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?

Sunday, September 10, 2006

Canadian Medicare, Another Failed Utopia

The thought occurred to me the other day that the reason we hang onto Canada’s “Universal” Medicare system is that it represents the “ideal”; the utopia of health care in a society. As normal biological creatures, we have a strong drive to move to comfort (who wouldn’t want total comfort guaranteed?), and therefore any perceived impediment to that movement is resisted and considered to be counterproductive and an enemy to the public’s best interest. It supposedly follows that to achieve the “ideal”, no regard for conditions, prerequisites, or stipulations are required, and everybody should have all their needs and comforts attended to equally in every respect. The other side of this equation is that, unfortunately, there are thirty million Canadians who all have unique needs and wants, and not having a want fulfilled generates frustration and discontent, and therefore stress; a very unpleasant phenomenon.
The truth is that as a society, and as a people, we have many wants, needs, and often different priorities, and most, if not all of them, are dependant in some way on resources (in the broad sense), and therefore, money. Resources and money on the other hand are directly related to productivity in the broad sense, and in particular, effort; again, one of those things that requires us to be somewhat uncomfortable (note that we know many things we do are harmful to us, but effort is needed to change them and their eventual result).
The point is that our original Medicare System was seen (and is still seen by some) as a health care utopia, and as is the case with all utopias, they eventually self destruct because of the complexity of human nature. Communism and other social structures that were purported to be “ideal”, have demonstrated that as time goes on, more and more regulation and micromanagement is needed to address the dissatisfactions of the people within the “utopia” and maintain its “utopian” perception. The more control imposed, the more people will find control measures objectionable (note the objections to airport security that is designed to safeguard the people using the facility and planes). Dr. Rachlis has stated that it is better to build a fence at the edge of a cliff than a hospital at the bottom of it; but the question again arises as to when your “fence building” creates a corral, a containment that is objectionable in a free society. Addressing the problems of one group to try to achieve perfection creates problems for another group. Soon the supposed “utopian” society pleases no one other than those that cling to its ideological intention. Further, any attempt at change is made impossible by both the forced micromanagement and control, and the fear of loss of the “ideal”. Is it any wonder that the Canadian Health Care System continues on a downward spiral? Handicapped by the utopian ideology, that a system of “one size fits all” is ideal, and can be devised, stagnation and decay sets in.
Perhaps the premise to start with should be that we are all unique and have unique needs and wants and “comfort zones”. The ideal system in Canada then, with its thirty million people, would be a system with at least thirty million health care options (thirty million “tiers”, if you like); each one perfectly designed for each person, with each person determining their own “tier”.. True, this “ideal” can never be met to perfection, but wouldn’t we at least be on the right road? And wouldn’t it be better if each one of us were given the opportunity to at least look at options, and decide where our priorities lie, and how we wished to participate in those options? We have gone a long way down the road in our attempts to give life support to our present “utopian” health care system; but from what I can see, there is no question that both the Canada Health Act and our Canadian Health Care System have passed their “Best-Before-Date”.

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