Tag Archives: lääkärit

Sahco Pt. II

Normaali

Viikko 17


 

Date: Apr 24th, 2017
Motion: THB that over time the social and health care overhaul will succeed
Role: Chair (opp.)


I have mused on the social and health care overhaul in Finland a little, and christened it ”Sahco”. I have been disappointed with what the earlier one and present regime have accomplished (= little, or nothing), so I think it’s time I presented you with an alternative vision about the reform that we ”have to” do, or are to do, at any rate. Let us first run through the basics.

The way that I understand the Sahco reform drive is that pressures from both doctors and patients have forced politicians to declare that the present state of health care, and to a lesser extent, social care, is inadequate, which has prompted a trend towards centralisation. There is also the financial question, or the seesaw between smaller units and the state, as to who will foot the bill.  As far as I can see, on the human level the reform is informed by

  1. patients’ desire for quality treatments
  2. patients’ desire to be able to jump queues and get quick fixes and
  3. doctors’ desire to have the most amount of colleagues and the best kind of equipment available

At present, there are several models and key numbers that rival each other:

  • Municipalities will shed off the responsibility for health affairs
  • There are 19 legacy provinces in the country
  • However, only 18 provinces are taken into account
  • There should be 12 hospitals with full service on a 24/7 duty
  • 1 extra hospital with full service on a 24/7 duty is being required by the Swedish-speaking, who want to have a hospital of their own due to their special, evident lingual needs.
  • Maternity wards at hospitals where fewer than 1,000 babies are born annually will be shut down
  • Specialised health care, (whatever that means), will be divided between 5 administrative and regional units

Even so, I think that the controversy is pointless, as it seems that the changes would be minimal compared to the amount of debate that has been maximal. To redeem the volume of ink that has so far been spent on the issue, I propose that the following, more drastic model be put into action to implement the reform.

  1. People need major operations fairly seldom in their lives. Most people are operated once, twice or thrice in their lives. As the need is fairly rare and the biggest concentration of expertise is based in the capital city Helsinki, I would have all operations of a major magnitude (by-pass operations, cancer removals, plastic surgery, hip replacements) performed in Helsinki. Helsinki has the best hospitals, the best doctors and the best nurses. And everyone who needs a surgery of the big sort can afford to have the operation in Helsinki, even with additional costs from accommodation, travel, eating out and so on.
  2. Giving birth is the only major operation that many people go through in life that can’t be classified as an accident, defect, disease, emergency, injury or illness but which requires a hospital. I would apply the same kind of thinking here as before. As labour is part of one’s life likely only once, twice or thrice, I would place maternity wards at only three hospitals within the country. To serve Northern, Central and Southern Finland equally, I would place baby-delivery services in Rovaniemi, Jyväskylä and Helsinki. They would allow any pregnant Finn, but more logically people would choose the one that they would consider the nearest. As an aside, Kuopio, which is a town with a university hospital, could be regarded as an alternative to Jyväskylä, as it may have a more central location within Central Finland. The country would be divided up geographically with diagonal northwest-southeast lines into three sectors.
  3. All minor medical procedures (dental care, injuries, vaccinations etc.) would be carried out at health centres around the country as usual. Services could be offered by corporate or communal players. Politicians could set the bar of state-sponsored services at the desired percentage.

The enclosed image depicts the model that I favour. It could be considered the ”3 + 1” model. I hope that this bolder, more radical and drastic model will gather support, once people realise that they need medical services, but that they do not need them as frequently and as near to them as they think they do.

Thank you.


Arvio: Edellisellä viikolla katsoin, että opposition muut jäsenet voisivat tehdä erinäisiä muita asioita, jos sihteeri keskittyisi lääkäreihin, kun tästä nimenomaisesta aloitteesta puhutaan. Tässä nyt sitten opposition puheenjohtaja esittää vaihtoehtoisen mallin. Nimenomaan hän tekee sen, koska väittelyssä ”järein” aines sopii ensin puhuvalle.

 

What’s Up, Doc?

Normaali

Viikko 16


 

Date: Apr 18th, 2017
Motion: THB that over time the Social And Health Care Overhaul will succeed
Role: Secretary (opp.)


In Finland, there has been a longstanding project to overhaul the environment of social and healthcare. It has been abbreviated as ”sote” or capitalised as ”Sote”. In English, it could be abbreviated and translated as ”Sahco” (short for social and health care overhaul), or ”Sochel” (a letter longer).

However, however much people flip and fling the issue, results have been thin on the ground and people have grown tired of the tardy process. So far, nobody has brought up the role of physicians in this question. As I see it, they play a key role in necessitating and complicating the issue.

Doctors of the medical kind have long been a pampered group and profession in this country. This heightened importance is to some extent universal, while it likely stems from the time when only doctors could prevent the spread of infectious, debilitating disease, such as polio, syphilis, tuberculosis, typhoid fever and the like. This has led to a situation, where physicians have enjoyed the best salaries for about a century now. They are in demand, and they know it.

In the past, doctors did tour the countryside and small towns, but even then they knew their status as a pampered professional. Many did it only when they were freshly released graduates from their institutions, young and possibly without a family and a partner. According to some of them, they could quite freely collect easy money from these tours of the farther corners of the country, as the doctor-depleted localities were willing to spend generously on ”life & death”.

Many smaller towns don’t have any specialist doctors that would be the most desired. We are not talking about infectious disease anymore. We are talking about experts on ad/hd, anorexia, autism, obesity, plastic surgery, oncology and heart disease. Should the need for one arise, the patient has to go to the nearest place that affords such consultations. All of those doctors reside in Helsinki or other key cities in the nation. Often the cities that physicians favour have a university hospital downtown or on the outskirts.

I claim that physicians endanger the health of the nation by settling in cities where they can consume in the freest possible way. Since physicians enjoy salaries in the high four digits, they require a place to live where they can spend that money in a way that they consider dignified. They spend on apartments, high-end sports, cars, their children and travels. Small towns and the countryside cannot supply the services that these professionals demand and desire. Consequently, they settle in the biggest available consumption centers. And that is the root reason why patients have to follow them there, if they want to be treated.

So far, the ”Such Hell” situation has been addressed in trying to create an additional level of governance or administration between the existing levels of patient, Community (or Municipality) and the State. As far as I can see, this Provincial (or County) level is nothing less than a way to divide the country up in neat slices that follow quite nicely the way the country has been divided up and supplied with a university hospital.

So, it seems that politicians do not want to question the role of physicians, doctors and medical professionals in any way. Should they blame anyone, they would tend to blame the patients seeking treatment or members of another political party. Politicians just want to go out of their way to create a setting for medical pros in which the latter are able to ”flourish” and consummate their role as a consumer.

Thanks.


Arvio: Puheessa lähdetään siitä, että oppj on jo antanut täyslaidallisen koko reformia vastaan sinänsä. Sitten sihteeri tässä käy yllättäen lääkäreiden kimppuun, siinä missä edustajalle jäävät vapaat kädet valintansa mukaan joko a) tuomita koko projekti julkisen sektorin hyödyttömänä puuhasteluna, b) tarjota vaihtoehtoinen malli projektin saattamiseksi loppuun tai jopa c) vaatia ns. yövartijavaltiota. Oppositiolla on täten selkeästi helpompi rooli kuin hallituksella.

Cap It, A-List

Normaali

Viikko 12


 

Motion: THB that we need more capitalism in order to overcome the problems in Capitalism in the world today
Role: Chair (opp.)


Dear Assemblage, Chair[wo]man, Ladies and Gentlemen,

There are four so-called ”hard fields” or ”hard professionals” in this world in any given society. They are the following: doctor, lawyer, economist and engineer. Everyone else’s job or workplace is less coveted or less appreciated or less remunerated (as these ”prestige” things go together). Let us take a look at how these professions have shaped the world so far.

It would be safe to say that medicine has made the world a better place. Life spans have soared. We can now expect to live to a hundred, unless cancer = shit happens. Infectious disease have been conquered, and AIDS can be controlled through medication. When 50-year-old women can today declare grandmother status, looking as fit as fiddles, without wrinkles, we know that pensions-age has to be lifted upward, so that money will suffice in society. Medicine has made our lives better, but this does not mean that all doctors do good or are honourable. The field in itself has been fruitful with astute enough practitioners and generous help from pharmacology, biochemistry and so on.

Engineering, likewise, has made our lives better. All the new technology that we use has made it easier to adapt to the world, travelling and business. Houses have become more comely and comfortable, roads less bumpy and vehicles more reliable. Home electronics is a success story, with always some novelty in the shops in the autumn or for Christmas, usually something that adds to our comfortability. On the other hand, big breakthroughs in cars, space travel, fossil fuels, ecology and waste management have been dragging their heels and may never appear. We haven’t made any real progress in decades on those things. Recycling does not eradicate dumps that can be seen from space. And some feats of engineering may be downright dangerous to humans and animals, such as GPS phones and the link-tower revolution. If bees dies, we’ll all die soon.

Justice, or jurisprudence, aims mainly @ the maintenance of the rights of conservatives to keep and retain their properties. The biggest innovation in justice seems to be the so-called class-action suit, i.e. a group of people seeking damages instead of one-on-one justice or cases of the state vs. the individual. On the other hand, litigation per se has become a problem when things could be settled or suffered in silence instead. Petty crimes slow down the wheels of justice when it comes to battling more serious felonies. If I was a judge, I’d deny the right to suing just as gladly as I would grant the right to appeal. Law is treading water, and it has a corrosive effect on society in that its ties to the economical elite and its reluctance to send certain people and certain criminals to prisons weakens its creditability in citizens’ eyes. Law, after all, was to be independent from the other powers that be per Montesquieu.

Of the four strong fields, guilds or trades outlined in the beginning of this speech, what kind of measures, promises and plans for improvement have economics and economists taken and made then? Let us take a look. Bear with the very adverse list…

Liberal and libertarian economists believe in not contributing to taxation and not distributing company ”gold reserves” to others than top brass, proprietary families and shareholders (who often are the very same people). The culture of headhunting has made CEOs mobile (and expendable), while outsourcing has ”redunded” employees. Where there once was responsibility, there is now greed. Trade unions have been squashed by moving all factories that can be to the Far East, where labour is cheap. From Asia the factories will most likely move to Africa, where labour is even cheaper, if Africans learn to work as hard as Asians. Rating agencies cheat their paying customers in hopes of bigger payoffs. Real-estate agents and sellers blow hot air into their prices in order to get heftier commissions. Easy credit is available to people who cannot pay back, or who are extremely vulnerable. MTV is filled with online gambling advertisements during evening and night time; no other kind of advertising exists anymore. Young people do not want to work for a living but ”shine for a living” in positions of fame and celebrity. Things were not well in the past, but there was some sort of equilibrium and temperance in place. Now there is little of that left.

Of the four fields, medicine has advanced the life expectancy of humans to nearly a hundred, while economics and the industrial and commercial life have turned the clock back about a hundred years, when it comes to factory workers’ rights in foreign, strange countries. This is the state of things.

Medicine is the mirror that divulges that some things are being strange or surreal (~ 50-year-old grannies), while economical practices are the thing that IS WRONG, or the abscess, the curing of which will likely make everything else fall right into its place.

Unfortunately, the smoke screens by which we can hide from the world and hide everything else that is amiss in our world prevent us from seeing this. 

Thank You.


Puheen kesto: 6 min 34 sek
Arvio: * * * *. Puhe ottaa hampaisiinsa kapitalismin ja sen mannekiineiksi ekonomit. Se yrittää todistella, ettei jälkimmäisissä ole juuri mitään hyvää. Näin se vihjaa, ettei hallituksen esitys voisi viedä asioita eteenpäin. Toisten on helppo jatkaa tästä haluamiinsa suuntiin. Puhe on myös pitkä ja täyttää aukkonsa melko täydellisesti.