{"id":748,"date":"2004-01-03T16:43:28","date_gmt":"2004-01-03T15:43:28","guid":{"rendered":"http:\/\/www.freiholtz.se\/forvetet\/?p=748"},"modified":"2004-01-03T16:43:28","modified_gmt":"2004-01-03T15:43:28","slug":"v%ef%bf%bdrdmonopol","status":"publish","type":"post","link":"https:\/\/www.freiholtz.se\/forvetet\/2004\/01\/03\/v%ef%bf%bdrdmonopol\/","title":{"rendered":"V\u00e5rdmonopol"},"content":{"rendered":"

I Sverige har landstingen i praktiken regionala monopol p\u00e5 sjukv\u00e5rden. I likhet med andra monopol behandlar landstingen sina leverant\u00f6rer, anst\u00e4llda och kunder (patienter) uselt. N\u00e4r det inte finns n\u00e5gon konkurrens beh\u00f6ver man inte bry sig eftersom varken leverant\u00f6rer, anst\u00e4llda eller patienter kan v\u00e4nda sig n\u00e5gon annanstans.<\/p>\n

Landstingen p\u00e5minner i m\u00e5ngt och mycket om de forna sovjetiska industrikombinaten. De var ocks\u00e5 j\u00e4tteorganisationer med en diversifierad verksamhet och styrdes i likhet med landstingen av politruker med minimalt verksamhetskunnande. I de sovjetiska industrikombinaten slavade miljontals ryssar med att transformera perfekta r\u00e5varor till skrot, t.ex. VAZ<\/a>– eller Volga<\/a>bilar. I landstingen f\u00f6rvandlas sjuka till medicinskt f\u00e4rdigbehandlade av underbetalda kvinnor.<\/p>\n

Det fanns en g\u00e5ng goda sk\u00e4l (oj\u00e4mn inkomstf\u00f6rdelning, brister i information och kunskap hos breda befolkningslager o.s.v.) till att bygga upp en politikerstyrd sjukv\u00e5rdsapparat. Men n\u00e4r dessa sk\u00e4l i stort sett \u00e4r undanr\u00f6jda blir den bristande konkurrensen ett problem.<\/p>\n

I GT<\/strong><\/a> (Expressens g\u00f6teborgsupplaga) den 1 januari redovisas ett projekt vid Sahlgrenska Universitetssjukhuset<\/a> d\u00e4r man med hj\u00e4lp av externa logistikkonsulter halverade patienttiden, d.v.s. tiden fr\u00e5n patientens f\u00f6rsta bes\u00f6k vid kliniken till att han \u00e4r f\u00e4rdigbehandlad (i artikeln st\u00e5r det t.om. ”frisk<\/em>”). Det hela \u00e5stadkoms med enkla medel:<\/p>\n

1.<\/strong> Man s\u00e5g till att planerade l\u00e4kartider alltid var fullt bemannade (l\u00e4kare, sjuksk\u00f6terskor och l\u00e4karsekreterare) under mottagningstid.<\/p>\n

2.<\/strong> Inga remisser fick vara obehandlade vid arbetsdagens slut.<\/p>\n

3.<\/strong> Tid f\u00f6r \u00e5terbes\u00f6k bokades redan vid f\u00f6rsta bes\u00f6ket.<\/p>\n

Dessa \u00e5tg\u00e4rder resulterade i att patienttiden minskade fr\u00e5n 278 till 140 patientdagar. F\u00f6rs\u00e4kringskassan sparar i genomsnitt 60 000 kronor per patient i sjukpenning. Samh\u00e4llsvinsten \u00e4r naturligtvis \u00e4nnu st\u00f6rre men sv\u00e5r att ber\u00e4kna. Vinsten i form av minskat m\u00e4nskligt lidande g\u00e5r \u00f6ver huvud taget inte att v\u00e4rdera.<\/p>\n

I en konkurrensutsatt verksamhet \u00e4r \u00e5tg\u00e4rder som de ovan beskrivna en sj\u00e4lvklarhet, i praktiken ett \u00f6verlevnadsvillkor. F\u00f6r H\u00e4lso- och sjukv\u00e5rdsmonopolet<\/a> i V\u00e4stra G\u00f6talandsregionen<\/a> \u00e4r de ett besv\u00e4rande undantag. Efter ett idogt s\u00f6kande har jag inte lyckats hitta n\u00e5gon information om projektet p\u00e5 V\u00e4stra G\u00f6talandsregionens webbplats.
\nDet enda sp\u00e5ret p\u00e5 webben \u00e4r ett program<\/a> fr\u00e5n en konferens i Norsk Dataf\u00f6renings regi d\u00e4r v\u00e5rdenhetschefen och en av konsulterna redogjorde f\u00f6r projektet i 45 minuter.<\/p>\n

Fr\u00e5gan \u00e4r v\u00e4l n\u00e4rmast om v\u00e5rdenhetschefen kan f\u00e5 ha kvar sitt jobb nu n\u00e4r informationen l\u00e4ckt ut. Hon har ju helt missf\u00f6rstt\u00e5t sin uppgift. Hon ska administrera de av politiker och sjukv\u00e5rdsbyr\u00e5krater nogsamt underh\u00e5llna v\u00e5rdk\u00f6erna, inte korta dem!<\/p>\n","protected":false},"excerpt":{"rendered":"

I Sverige har landstingen i praktiken regionala monopol p\u00e5 sjukv\u00e5rden. I likhet med andra monopol behandlar landstingen sina leverant\u00f6rer, anst\u00e4llda och kunder (patienter) uselt. N\u00e4r det inte finns n\u00e5gon konkurrens beh\u00f6ver man inte bry sig eftersom varken leverant\u00f6rer, anst\u00e4llda eller patienter kan v\u00e4nda sig n\u00e5gon annanstans. Landstingen p\u00e5minner i m\u00e5ngt och mycket om de forna…<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[7],"tags":[105,113,124,155,195],"class_list":["post-748","post","type-post","status-publish","format-standard","hentry","category-politik","tag-logistik","tag-monopol","tag-organisation","tag-sjuk-vard","tag-vg-region"],"yoast_head":"\nV\u00e5rdmonopol - F\u00f6rvetet<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.freiholtz.se\/forvetet\/2004\/01\/03\/v\ufffdrdmonopol\/\" \/>\n<meta property=\"og:locale\" content=\"sv_SE\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"V\u00e5rdmonopol - F\u00f6rvetet\" \/>\n<meta property=\"og:description\" content=\"I Sverige har landstingen i praktiken regionala monopol p\u00e5 sjukv\u00e5rden. 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