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, June 21, 2006

Yay! I'm a Canadian

Yay! I am now a true Canadian by virtue of being on a medical wait list. After two and one half years of severe back and upper leg problems and by virtue of the sudden onset of more pain associated with significant numbness of my left upper leg, I was given the privilege of an MRI that showed a significant protrusion of my L2L3 disc to the left, resulting in a referral to a back surgeon. I was also given the advice that should I loose bladder or bowel control, I would need immediate surgery. In fairness to the physicians and staff at the emergency department that I visited, they were all extremely professional and courteous and I thank them sincerely; but the fact is that I had been having back and upper leg pains for two and one have years with intermittent transient weakness in both legs off and on for over eighteen months. A specialist that I attended some six months ago suggested that I may have early spinal stenosis and said that “if I wished” a CT of my spine could be done.
What happened to the physicians that stated “you should have the following done so that I can make a definitive diagnosis”? My response was likely typical of many Canadians at this time: “Well, the doctor doesn’t seem too concerned so why take up space in an area of scarce supply”, or, “we have to work together to control health care costs”.
Still, there are people like Dr. Dennis Furlong (written up in the May9/06 issue of the Medical Post) who is strongly against a parallel private system (but feels the present system is unsustainable) who feel the solution is to add another tax to the Canadian tax system. He states (from the Medical Post): There should be a system of prorated patient participation in the cost of their care. It’s called accountability, and it’s been categorically avoided by all studies and reports to date”.
What planet is this fellow living on? The acuity of visits to the emergency departments of our hospitals is steadily rising. Trivial complaints are almost non-existent in Calgary emergency departments these days. A recent study shows that only twenty five percent of our hypertensive patients (at major risk for strokes and heart attacks) are being treated to target. How is adding their treatment to their tax bill going to give the seventy five percent of hypertensives (at present not being treated or inadequately treated), incentive to address the issue? Besides, I thought this universal system was brought in so that people would not have to worry about the cost of seeing a physician or getting appropriate treatment. How can Dr. Furlong’s plan not be seen as taxation on the ill in our society? Is it really so difficult to understand that a healthcare system within a society should care for the poor, the chronically ill, and the frail elderly, and that a parallel private insurance system could look after the “unexpected” health-care events. Further, I would suggest that a government “universal” system has an obligation to seek out and treat the chronically ill, and I would categorize the people with hypertension as “chronically ill” (being asymptomatic does not mean you are not ill). As a recent study shows, thousands of strokes could be prevented annually in Canada if the people with hypertension were treated to target. So let’s not blame the ill patient for the cost of our health care system. I fear that many already are not receiving the care they should be getting by an exulted “save the health-care system” attitude on the part of physicians, advocacy groups, and patients themselves (to say nothing of aggressive cost saving measures by governments). Let’s get back to a public health care system that has a mandate to look after the sick, and not worry about whether the sick can get private insurance. If we do it right, everyone will get better healthcare.

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