by Howard MoscoeNo doubt in this provincial election there will a lot of gnashing of teeth and jawing of gums about the Ontario Liberal government wasting Millions of dollars moving hydro plants and the Ornge ambulance scandal.These are small potatoes when compared to the waste that they’ve built into the structure of the hospital system. I learned about it the hard way, tried to do something about it and failed.In 2004, I spent almost six months in and out of hospital beds at Mount Sinai Hospital where I witnessed first hand how hospital funds are wasted.I had picked up a virus on a trip to Spain that began to harden the lining around my heart. It is called constrictive pericarditis and as the lining turns to cement it begins to impair the ability of your heart to pump out fluids. To correct that doctors administer diuretics, drugs that cause you to pee.In my case, the pills didn’t work, so I had to enter the hospital so they could be administered intravenously. Eventually, they would operate by stripping out the lining around my heart to permanently relieve the pressure.During that period, I was scheduled for several major tests some at Mt. Sinai and some at the Toronto General Hospital, where the operation was to take place. The tests were scheduled and what invariably happened was the day before the tests were to occur I was bumped.When I looked around me and I spoke to nurses and other patients I learned that being bumped from a test was a very common occurrence.It seemed that being bumped for an average of three days was the norm.Why? It’s because the hospital is paid a per diem (daily fee) by the Province of Ontario for each day that a patient is under hospital care. At that time it was around $900 a day. That fee covers the total cost of a patient’s care including major tests.When an outpatient comes in for a test, the hospital receives a separate fee for that service. Therefore there is an incentive for the hospital to bump inpatients in favour of outpatients. Think about it. Every time I was bumped from a test, I spent an extra three days in hospital. That cost the Government of Ontario $2,700. Multiply that by the many thousands of patients who are bumped from tests and it makes the Ornge ambulance scandal look like chump change. It doesn’t just happen in cardiac wards, but almost every other department where major tests are scheduled.This could explain why in two instances, I had to spend a full night on a stretcher in the emergency room because the cardiac ward was full. That’s one of the many reasons that emergency rooms are crowded and why you have to sit there for endless hours waiting for treatment.So what’s the answer? It seems easy. Exclude the cost of tests from the per diem payment, lower it to offset that cost and pay hospitals separately for major tests. In other words eliminate the incentive for bumping inpatients.It may sound easy, but I am sure it isn’t. I was determined to do something about it. I scheduled a lunch with George Smitherman, the then Liberal Minister of Health in the members’ dining room at Queens Park. I know George from his time a City Hall.He took careful notes and nothing ever happened. I know how difficult making a structural change in any government system can be. Every time you try to change the dynamics, there are powerful interests that will lobby against it and hospital boards and administrators are among the most powerful.That’s why sometimes you just have to change the government if you want to change the system.