363 - 369 Perspectives

Picture a drowning child struggling to stay afloat.  Picture yourself in a position to help.  Picture yourself rescuing the child even though there is some risk. We would all like to think that we would help if we could.  Now picture yourself saving many more lives with much less effort.  You already have.  As have the rest of us – by being part of the Canadian health care system.

 

The current health care system has been a part of Canada since its nationwide introduction by Lester Pearson, the 14^th prime minister of Canada.  The initial introduction of public health care took place in Saskatchewan in the face of significant opposition and skepticism from the public and doctors.  Despite this initial resistance, Tommy Douglas, the premier of Saskatchewan at the time, was convinced that a public health care system could be administered responsibly and sustainably.

 

Douglas’ conviction stemmed from an episode in his own life, at a time when medical care as we know it was not available.  He was faced with amputation of his leg because his family could not afford the necessary surgery.  A kind deed by a specialist saved his leg and allowed him to become the great Canadian that he became.  This kind deed was not forgotten by Tommy Douglas and it provided the conviction that in Canada “we would provide health care for every man, woman and child, irrespective of their colour, their race or their financial status”.  This Saskatchewanian example proved to be sustainable, and was soon adopted by the rest of Canada.  Today the issue of responsible administration of health care has become debatable again.

The concern is once again focused on sustainability.  This concern is legitimate.   Canada has a large baby boomer generation that will both likely make more use of the health care system as they age and contribute less as they leave the workforce. These two factors should be a source of concern to all of us.  There are signs that our current system is already under pressure – including long wait lists for treatment and crammed emergency rooms.  

These signs of a strained system have led some to suggest that changes are necessary: change not only in the administration of the current system, but a change in the overall operation of the health care system  -- privatization.  The argument for privatization of what some people see as a broken or breaking system is rooted partly in what they see as unsustainable in the face of an aging baby boomer population, and partly in libertarian principles.  The unsustainable aspect of the argument is understandable as is the right to have choice in medical treatment.  Regardless of our position -- privatized health care or public health care -- I believe that both sides agree that some change is inevitable.  This change, however, does not have to be privatization.

Yes, I know, it is easy to take sides and much harder to justify it.  I have been on both sides and felt justified each time.  So why the flip-flopping and the second guessing?  Well it’s actually pretty simple in hindsight.  When we are young and full of life and our friends and family are healthy it’s easy to say I want choice and why should I pay for other people’s problems and their lifestyle choices.  Of course, it’s always the victim’s fault – they must have done something to bring the problem onto themselves -- right?  No, not always.  My change of conviction started during a bioethics course a few years back when I started to think deeply about the issue, when I had to justify my beliefs, when I had to justify why my mother should receive care from a public system.  While this transition was taking place my mother was diagnosed with breast cancer -- a shock to all of us.  Of all the people who seemed the least likely to get cancer, it was my mother.  Never smoked and rarely drank.  Her diet was far above the norm – I can attest, with some bias I suppose, that her cooking is both healthy and delicious.   So what brought it on?  Was she a bad person?  No, there are far worse and they seem healthy.  So then what can warrant denying her the right to medical care, the right at a chance to be whole again?  After all we take care of the ones in need in Canada.  We take care of one another.  We take pride in our health care system when abroad – particularly in the United States, the flagship of private health care.  A big part of our pride and the envy of our southern neighbors is our health care system.

Interestingly, Canadian proponents of privatization look south for inspiration.  Yes, we have great American neighbors, with many enviable qualities of their own, but I don’t envy their health care system.  According to the Conference board of Canada, the US has the highest per capita health care costs of any other nation in the OECD but also has the highest infant mortality and the lowest life expectancy of the countries surveyed. To add to the system’s woes, a 2009 study published in the American Journal of Medicine estimated that 29 percent of bankruptcies in the US are due to medical bills alone. This figure is much higher, 62 percent, when other medical related issues are considered, such as mortgaging a home to pay for medical bills.  This is sad.  These are real people with families and dependents.   Far from taking excessive pride in our health care system, we should instead ensure that we improve it so that change will never mean privatization. 

This all comes at a time when we often hear that Canadians are struggling with their identity, that we don’t know what it means to be Canadian, that we’re too diverse from coast to coast to be a whole.  I say they are wrong.  We are simply not looking closely enough.  I argue that we just need to look back to our history, political ideology aside, to all the great figures that have made this country what it is -- to look at our growth, to appreciate the diversity of all the provinces, to appreciate what we have in common.  There are many great things about this country, and our health care system is one of them.  So please, take the time to understand the issues and make up your own minds on where you stand before any changes of significance need to be made.

For more information on the above topic and Canadian history please see:

http://www.canada.gc.ca/aboutcanada-ausujetcanada/hist/canada-eng.html

http://medicare.ca/wp-content/uploads/2009/05/factsheet7-2009.pdf

http://www.conferenceboard.ca/hcp/hot-topics/healthSpending.aspx