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?

Thursday, February 16, 2006

The Heart of the Matter

It is one thing to NOT put out information to the public that is needed to form rational opinions, but it’s another thing to put out misinformation.
Today on the Dave Rutherford talk show, Dave Havelock stated governments cut back on Medical school enrollment because this was recommended by the medical establishment, namely the Canadian Medical Association. Now, I’m not sure where the CMA came in, but the real reason these cutbacks occurred was the Barer/Stoddard report (that I’ve referred to previously), and that had no medical input of which I am aware. In fact, a good friend of mine who chaired the Alberta Medical Association’s Manpower Studies and their committee at the time, predicted there would be an acute shortage of physicians within ten years and was ignored.
This year’s Health Care in Canada survey suggested that Canadians need a better understanding of “social” factors that affect health. Dr. Gerald Predy, Chief Medical Officer of the Capital Health Region (Edmonton), goes on to say: “there’s an obvious connection between lifestyle and what you eat and your health, but I think they need to have a deeper understanding”. Then he goes on to say: “Reducing income disparities and ensuring as many of our kids as possible will get a good education will probably do as much for health as anything else we can do”. Basically, it would seem, he thinks the socialistic idea of wealth redistribution is the answer. We can excuse him to some degree because he is from Edmonton, BUT, he needs to read my entries “Education versus Motivation”, and “Determinants of Health” entries.. To understanding why there is a relationship between education, poverty, and health we need to look at the determinants of poverty and behaviors that may negate both achieving an education and achieving good health. Does Dr. Gerald Predy really think that transferring wealth from one group in society to another will cause recipients to seek healthy life styles? It sure hasn’t happened with our native population. From what I hear, the winners of large “jack-pots” like the 649 lotto don’t seem to fare so well health-wise.
The Calgary Herald in section E stated that one third of Canadians could not name one “risk factor”. I would suggest that most of these were not familiar with the term “risk factor” which is primarily a medical term. I used to tell my patients that they would score 100% on a health questionnaire and 20% on “do you do these things?”.
Go ahead and try it:
1) Is it better to have high blood pressure or normal blood pressure?
2) Is it better to be over weight or normal weight?
3) Is it better to eat fatty foods or fruit and vegetables?
4) Is it better to be a “couch potato” or exercise regularly?
5) Is it better to smoke or not smoke?
6) Is it better to have high cholesterol or normal cholesterol?
7) If your mom and dad had heart attacks at an early age would you worry about having a heart attack?
8) Is it better to have diabetes or not have diabetes?
Well that takes care of most of them! How did you do? Now, how vigorously do you actually apply your knowledge? The problem of the intro to the article was that it suggested the problem was one of education. Fortunately, it followed this up with some constructive advice. To be truly helpful, we need to come up with the key element----motivation, but that may not be politically correct.
On Valentines Day the Calgary Herald had the heading “Baby boomers face health bust”. The article goes on to say that 58%, in some survey, thought their weight had no effect on their heart health, once again inferring education was the answer. I would suggest this is more a matter of denial. I have on occasion had the opportunity to watch our geriatric “snow birds” at smorgasbords in Las Vegas. Invariably, the most obese have the biggest plates heaped to the brim and go back for seconds including a similar plate of desserts. There seems to be an attitude of “getting my money’s worth”. Believe me, if these people have ever seen any health professional in their adult lifetime, they would have been read the riot act. Perhaps a “free” health care system doesn’t have financial disincentives in place to cause a “second thought process”. It is clear the system I have suggested in a previous blog (To Summarize) with screening every five years with a push in the right direction, and reminders every year, may have a more beneficial effect than preaching to the deaf.
My last beef today has to do with the Friends of Medicare and Alberta’s opposition parties. Ralph Klein’s third way has not yet been released and already they are opposing it. I can see the” Friends of Medicare” (who are not necessarily the friends of good health care) may have some concern over anything that may erode their “idol’s” status. In fact the status quo, with significantly more money into the glorified “Health Care Pot” is certainly a plus for them. But isn’t this about what is good for patients? Various unions are also benefited by more money in the “Medicare” pot and any privatization or free-lancing isn’t to their benefit. Is that possibly why the Liberals and the NDP are also maligning the “third way” before they have even looked at it? Is this a move for the Union vote? I certainly have not seen any solutions they have come up with. And what’s this about people will have to pay health insurance premiums? It seems to me Albertans have been paying them for years and recently Ontario citizens are now doing the same.
As I’ve said in previous blogs: “The greatest problems facing reforming the health care system and making it sustainable and viable are not medical, they are political. Until we put patient interests above those of political parties and special interest groups we are destined to continue down this painful frustrating road.


Blogger vicki said...

Again, as I health care professional it is so refreshing to hear this from a doctor!The 'politics' of treating the frequent flyers in our ER is very costly. I always sound a little harsh when I say if they had to put $25.00 on the the admitting desk we wouldn't see them.

22/3/06 9:23 PM  

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