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?

Thursday, November 16, 2006

Mr. Gary McPherson's Vision of Healthcare in Canada

For completeness and fairness sake, I will continue this dissection of the “vision” of Alberta’s “would be premiers” by critiquing the information obtained from their home web sites. Keep in mind, this information has been compiled by the candidate and, I would presume, their advisers, with ample time to think, ponder, pontificate, obfuscate, and in general confuse the reader. Is anyone out there good at de-coding?
Today we will look at Mr. McPherson’s “vision” and solutions for healthcare in Canada. He states that heath care in Canada needs to be sustainable, and does not believe that this should be done by bringing in “private” medicine, because this would amount to a “two tiered” system. I’m sorry, Gary, but we have many tiers to our health care system at present. One of my patients recently returned from the U. S., where he had life saving surgery done, that was not available in Canada. This “two tiered” boogy-man is getting tiresome. We have multi-tiers, at present, in our health care system. It would also seem that Mr. McPherson believes that “expanding the role of the current department of health to include more opportunities for alternate treatment methods and healthy living initiatives that will help to ensure that the medical care system is only accessed when it is absolutely necessary to do so”. Wow, that sounds good, except it implies certain things. It implies that people are using the system when they don’t need to. The evidence shows that people are actually using the system appropriately. Who would sit in an emergency department for eight hours if they didn’t genuinely feel they needed help. And the statistics back this up. Check it out Gary! Besides, wasn’t the system brought in so patients didn’t need to “worry” and make choices between food and medical care? Now their choices are wait on lists or ignore your problems or concerns. Both amount to “no care”.
The healthy living initiatives sounds good, but this has been pushed for forty years and we are failing miserably. Only 25% of the people with high blood pressure are being treated to target. Similar statistics apply to people with high cholesterol. The Saskatoon Star Phoenix newspaper recently reported a study that showed 95% of children in most average and well to do communities were up to date on their immunizations, but there still were “poor” communities in Saskatoon, where only 46% of the children were up to date on their immunizations. Now, immunization programs are the most cost effective preventative measures in medicine, and have been around for more than fifty years and ARE and HAVE BEEN FREE. Please don’t tell me that these parents don’t KNOW that, or that smoking is BAD, or that they shouldn’t eat junk food, etc. The problem is MOTIVATION. How are you going to get people to be motivated to live healthy life styles, Gary? What is your PLAN?
Mr. McPherson’s final assumption and implication is that other providers offer cheaper services than a family doctor for an equivalent service, and by involving these providers more opportunity, we could reduce costs to the health care system. I suppose that is true if we keep them OUTSIDE of the public health care system; but it seems Gary means to bring them into the public system! Let us look at some of these opportunities:
1) Maternity care and delivery
Midwives $2500.oo to 5,000.oo
Family Physician Approximately $1000.oo
2) Office visits
Family Physician Approximately $30.oo
Podiatrist App. $40.oo to $45.oo
Chiropractor App. $30.oo to $40.oo
Acupuncture App. $40.oo to $50.oo
Physiotherapy App. $40.oo to $50.oo
Holistic physician outside of Alberta Health care---- $300.oo to $325.oo per hour.
The bottom line, Mr. McPherson, is that a good family doctor, doing comprehensive continuing care, is the most cost effective practitioner we have, so we had better come up with ways of restoring that part of our health care system. The Americans recognized this twenty years ago, and aggressively recruited our family doctors. In Canada, we are just beginning to see their value. Other care givers are saving the system money at present because, for the most part, they are outside of the system, and people fork money out of their pocket to obtain these services. Our long waiting times for traditional medical services actually pushes people outside of the system, and saves the system money. Of course, I am referring to those that can afford to pay for these services (it’s another tier of health care).
Tomorrow we will look at Dr. Lyle Oberg’s “vision” and contribution to the health care debate.

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