The recent series of public consultations organized by the Canadian Medical Association (CMA) was a worthy exercise. Important issues were raised, stakeholders consulted and the public’s temperature taken … no medical pun intended. But let’s face it — Canadians have been jaw-jawing about health care continuously since health care consisted of a shot of penicillin and a recommendation to take up smoking as a way of combating anxiety.
So one can’t expect miracles in reports such as these. For all the talk of the need for innovation and original ideas, it’s hard to find either when discussing what is without a doubt the most thoroughly tilled soil in Canadian public policy.
It is reassuring, though, to have it confirmed that Canadians grasp the problems facing the health-care system. It seems everyone is in agreement that the system does a good job delivering acute care to those facing serious medical emergencies (injuries and illnesses that require short-term treatment), and that’s true. And it seems that everyone is in agreement that the system is not doing so famously in providing affordable long-term care to those with chronic, ongoing medical conditions.
Unfortunately, the most serious chronic, ongoing medical condition that will confront the system in the decades ahead is the mother of them all: old age. And due to advances in health care, many of the Baby Boomers who are now hitting their golden years have parents who are still alive and kicking, too.
It’s therefore no surprise that one of the themes hammered away at in the CMA’s summary of its public consultations was the need for the health-care system to better address aspects that fall outside of what’s generally covered: long-term care, home care and pharmaceutical expenses. The three things are a veritable shopping list for the types of care that an aging population will consume with gusto.
They’re also hellishly expensive, and will need to be added to a system that’s already groaning under the pressure of delivering basic care for sickness and injuries in a timely manner.
The problems are mutually reinforcing, unfortunately: Delays in arranging long-term or home care for patients forces them to remain in acute-care hospital beds longer than is necessary to address the original medical issue, causing delays to ripple through the health-care system. And those delays can easily have an impact on outcomes that may mean the difference between a full recovery and someone needing ongoing support. The circle is complete.
Efficiencies can no doubt be found, and innovation should by all means be encouraged, but no one seems to deny that when an aging population meets increasingly expensive high-tech treatments, overall expenses are going to climb. The only real issue is how Canadians will hand over the extra dollars: through the single-payer public system, with government serving as the Grand Redistributor, or through private transactions and insurance.
The final answer will almost certainly prove to be some combination of both, and the CMA’s report at least has some good news on that front. The Canadians it spoke to seem at least somewhat reconciled to the notion that the private sector will play a role in the delivery of care in the future. In this, they seem to be further along in their thinking than every major federal political party.
I wonder if any of the politicians are listening: Canadians might not be eager to embrace private delivery, but they’re willing to at least talk about it. It would be nice if they had some elected officials prepared to have the conversation.
National Post
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