fringe. Individually, the health startup movement will never have the resources to take on the Russian style madness of Australia’s regulation bureaucracy and the swarm of US industry lobbyists.

However, if we pool our resources and collaborate, we could offer a widespread and mainstream health services at far lower cost and far greater effectiveness. Then we could contract out for health jobs like reforming one of the trusts in the NHS. Or even running an Australian State Government health service.

This is what Wikihospitals is designed to do, and why I’m building my database. Matching startups with common errors, medical specialties, diseases, technology and funding groups. We could form our own health insurance plan and take it to a less regulated environment like Asia. There is a whole world out there, of Governments wanting to control their health budgets, and get a far more effective use of resources.

Enough talking, enough social media posts and enough meetup groups.

It’s time for a business plan.

© Wikihospitals 2015.