There is no shortage of organizations and institutions reporting information on the status of Canada's health care system. Journalists, CIHI, ICES, Statistics Canada, OECD, and The Commonwealth Fund come to mind but there are many "institutes" and "centres" that gather data on how long patients are waiting, what they are waiting for and how provinces compare.
What's curious is the huge variation in the conclusions. Some say that aging of our population will not pose a problem. The same organizations report that public health care is fully sustainable. We just need to be smarter about how we use resources. Big Data is going to be the saviour.
Other organizations use data to show that wait times are increasing and that the aging population will cause social entitlements to buckle, including pensions and public health care. Their conclusion is that the public system is unsustainable and that just about every option should be on the table including copayments and private options for medically necessary care. The message I hear from these organizations is that we need to look ahead and prepare for changing times.
Can the public sift through the barrage of information to find the truth?
Is there bias, unconscious or conscious, by journalists and left or right leaning organizations that report on health care?
Answer to the first question is that people judge the health care system by their own anecdotal experience. If things go well for them or their loved ones, they believe the system is just fine. They do not see what is happening to other patients in their own region or elsewhere. The reality is the vast majority of citizens are not waiting in queues. They simply do not know what the reality is for others.
Answer to the second question is that bias is quite likely. It's fairly clear that some groups start out with an end point that they want to prove using data. Unfortunately, the data can be selected and is not complete. I often use the analogy of health care as a balloon. If you squeeze one area, another will bulge-you just may not see it if all changes in the health care system cannot be simultaneously evaluated.
As I've said many times here, the unintended consequences of government health care decisions are not usually apparent at first. They occur over time with the result that the decision that prompted the change elsewhere is difficult to link. Health care is truly a complex system.
The Mowat Centre, a left leaning think tank initially created by Dalton McGuinty with five million dollars in provincial seed money, reports that the "doomsayers" about sustainability are wrong.
The Fraser Institute, a right leaning think tank, raises the issue of unsustainability and makes various recommendations for changes.
What are the risks of siding with one or the other?
If you subscribe to the "just work smarter all will be well" camp, there is a distinct possibility that this prediction will be wrong. It is not possible to know what the changes in a complex system will create. It is also impossible to predict sufficient efficiencies for the future that is unpredictable.
If you subscribe to the "act now to create more ways for patients to get care" camp, there is a chance that the flexibility created will drive free-minded innovation and that the need for accurately predicting the outcomes of various programs will have less significant impact if the predictions are wrong.
Governments can regulate. They can fund provincial public health care systems, but there is danger in wishful thinking. Let us prepare for the worst case scenario. Let us be prepared.
On another note, I would like to thank you all for your contributions especially in the past few weeks.
Cheers to you!