Healthcare Policy: A self-handicapping strategy?

We, members of a caring and democratically-geared system, are constantly vigilant of new ways of making healthcare services more economical and accessible to everyone. Yet, in spite of advanced techniques in research, treatment and increased funding, we are faced with higher morbidity and moratility rates, increased cost and reduced resources. In spite of our good intentions, each time we generate a new healthcare policy, it is accompanied by new ways of taking advantage of it. This occurs not only in our local community but indeed, in our efforts to improve international healthcare resources and services as well. The outcome invariably amounts to reduced healthcare goods and services to those who really need it. In addition, those who are able to provide the goods and services that are needed by the people are excluded by the healthcare system. There are essentially three general drawbacks at the policy and programming level that seem to be leading to this constant battle between those good intentions and our seemingly uncontrollable urges to take advantage of them: (1) lack of an effective follow-up and monitoring system that will report, enforce and implement policies and changes as required; (2) lack of knowledge about healthcare sciences and research that can help to formulate practical, realistic guidelines; (3) insufficient participation by healthcare scientists and practioners and too much participation by politicians (i.e., business, legal and labour personalities). Public debates and discussions held (and often televised as well) remind me of our grade nine science class trying to come to grips with nuclear physics. Why isn't the system allowing the "right" people to "do well" ? The answer is not a simple one! A good start would be to observe cases in point - to troubleshoot so-to-speak. There are far too many at all levels - government, frontline practice and end-user, who are taking advantage of healthcare regulations and too many to mention here. We can start by discussing a few here... (to be cont'd)