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?

Tuesday, April 04, 2006


The big question among many sociologists today is: “Why has Canada’s birth rate dropped to 1.5 children on average, per female? In other words, without immigration, Canadians would become extinct. This has been a trend now for many years and we are not alone. As I recall, France is at 1.1, and other European countries fare only slightly better. The U.S. barely holds its own at 2.1 children on average per woman.
As I pondered this question I recalled a discussion I had with a school teacher many years ago who had thirty plus years of teaching experience. We were bemoaning the fact that the “modern generation” seemed self absorbed. She reassured me that the pendulum would swing back; that as self absorbed parents, their children would be self sufficient and independent. They would have to be, in an environment that didn’t have the time of day for them. Wrong. This, and the preceding generation, have simply decided not to have children. Who needs the hassle?
And who can blame them? The following has been my experience in my medical practice and my conclusions, such as they are.
Like minded people “hang” together. There were some wonderful mothers in my practice who had three to five children. Interestingly, they all seemed to know each other and curiously seemed to have similar attitudes towards parenting. Even more curiously, this group didn’t seem to need the “valiums” and the sleeping pills. They socialized frequently and often did “relief baby sitting” for their friends. It wasn’t uncommon for a mother to come in with five or six kids in tow, hers and a neighbor’s. And the children seemed to be able to amuse themselves in the waiting room until the delegated patient was finished. And, yes, they were usually “stay at home moms”. There seemed to be a general philosophy among the children that the older ones assumed responsibility for the younger ones while mom was busy with “the patient”.
A classic example was a couple who had a three year old daughter and then was blessed with triplets. One would think that the daughter would be envious of the attention that was bestowed on the triplets. Surprisingly, even at that age, the three year old was enthusiastically involved with the triplet’s doctor’s visits, announcing in the waiting room whose turn it was next and supervising each examination.
On the other hand there was the group of mothers that had one or two children. This seemed generally to be a more stressed group of moms that attempted to do everything for their children, and felt their function on earth was to, at all cost, keep their children entertained, or, the alternate group who allowed them to grow up as weeds. And yes, there seemed to be a predominance of working moms in this group, but certainly a fair number of stay at homes as well. Generally speaking, these children seemed unhappy, didn’t relate well to others, and were more difficult to deal with. Don’t misunderstand, some of these children were “model” children (whatever that is), and the parents had obviously “dedicated” their lives to raising them to be upstanding citizens, but for the most part, anyone observing these one and two child families would swear celibacy. The parents were chronically tired, and the children chronically agitated. These groups have, by far, become the more common and more visible group.
An example of this group was a couple that believed “no” was a bad word and should never be used on children. Her visits were feared by all doctors in the medical clinic since the four and six year old virtually tore the place apart. One day as she was visiting the doctor and her children were rifling through drawers and emptying them on the floor of the examining room, she turned to her children and said: “Children, perhaps the doctor would rather you not do that”. The doctor replied: “It’s quite alright ma’am, I’m sure they will stop shortly after they get to the poisons”. Gladly, we never saw these people in the clinic again.
The point I’m making is that as a society our priorities have changed. When there were large families it was because families were valued and the people within the family units felt valued. Each family raised their children as best they could, and other people observed the results and patterned their behavior accordingly. In small subgroups within our society where families are still valued, we can still see evidence of success with larger families. Generally, in today’s society, the family is not valued to the same degree. It has been replaced with an attitude of “I want what I want when I want it”; two cars, a large home, continuous entertainment, and self gratification are a must. Live for today is our motto. Immediate gratification is our ideal and a “throw away consumerism” is the gold standard. This doesn’t really fit in with having and raising children----a life sentence. I sometimes wonder why we as a people are so blasé about the thousands of abortions performed in Canada every year; more evidence of our throw away society? You would be surprised to know how many abortions are performed annually in Canada on women who are married or in a stable relationship.
But I digress.
If we couple the above changes with the determination of other people to tell us how to raise our children, the simplest solution is to not have them. Any young person who comes in contact with their struggling and haggard married friends who are trying to meet their personal goals in “keeping up with the Joneses”, and still provide everything for their equally spoiled and self centered “only” child, will make the logical decision simply not to have children. We have senators and judges advocating against spanking because it is violent, sociologists and psychologists recommending to not use the word “NO”, lobby groups that push the idea that children are better off being raised in a day care than by loving parents, and government leaders that wish to spend billions of dollars on day care but have continually rejected the idea of splitting family income for tax purposes, so one parent could then afford to stay home with the children. More recently, we as a Canadian society have acknowledged through parliament, that non biologic coupling is just as valid and important to us as a nation, as biologic coupling. In this setting, our young women of today would need some pretty strong motivation to have children, or be pretty stupid. I know they may be a lot of things, but stupid isn’t one of them!


Anonymous Anonymous said...

very wise insights. I like it when people agree with me. It is good to see the family where children accept responsibility. I am hoping my children will take care of me when I finally get old.

4/4/06 7:33 PM  

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