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 01, 2006

Here Come The Boomers!

What is it with the Main Stream Media? Once again today’s Calgary Herald is filled with pages of material on “code burgundy” and “coed” accommodation. These are simply coping or crises management scenarios in a bigger “mash-like” setting. They do not represent innovative ideas or long term planning strategies. I’m sure there is nothing unusual about “coed” care or “stacking up people in hallways” in a field military “Mash” unit. These certainly are symptoms of a very ill system, but as a physician I have been trained to look for the disease behind the symptoms. Where are the inquiring minds of the main stream news media? Code burgundy, it would seem, is a decision on the part of the powers that be, within the region, to move patients from emergency room beds to hospital hallways instead of allowing patients to back up into the emergency department parking lots. This seems like a reasonable way to deal with the symptom but does nothing for the underlying disease.
Coed accommodation within the region just simplifies bed assignments. Under the ongoing, perpetual, present “tight bed situation”, accommodation for contagiousness, specific nursing expertise, and other considerations, may well have priority over sensitivities with regard to coed accommodation---and rightly so. But allowing coed accommodation within the region primarily saves time on shuffling patients about. It may improve bed use by three or four beds within a region of approximately 2000 beds. It may save the cost of transporting a few patients between regional hospitals. Clearly, the above is a tempest in a teapot and has nothing to do with long term planning or sustainability------except the dire need for it!
So let us look at problem # 1 in yesterdays outline pertaining to the un-systainability of our present health care system-----baby boomers. How do we address this issue other than rushing to the need for euthanasia and assisted suicide?
Some ten years ago I proposed to the Calgary Regional Health Authority C.E.O. with copies to government, the idea of having a short training program for people who wished to volunteer or work for minimum wage in the field of medicine. This would be tailored specifically to the care of the elderly and chronically ill. Many of the health care needs of this group in our society have to do with transportation, companionship, assistance with activities of daily living such as eating, dressing, toileting, etc. This group of care givers would require minimum training but would serve a tremendous need in the community. They would provide a valuable service in our long term care facilities, and would be invaluable in keeping our seniors in their homes and out of these facilities by working with home care and other community health care providers.
In 1988 Calgary surprised the world with its world class Olympics. Much of the credit for this can be attributed to the outstanding contribution of volunteers. Volunteerism is by far the most cost effective approach to any problem. Let us examine where volunteers and low cost workers could come from.
a) As the baby boomer generation ages they can be divided into two groups, the well and the unwell. Just as there will be a large group of unwell elderly there will be a large group of retired well. Why isn’t there some effort made to interest this “well group” in caring for their “not so well” peer group? The years of life expectancy has extended well beyond the age of retirement that was set more than fifty years ago, and many retirees are bored with their retirement and have time on their hands. This group would have much in common with the people needing care and could relate much better to their needs than some of the minimum wage people presently used from third world countries.
b) I have on occasion seen high school students or University students sitting with elderly people in nursing homes. Is there an active recruiting program going on in our schools or are these isolated examples of volunteerism. A student sitting with a restless senior could be studying while earning money for continued education. Further, if there were active recruiting programs for this kind of work perhaps there would be an increased interest in making “care giving” a life’s vocation.
c) There is at present a vast amount of volunteerism in the community. Churches, service clubs, food banks, and special interest groups, are just some of the communities’ volunteer services. But what is our government doing to encourage and help coordinate the services that are there. The 1988 Canadian Winter Olympic games were a huge success because of the incredible contribution of the many volunteers. However, this still would not have been enough without the incredible planning, enthusiasm, focus, and participation, and cooperation of everyone from the community level to the federal government level. Leadership also was imperative.
d) Some of the ideas in the next blogs may soften the impact of the “boom”.
The question then remains: “What planning and development is being done, and what incentives are being put in place now to mobilize this tremendous resource (volunteerism) when we need it in the future?” Or will we continue to epitomize Einstein’s definition of “stupid” and keep doing the same thing over and over while expecting a different result, and move faster down the road to euthanasia and assisted suicide as some countries have?
Tomorrow’s discussion: “The rising cost of pharmaceuticals”.

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