What's Wrong with Healthcare?

Thinking inside and outside of the healthcare box. After 41 years of family practice, what's happened to Canada's healthcare system?

Wednesday, February 22, 2006

Are Traditional Journalists Failing Their Duty to the Public?

February 19/06 Calgary Herald had an informative piece on cancer drugs and the huge disparities in coverage from province to province of various medication treatments. There were quotes from reputable physicians pointing out the rational of this discrepancy and it seemed obvious to me that the various Cancer Clinics “criteria” vary from province to province. When I looked into the tamoxifen issue many years ago I was told there was no evidence that the drug didn’t impact breast cancer “survival” although there was eight years of evidence that it significantly reduced breast cancer recurrence. I wonder if some of that archaic thinking still impacts whether a cancer drug is covered or not. From my perspective the yardstick we should be using is: “does it add to our cancer-free years and how do the side effects of the new drug compare to the traditional drugs?” Remember, it is not just length of life we should be looking at, but also the quality of life.
This report stated that a patient had to pay $10,000.oo over the past 10 months for his cancer drug. It sounded like he was getting this drug administrated in Calgary’s Tom Baker Cancer Center. Although the drug company involved has a “compassionate” list of free recipients, it wasn’t clear to me whether everyone who had this type of cancer was able to be put on this “charity” list and, who determines whether someone must pay or not. Are there some Albertans who are getting expensive drugs from our government funded Cancer Clinics by paying for them and some who are not, for financial reasons. If this be true, is this not a two tiered system within a government institution? How is this different than getting the most recent advances in cardiac surgery at the Foothills Hospital by paying for it, but if you can’t afford it, and there isn’t a charity that will foot the bill, you do without.
My main point is that I think only half the story was reported. Is it possible that in Alberta I can get insurance for medications not covered by Blue Cross (seniors plan), or the Cancer Clinic. Obviously, in this case, Blue Cross was not picking up the $10.000.oo tab. for this senior. How am I to know what the Cancer clinic covers or the Blue Cross Plan for seniors covers, and what it does not? Most of us assume that any drug or medical procedure that is purported to be useful will be provided in our care, but obviously there are differences of opinion in “what is useful” or in the definition of “useful”. The bottom line is that we are led to believe that we don’t need insurance and are in fact prohibited from having certain types of insurance but may be faced with significant health related bills for significant disease. The article in the newspaper did not say whether in Alberta insurance is available for these things.
Generally speaking, medical matters are covered very poorly in the Main Stream News Media. Every time we turn around someone is quoted as promoting a two tier medical system, or it is stated that we are moving towards an “American-style” or “American-like” system. In fact, we already have a “multi- tier” system and attempts are being made to move towards a “European style” health care system. The news media, I believe are well informed and know all these things. For some reason they prefer to quote the spin of the “Friends of Medicare”.
Another article that hit the news stands both provincially and nationally was a pilot joint replacement project that supposedly “shortened waiting times to four months. Where did it start out in terms of waiting times? Was this for one orthopedic surgeon, all of Calgary, or the entire province? I understand that hospital stay was decreased by two days but there would be an increase in cost for “pre.” and “post.” operative out patient care. Were the surgeons involved given more operating room time?
Apparently this project was funded to the tune of $20,000,000.oo. What did the budget for this money look like (where exactly did it go) and where were the cost savings aside from early discharge from hospitals. Was there a more rapid turnover in the operating rooms and if so, why, because most joint replacement surgeons have been “block-booking” their surgery for years and supposedly the hospitals have been booking them in a cost effective way. Was there more equipment purchased so that time loss for sterilization no longer was a factor? Supposedly, this appeared to be the “Messiah” program for joint replacement surgery, and waiting lists were the number one concern of Canadians in the last election, and all we get is “Emerson” crossing the floor week after week in the mainstream news media. The pilot orthopedic program, on the other hand, is presented with few details and a positive spin with little justification that I could see. It may be a move to more efficiency, but it isn’t going to save our present Universal Health Care System. At times one might get the impression that the news media prefers confusion and disharmony and an “oh dear, what can be done attitude” in the health care field. I suppose it makes good headlines. Isn’t it time we had some responsible journalism on health care. Some glimpses of other systems that are functioning better would be helpful and positive (such as some of the European systems or the New Zealand system, previously mentioned in my blogs). It may even encourage politicians to move forward on true health care reform. As it is now, the news media serves as an enabler of stagnation and inaction. Any suggestion of a move forward by a political party is portrayed as “American- like”, but at the same time the status quo is reported as unacceptable. Every once in a while a pseudo “breakthrough” big story can be reported, like our orthopedic program, and so we keep limping along, giving mouth to mouth resuscitation to our dying Canadian Identity----Universal Health Care.

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