Health Care for all........

One of my favourite blog friends Leslie has had a very stressful year to say the least. Just before Christmas her daughter became very ill requiring hospitalization and surgery. Leslie tells us today that her daughter is home and recovering. Thank god for that. Leslie made a very poignant post aboutCanada Health Care system and I really think it is worth a read. She itemized for us all the tests her daughter endured, the numerous doctors that her daughter saw and the surgery and and was explaining that it didn't cost her or her daughter anything.

I know this is always an amazement to our neighbours south of the border....how can this be. How can you get all this health care for free? But they also ask the question, if Canadian health care is so good why do so many Canadian come across the border for health care?

I wish there was a simple answer to that. What I would like to share with you is what I know about our health care system the good and the bad.

First, our health care system is not free. We pay for it in our taxes, our employer pays in some cases 100% of our premiums or if you are self employed you pay your own premiums but for example they are only a few hundred dollars for 6month coverage. Now that is different in each province, but the basic concept still stands. Where I believe our health care system started to get into trouble was when our Federal government made huge cut backs to the provinces for health care. It then became the provinces responsibility to pick up for the lack of funding. For provinces like British Columbia, Alberta and Ontario it's not so bad as the majority of the countries population lives in these provinces and the pain of the tax increases to cover costs is spread amongst a few million rather than in smaller provinces who would feel the cutback even more.

I personally believe the "Crisis" that the media is so fond of using in health care is really politically fed. The American insurance companies want a piece of us, the pharmaceuticals certainly want their share and the doctors and private clinics want a piece of the pie as well. So what better way to tell the public you need more private clinics than to cut back services in the public system.

Now this leads to another issue. Supply and demand. There are not enough, doctors, nurses and technicians to go around. So if you have a doctor wanting to open a private clinic to do let say orthopaedic day surgeries. In order to run these clinics you need surgeons, anesthesiologist, RN, x-ray technicians. So if you need all of these professionals to run this clinic and the system is already short where do you think they are coming from? The public system. The doctor/surgeon feels he is not getting enough OR time in the public system so he wants to open up a private clinic, in order to do that he needs staff. That staff comes from the public systems, nurses and radiologist or technicians come to the private clinics on their days off....but what happens then to the public system if Susie or John RN call in sick and there is no one to replace them because Mary or Joe have gone to work in the private clinic that day, the employer is then forced to pay overtime if they can find someone at overtime or close beds. So I ask you, how are we any further ahead? We talk about the wait lists....well that is one of the ways the wait lists are happening. Doctors/Surgeons are working in two systems.....private and public. Personally, I don't think that should be allowed. But the promotion of private clinics is also being fed by the insurance companies, which are now becoming more and more American....you start to see the connection.

So we have a shortage of professionals, so what do we do? Hire more staff? Not that easy, there just aren't enough of us out there, it's an international problem. Today for example, I was to see my GP. Before Christmas, my appointment got cancelled because he was sick and then their office was closed for Christmas and so I was rescheduled for today. Guess what, he is in the hospital there are no doctors in that office today. So how does that happen? I live in a small town, there are no locums that the local doctors can call upon to keep their practise running, so it gets shut down and then guess what happens,it snowballs. The senior who really needed to come in to see the doctor because their blood pressure medications aren't working, ends up in ER in a hypertensive crisis. The colleges and university don't have the physical space for larger classes or extra staff to teach more students. Even when we get the students in, it's a matter of finding them appropriate placements in the hospitals.

I have heard some of the senior nurses talk about how they never should have done away with nursing schools being part of the hospital. They felt that not only did it provide the hospital with extra staff but it really made the nurses job ready.

Then we talk about salaries. RN's, radiology technicians, Lab Techs, ultrasound techs are all salary. Which means are wages are capped. But that is not so for the doctor's. I have heard the argument that doctor's have more overhead because they have offices to run or have more years of schooling etc. Well I don't know how much of that still holds true. Many doctors opt to either run their office or work out of the hospital, and as far as schooling goes, now with the Nurse practitioners you have people in all walks of health care that have as much if not more education than some medical doctors.

So what is driving this so called health care crisis......the only thing that I can think of is GREED, and the desire to live forever. Or find a cure at all costs. That takes us down a whole different path. But just think about it....pneumonia's used to be what they called an old persons friend. I know that sounds harsh, but it is true...the older person would get a pneumonia and before antibiotics came along they would made comfortable and basically told they were going to die. Where do we draw the line on the care one receives. I mean medical advancement are marching on, and we as a society now expect everything to be done. Before babies born under 28 weeks gestation would not make it. Now with technology being what it is we are able to save babies at 22 or 23 weeks gestation. These little ones need longer hospitalization and treatments which of course all drives up costs. Again, please don't misunderstand me, I am in awe of what we can do and how we can save lives, but again at what cost. What will be the quality of life of the person who was without oxygen for 15 or 20 mins going to be like if we are successful in reviving them? Who pays the long term care costs for that person? These are tough questions, which often I have seen taken to ethics committees. But we as a society have to keep this in mind as well. The medical advancements come with a cost and are we willing to pay for those advancement. My conscious tells me we would, but when is enough enough? Or is there ever enough? I don't have the answer to that, I wish I did. But as long as we as humans continue to want more we will always find ways to get more, even if it is on the backs of the less fortunate.

When we start talking about drugs and the pharmaceutical companies many variables come into play, like product patents, research and drug testing. Many posts can be done on that alone, but again it is something to keep in mind when we talk about health care costs.

Then there is our own responsibility and accountability for our health. What about tobacco companies or alcohol...we all know the ailments both these drugs can do to our bodies, but because these companies have such wonderful lobbyist who pay off government politicians to help keep the taxes low on these items them then they will continue to be available and we be human will continue to consume and use because that is our god given right even when we know it can cause us health issues. So personal accountability plays a role as well.

I don't have the answers, and I suspect I am going to get some very interesting comments regarding my post. But you know when I watched the movie Sicko one of the things that stood out the most for me, was when they showed old footage of politicians talking about how public system or any social program was communist of nature and that was BAD! I just shook my head. The fear mongering they tried to instill in the public....that any social program was bad. I think they feared for what they didn't know. Well now they do know that there can be a public health care system, one that can be enjoyed and shared by all.

I want to leave this on a positive note. In all my years of nursing I have never experienced a patient being denied or turned away because they didn't have health care coverage . OUr system is by no means perfect but I am proud to say that I am Canadian simply based on the fact that we do provide public health care for all.

I wish you all good health!