Perhaps Size Does Matter

On Friday, Jan.13/06 I spoke of the success of the Calgary Regional Palliative care program that was the product of initiatives on the part of concerned people with regard to specific health care needs in the community. To some extent, some initiatives are continually going on, but these are in the form of money raising projects that supplement our government health care system. There seems to be a myriad of “fund raisers” and charities that are described by the organizers as “essential” to our health care system as we can tell by the many phone calls we get and the many lottos that seem to go on endlessly. These projects add an important dimension to our public system, but in themselves are not innovative but rather of a philanthropic nature.
A new and exciting event, I believe, is the advent of non-profit community funded palliative care facilities. These are totally outside of the government funded health care system. The exciting thing about this initiative is not necessarily because it is outside of the system, but rather that it was initiated by community need, medical and other care givers, concerned and compassionate people in the community and surrounding area. The land was donated; the roadwork and building site preparation was donated, and many other businesses contributed their services to the project. Fundraising has been incredible. My understanding is that this is a $6,000,000.oo project of which over $3,000,000.oo has been raised in two years. When completed it is hoped it will be run free to the people needing it, as a community program through fund raising. When relating this to a retired business man from Ontario, he told me a similar facility had just opened in his community.
Centralization, cost effectiveness, and a big business approach have been the pillars of our health care system to date. Would de-centralization and a grass roots small business approach have been more appropriate? Would a combination of both been more appropriate? In a monopoly it has been my experience that service becomes sacrificed for cost. In our present huge health care monopoly we have lost the tremendous energies, knowledge, volunteerism, and input of our health care providers, small businesses, and the people at large in the community. The present “Universal” health care system uses the community to raise money and hide health care needs. We should ask the question; is it ethical on the part of the Government of Canada to with-hold transfer payment from provinces if they disallow private health services and private insurance? The Supreme Court of Canada has ruled that the Government of the province of Quebec has denied its citizens their basic rights. Have physician’s organizations such as the Canadian Medical Association and the provincial Medical Associations been delinquent in not speaking up more during this process over the past twenty years. Is it possible to be an ethical physician with-in the system today? We will look at it in my next post.