Looking for Solutions in Health Care for 2006 and Beyond

Our health care system needs to change to accommodate new demographics, new technologies and new pharmacologic advancement.

The roots of compassion and caring in health care should not change however, and it is with this in mind that the dialogue of change should be had surrounding health care.

How can we adapt to different needs that emerge as our population ages?

How can we  find sustainability in the midst of so many new advancements?

How can individuals become more empowered in serving their own health care needs?

What role does the individual have in enabling the  health care of others  beyond paying taxes?

Many questions like these need to be answered and if we are willing to look with open minds at the problems within our health care system, and beyond political posturing, then we can find new  solutions to take us further into this century. 





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Different Strokes for Different Folks

 Two areas of the country are experimenting with new approaches to healthcare. Quebec and BC are leading with vision and whether their vision is good or bad depends on who you talk to.  But they are allowing evolution to occur within healthcare. One cannot say the same for Ontario, where the status quo is retained at the population's peril where there is an attitude of "short term safety, for long term pain".

Quebec has always been a little heavy handed with its medical practitioners. Probably because it understands many will stay because of language and cultural issues but this is changing. So it is not surprising to see that Queb ec tried to cap specialists wages at about 60% of what their colleagues earn in the rest of the country. "The Special Bill", Bill 27 inspired Quebec specialists to respond and they did, suing the government and encouraging its members to effectively work to rule until the government came back to the table.  Time will tell whether Quebec physicians regard their cultural identity as more important than their ability to earn a living on par with other provinces as talks resume.

Quebec is also attempting to respond to growing medical need of its population by opening  the doors for more private experimentation which seems to be quietly accepted by much of the population. Even Paul Martin used Montreal-based Medisys, an executive wellness centre, whose CEO is Dr. Sheldon Elman, the former PMs personal physician.

Quebec's Bill 33 was slated to pass this fall.  The Bill establishes a role for private healthcare delivery in the public system. It gives doctors permission to run publicly funded, privately owned, for profit medical centres. It will create a wait list management system in public hospitals to determine when overflow patients must be sent to private clinics. It ends the absolute ban on private medical insurance which will allow hip, knee, and cataract procedures. Non-hospital surgical centres (affiliated medical centres) may be allowed to expand into other areas acting as "safety valves". These changes are in direct response to the Chaoulli decision's requirement to improve accessibility to public healthcare.

 As always not all doctors (or patients) agree, but something has to be tried and it is possible that by bringing these centres on in a controlled way  the fear mongering may be assuaged regarding the "private care boogeyman".

In Victoria BC, a new private health clinic has sprouted up called "Options Health Systems". It opened in November and has been criticized for collecting an annual fee for a range of "executive" style health services. It claims to be the first clinic in Canada to bring affordable "executive" care to average Canadians with a fee-based mix of GP services with complementary medicine and alternative medicine. Service fees are $300 a month for year one then $200 a month each subsequent year. Patients get a minimum half-hour visit with guaranteed same day appointments.

As mentioned previously on this blog, boutique practices are springing up quietly but executive care has been around for years. Why should the elite executive have access to more care than the average senior? Why should a person who chooses not to spend their retirement income on a car, be refused the liberty of spending their money on an annual fee to provide themselves with more time with their physician and more medical attention?

Interesting that Don Copeman, founder of the Copeman Clinic in Vancouver, tried to establish similar clinics in Ontario but was held off by the MOHLTC.

 In some parts of the country, patients are allowed to spend their money on healthcare, while in other jurisdictions the same clinic is banned.  So much for consistency across Canada.

 Quebec and BC may differ in their approaches, but at least they are willing to try new approaches on a small scale and see where it leads. Ontario seems to want to keep plodding, afraid of it's public shadow.

Not a bad plan to evolve and respond to the changing medical climate; just remember what happened to the dinosaurs and how more agile and adaptable organisms managed to survive.

Let's hope Ontario figures it out before its too late. 







Reader Comments (4)

The demanding and self indulgent boomer generation have stacked the deck providing themselves with indexed pensions and benefits etc., that they they knew that they could not afford but gave themselves the promise in the name of future generations of tax payers anyway---the baby boomers also created this dysfunctional health care system in which the front line, grassroots providers are poorly compensated whilst the upper echelons of the health care bureaucracy, overladen with unproductive baby boomer drones, have rewarded themselves most generously---the baby boomers may well hold the upper hand in the electoral sense, but one anticipates at they start retiring in 2007 that the younger generation of tax payers and front line health care providers may resentfully not follow their insatiable elders' script---one can anticipate laws which will not allow the boomers to extract more from their pensions than they put in themselves and that they will have to pay through the nose for the care and attention that they thought that they had arranged for themselves for 'free'.

They will find themselves increasingly 'free' to dip into their own resources as the younger generation shed the promises laid on their shoulders by their elders---the golden years may not be as golden as the demanding baby boomers thought, in particular in the field of health care, a poorly conceived, a poorly constructed and even more poorly managed statist 'system'---they can demand untill they go blue in the face, and many will--but the younger generation , looking to their own interests, will likely not accommodate them.
December 30, 2006 | Unregistered CommenterAndris.

I don't blame the boomers for being one of the biggest demographic bulges in history. They can't help it.

By virtue of their size they have the ability to influence many many things....purposefully or not.

I think it will be the Boomers who drive the shift towards more options in healthcare ie more privatized care, more complementary care, more alternative care. If this is what they want to spend their money on then it seems to me they should be free to do so.

If you believe what some books and ads tell you about your colon needing cleaning and you want to spend on that then that is your choice. In my opinion this is money poorly spent but there are people who will buy into this concept. That should be fine. But if they also want to spend to have more time with a highly trained and highly skilled medical provider to discuss their medical issues, then they should also be free to do that.

Boomers will have influence in healthcare. Many of the politicians just haven't seen the light yet.
December 31, 2006 | Unregistered Commenterrealist

This benefactors' lecture by Patrick Monahan, Dean, Osgoode Hall Law School on Nov. 29, 2006 is a good read.

"Chaouilli v Quebec and the Future of Canadian Healthcare: Patient Accountability is the "Sixth Principle" of the Canada Health Act.

Clear and concise and logical and hopeful.
December 31, 2006 | Unregistered Commenterrealist
should be "Chaoulli" not "Chaouilli".

Of interest, the 2004 Accord with the First Ministers and the feds allowed for $41 million over 10 years with the agreement by First Ministers to achieve meaningful reductions in wait times in specific areas by March 31, 2007 and setting multi-year targets for "priority benchmarks" by Dec. 31, 2007.

It would seem that the increase in Cancer wait times and the misleading reports of wait times in Ontario (as suggested by the auditor general) might lead to some desperation on the part of politicians.

What will happen when these deadlines are not met...and they are not likely to be met?

Will gov't introduce more pseudo medical professionals to make it appear like patients are getting access to care?

Will gov't use the magic of numbers to make it appear that patients are getting improved access to care?

How will we know if patients are getting better access to care if we cannot trust the wait time statistics (as the auditor general has pointed out)?

How will we know?
What will patients demand?
What can physicians do for their patients when the gov't fails to deliver on improvement to access within the monopoly system?

December 31, 2006 | Unregistered Commenterrealist

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