Thursday, October 26, 2017

What Could Health Care Learn from Canada Post?

What?  Seriously?  Canada Post? can't be serious!

Just bare with me a moment.  

I just returned home from Ottawa last night.  Another work trip done. 

Overall, I’m proud to work at Canada Post. Don’t get me wrong.  Canada Post has problems, and lots of them.  What I like is that the vast majority of people at Canada Post are great people.  These people genuinely try hard to move the mail every day so that our fellow Canadians can get their orders from Amazon, or their letters from Grandma. 

It is disappointing that what the majority of Canadians hear about Canada Post is mostly related to labour disputes or the political games we get entangled in.  After all, we are still a Federal Crown Corporation and have many years of baggage to deal with.  That being said, could I find myself out of work next week?  Yes.  Our industry is volatile and our organization is not immune from the problems that all of us see in our workplaces.  

Nothing is forever and Canada Post has had to learn that lesson the hard way.

So what on earth does Canada Post have in common with Health Care?

Tomorrow is the Annual General Meeting of the Winnipeg Regional Health Authority.  This is where I make that transition from concerning myself with one bloated government bureaucracy (Canada Post) to focusing on another bloated government bureaucracy (Health Care).  As organizations there are many similarities.

I think the frustrating part about working for both of these organizations is that you are subject to the whims of government.  The decisions that governments make are not always rooted in reality.  Political agendas in many ways outweighs common sense.  Just a frustrating reality.  I also think that given our government ties both of our organizations are viewed with skepticism by the public.  

One of the things Canada Post has gotten right is that they have discovered that if they are to remain relevant in the future, they have had to discover the "customer."  The cash cow that was the letter mail business is drying up.  The era of e-business has arrived and with it came the avalanche that is the parcel business.  

The big difference for Canada Post is that in the parcel business Canada Post has had to face a hard reality.  Competition.  They have had to face stiff competition from established and successful competitors like FedEx, UPS, and DHL.  They were forced to compete or become irrelevant.  Their very survival depended on it.  If customers rejected Canada Post, it is likely that our organization would have been decimated.  Don’t get me wrong, we still have a long way to go when it comes to really be customer driven.  Federal Crown Corporations are bureaucratic behemoths that do not change easily.  Much like health care.  

Change is very hard.

Unfortunately, health care has not had to face the prospect of irrelevancy like Canada Post.  In fact, the demand for health care is increasing daily.  If you work in health care you likely have more job security than the vast majority of other industries.  This is all going on while health care has yet to discover their customers.  

I don’t think anyone would ever describe health care as being customer-driven.  

We like to use buzzwords like being “patient-centred” but we don’t see this language extend much beyond the words printed on the cover of a pamphlet.  The culture in health care is so awkward that you could likely start a heated debate by referring to "patients" as "customers."  How can you call yourself "customer driven" when you can't even agree on what you call the "customer."  Political correctness is more prevalent than common sense in health care.

Competition forced Canada Post to discover their customers.  Competition forced Canada Post to start thinking like a real business and not a Federal Crown Corporation.  Today, we actually talk to our customers and are listening to their input.  We still have a long way to go, but this new culture is definitely starting to pay off.  We are slowly becoming more innovative.  This is a slow process but we know that it is working.  

Canada Post is now the #1 volume carrier of parcels in Canada.  Thanks to our customers!

On the other hand, the Health Care industry in Canada has no threat of competition.  No incentive to serve their customers other than to avoid negative media attention.  All Health Care Administrators need to do, to be successful, is to not irritate their political overlords.  We as health consumers have accepted this reality and are accepting barriers to accessing health care.  The Canada Health Act states the following as its primary objective.

The Primary Objective of Canadian Health Care Policy

It is hereby declare that the primary objective of Canadian health care policy is to protect, promote and restore physical and mental well-being of residents of Canada and to facilitate reasonable access to health services without financial or other barriers.
- Canada Health Act

We violate this policy every single day in Canada and it is time we as patients and citizens of this great country demand better.  We get fixated on the "financial barriers" but we often ignore the systemic barriers of health care rationing.  Access to a waiting lists is not access to health care.  

The only way the culture of health care is going to change in this country is if we demand better.  We, as patients, need to organize and innovate and challenge the health care monopoly.  Health Care is stuck in the culture of the status quo and the only group I see challenging the status quo are patients.  Giving patients choices and a greater say in health care policy are a starting point.  Should we be introducing competition into the health care industry?  Pursue a public – private hybrid system?  I think so…but I think ultimately we need to let the patients decide.

Forcing an outdated dinosaur like Canada Post to compete in private markets has made a world of difference in our organization.  We now have a future.  Can the health care establishment benefit from some competition?  Again, I think so…but it is important to remember two things.

1)  Canada Post has achieved success and remained profitable while still remaining a Crown Corporation.  So it is possible to be customer driven while still remaining under the control of government.

2)  Government could also undo all of the success that Canada Post has achieved by changing our mandate.  Our future is not secure.

Free Health Care is not "free."  Also, free markets are not "free" either.  They would create their own problems and challenges for regulatory bodies.  However, it is time we let the customer decide what we want the future of health care to look like in this country.

We need to get past the idea that there is only "one" way of getting things done.  I'm obviously someone who supports competition and privatization in health care.  Does that mean I want to abandon single payer.  No...far from it.  There are many things we can do within our existing system that can make substantial improvements.  We have to get past ideological barriers and create a system that works.  That focuses not only on outcomes but how we get to those outcomes.

We CAN do this!

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