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, November 28, 2006

Canada's Healthcare Tsunami

Outraged readers of my previous post suggesting outsourcing of Canada’s healthcare needs, as a solution to the rising cost of our Universal Healthcare System, should not read today’s post. After all, if the idea of outsourcing our wealthy people to the U.S.A., as is now occurring, and our poor to India (a future consideration), as a solution to health care costs, is a problem for you, then, today’s post may be totally offensive!
It has been said to solve the problems of today, we must often look to the past. Mark Steyn, in his book “America Alone”, goes to great lengths to show the impact of demographics and an aging population within a given society. It is hard to argue with his observations pertaining to demographics; however, I will confine my comments to the impact on health care. Further, I do not wish to get into the arguments put forth by economists (percentage of GDP, percentage of government budgets, etc). It is not my field, so we will leave that to the bean counters. From a medical perspective, and a common sense, here is how I see it (perhaps a more appropriate title would have been “The perfect Storm”):
1) The edge of the wave of baby boomers is now about 60 years old. The evidence is that these people will slowly and continually become increasing consumers of health care more than contributors to health care, i.e they will be hospitalized more, see the doctor more often, etc. and at the same time, they will be retiring from the medical and other work forces, creating both a shortage in health care providers and a decrease in the tax base supporting the healthcare system.
2) Canada has a reproduction rate of 1.6 children per woman. Therefore each generation continues to shrink compared to the generation before it. The relative size of the baby boomers to the tax-paying base of the population will therefore continue to rise.
3) Life expectancy continues to creep upward while reproduction rates continue to creep downward, with a corresponding increase in the disparity mentioned in #2.
4) Modern technology and pharmacology have dramatically increased our ability to intervene in the usual mortality, but not necessarily in the numbers of people requiring ongoing costly “maintenance” therapy and cost. This not only incurs the cost of the intervention and the maintenance therapy, but increases the effect of #2 and #3.
5) Within western societies, there has been a steady increasing empathy for the weak, unfortunate, elderly, disabled, mentally ill; well just about everybody in need. Whether this is good or bad is irrelevant; the net effect of this has been that, as a society, we have tended to bring about the two-fold effect of decreasing our tax base and increasing our “dependant” base with the corresponding increase in cost.
6) Underscoring all of the above has been our resistance to defining “what is a need as opposed to a want in our just society”.
So where will this all end? We have this tidal wave of elderly, demanding, and high needs people being maintained by a relatively decreasing supportive group in our society. Sounds like a societal “Katrina” to me.
I started this post by suggesting some of the answers may lie in the past. Environmentalists may also be showing the way. Perhaps the old saying “radical situations need radical solutions” is correct after all. With the global warming that has been reported, there have also been reports of increasing ice flows and ice bergs. Northern civilizations in the past (faced with the harsh reality of survival), took the most dependant and aged in their society, put them on an ice flow, and wished them “bon Voyage”. Most health care costs are accumulated in the last two years of our life, so that type of a policy could save over fifty percent of our societal health care costs! What’s that, you say. Some countries have introduced and legalized euthanasia with the same principle in mind? Well, then; it would appear that we have come full circle. Isn’t it amazing how things always work out?


Anonymous sildenafil citrate said...

It is hard to argue with his observations pertaining to demographics; however, I will confine my comments to the impact on health care.

25/6/10 10:18 PM  

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