Thursday, September 2, 2010
"Canary call from the coal mine!" on Health Care in Canada
Third-Party Delivery of Medical Services touches Down in Saskatchewan
Medicare's hallowed ground, Saskatchewan, has started using a private surgical clinic for orthopedic day surgeries normally provided through the public system.
The province announced their intention back in March, but has now started booking surgeries through the Omni Surgical Centre in Saskatoon. The centre will provide knee and dental surgeries referred from the province. Omni currently provides orthopaedic surgery as well as lap-band weight loss, breast augmentation and other cosmetic procedures for a fee.
Saskatchewan's Health Minister was quick to point out that contracting out the medical services will not lead to greater privatization of care. "We're looking at all options: Expanding the public system as well as looking at third-party delivery," said Don McMorris, as reported in the Leader-Post.
This was all foreshadowed last October when B.C.'s chatty Health Minister Kevin Falcon offered fast tracking Saskatchewan patients for orthopedic surgeries in B.C. - what he termed "medical tourism". "If people have been waiting for 15 months, do they care if [their surgery] happens in Saskatoon, Regina or Surrey? I'm not sure they do," Saskatchewan's premier Brad Wall said at the time, according to the Canadian Press.
The uproar this caused - partly from Falcon's ill-considered choice of the phrase "medical tourism" to describe the deal (that he then turned around and offered to Americans) - led to Regina backpedalling on the idea, but clearly they were in the market.
No matter how independent the provinces feel they are in the provision of health care they are still obligated to uphold the Canada Health Act - ultimate the responsibility of the federal government, who also hold the purse strings. But what can Canadians expect with the free market favouring, social program adverse Harper government at the gates?
Not much when the federal Health Minister won't even address the recent Canadian Medical Association conference and the minister they do send doesn't mention Medicare even once, according to a recent Picard column in the Globe. Reminding us that Harper, while the head of the National Citizen's Coalition, once said, "It's past time the feds scrapped the Canada Health Act."
If Mr. Ignatieff needs some policy substance on which to hang the Liberal Party's electoral changes of success, here is one issue that simply will not go away. What position is the Liberal Party going to take on the future of the Canada Health Act, in the wake of rapidly rising health care costs, enhanced technological and pharmaceutical developments, a growing and aging population, and a very skittish electorate?
While there are certainly other pressing issues, Health Care is an icon of the country. It represents what Canadians consider "fair" and "just" and worthy of the people and their governments and while the S.E.I.U. speaks primarily as advocate for the jobs of its members in the health care sector (in this release), this is another "canary-call from the coal mine" of the behind-the-scenes goings on between and among the provinces, while the federal government turns aside, in order not to see, and thereby not to have to answer questions to which it may not have answers. Or, even more likely, it has those answers about their real intentions and it knows Canadians do not want to hear them, especially if there is a election bird-song flowing down Wellington Street in Ottawa, past the Parliament Buildings.
Canadians will have some very troubling choices over the next few years, and we might wish to have a government in place that we trust to preserve the "best" our courty has achieved in this field, rather than one that openly seeks to scrap the promise of living in dignity, with access to full health care, even if that includes a reduced budget for "dramatic interventions" if and when one loses consciousness for what appears to be the last time. That is not a death panel, as the Teapartyers were and are wont to say; that is merely spreading the resources where they are most needed, and I, for one, will be happy to sign a document as part of my Living Will, to permit the doctors to proceed on a DNR (Do Not Resusitate!) basis. Will you? And will your next of kin be prepared to follow your instructions?
In the U.S., for example, some 30-40% of all health care costs are spent during the last three months of the lives of those preparing to die. While Canada is less "death-denying" than the U.S. generally, there is still a considered resistance to open discussion about the issues facing both the individual and his/her family when the end of life looms near.
Many Canadians have already signed "organ donor" cards, indicating our willingness to agree to the removal of healthy organs, should the appropriate situation present itself, where such a donation is feasible. The future of stem-cell research looks somewhat promising for the reduction, and perhaps elimination of certain diseases which now require costly care. However, we are all "in this" together and that means there will be sacrifices for each of us, provided we trust that the system is fair, balanced and administered by individuals whose compassion and ethics are, or would have been a match for Tommy Douglas's standards.
After all, it is his legacy that we are honouring in our attempt to preserve and protect his accomplishment.