Canadian Health Care Information

Our primary ethical obligation is to relieve and prevent human suffering. What is the solution to this ethical crisis? I believe that it lies in the community of Canadians realizing that we are one. We are the family caregiver who can’t find a doctor. We are the patient who cannot demand faster care for fear of falling further back in the line. We are the physician who feels s/he can’t retire for fear of leaving patients without a family doctor. We are the nurse who can bring pain medication, but not treatment. We are the worried bureaucrat who knows that the numbers spell doom. We are the torn politician who knows privately how bad it is, but cannot have a public conversation. We are one.

Together, we can acknowledge that no amount of money will keep up with the twin forces of technological possibilities and human expectations. And then we can get down to work on the discomforting yet critical job of redesigning a healthcare system that is universal, compassionate and affordable. No politician or healthcare expert can do it for us. Those choices must come from us, the citizens who will use and pay for the service. In our hands lie both the responsibility and the solution.

We have hard work ahead of us. First, we have to sadly, but surely release the myth of Tommy Douglas. It never worked long term anyway. Back then, medical care consisted of a small number of lab tests, diagnostics consisting predominantly of an Xray machine, and a modest selection of drugs. Today we can rescue premature babies weighing less than a pound, analyze your genetics and offer designer drugs. It is time to choose which healthcare services Canadians want their tax dollars to pay for and which services can be secured through different arrangements. Do we want serious illness tax funded and the day to day sniffles paid for with private insurance premiums, subsidized for those below a certain income level? Do we want every person to have a tax paid health care account wherein they continue to accumulate unspent funds?

There are many ways to achieve affordable quality healthcare for all. We are one. We are caring, inventive Canadians. We can do this. Let us not look to our politicians for answers. Let us gather across this great country and talk amongst ourselves and then direct our politicians with the solutions.

In election time, voters look to politicians for promises of more money for healthcare. Money has not fixed our healthcare problems in the past nor will it in the future. For nearly 30 years, since the first waiting lists were documented by the Ontario Medical Association, governments at every level and of every stripe have increased spending. Yet prominent international and national bodies have labeled Canada’s healthcare system financially unsustainable (IMF, December 22, 2010; Dodge & Dion, 2011). The latest 10 billion dollar infusion from the 2004 health accord is rapidly disappearing. Not so our problems. They remain and grow.

The reason that money can’t fix things is that the problem we are facing is not a financial crisis, but an ethical crisis. For example, we do not have a single tier system, but rather one with at least 10 tiers, where the least advantaged suffer the most. They do not have influence like politicians or senior business people. They are not insiders like docs and nurses or that booking clerk for the MRI machine. They are not independently wealthy to fly to healthcare. They are generally not the highly educated who know how to work the system. And they are not typically members of a preferred group like the Workers Compensation or the RCMP. It is morally repugnant to witness this. Further, by not objecting, we bear the guilt of benign complicity, but complicity nonetheless. What are the ethics of being aware that people are waiting one to 3 years for medically necessary care? Canadians suffer significant rates of addiction to pain medication (Paperny, 2009). What are the ethics of addicting people instead of treating them? What are the ethics of being involved in the unspeakable waits for those with cancer? Our healthcare providers also suffer when they must witness and be involved in these situations. As for patients themselves who are waiting, the picture
is one of serious disruption for their life, family and work; profound distress; and for too many, unendurable pain (Walker, 2009).

References
Dodge, David & Dion, Richard (2011). Chronic healthcare spending disease: A macro diagnosis and prognosis. C.D. Howe Institute Commentary.

International Monetary Fund (2010). Canada: 2010 Article IV Consultation-Staff Supplement; Staff Report; and Public information notice on the executive board discussion, December 22. Country Report No. 10/377, p. 16.

Paperny, A.M. Addiction by Prescription. Globe and Mail, Nov 13, 2009. Available at http://www.theglobeandmail.com/life/health/hooked-canadas-painkiller-problem/article1362848/

Walker, Janet (2009). Waiting in Line. Canadian Nurse, 105 (7), 26-30.