Republicans really want a Christian nation, they should start acting like it. Canadian Dr. Danielle Martin testified before the the U.S. Senate health subcommittee on Tuesday and learned just how uncharitable some GOP senators can be. When it comes to social welfare, Canadians are nicer than many Americans. We don't like hospital wait times either, but we're willing to accept some discomfort in order to ensure the less fortunate in our society receive the same care as everyone else. Millions of mostly-conservative Americans believe that if you're poor it's your own fault.
We know that the U.S. has the most expensive health care in the world. But beyond noting that dubious achievement, we seldom ask why. On my recent visit to Canada as a Fulbright scholar, I stopped by to pose that question to one of their leading health care experts, David Dodge, an economist who has served as federal deputy health minister and seven terms as governor of the Bank of Canada.
Caregivers don't need great riches to support their children. A strong, supportive adult figure can help children overcome otherwise unhealthy environments. This figure need not even be the child's parents (though of course this helps). A grandparent, and aunt, a family friend, even a dedicated teacher can have a tangible, long-lasting impact on a child's development.
A recent landmark ruling by the Supreme Court of Canada rejected a doctor's unilateral right to deny life-sustaining medical treatment to a patient over the family's objections. Attention needs to turn now to another life and death situation that is often bewildering and sometimes fraught with abuse: the do-not-resuscitate (DNR) decision when made by a family on behalf of a loved one. Physicians will often seek a DNR consent from a family member when an older patient is brought into the hospital. Their approach can be overly aggressive. I experienced this several years ago when my mother was hospitalized with a serious infection.
In our quest for solutions to big health care challenges, we can sometimes overlook the low-hanging fruit -- i.e. the small, practical changes that can bring about substantial savings and better health outcomes. Case in point: the cost-savings opportunities in medication adherence through incentives, health IT and data applications.
The link between health and income is solid and consistent -- almost every major health condition has worse outcomes among people who live at lower income. I will continue to advise my patients to exercise more and eat healthier food, but this tax season I will also spend time prescribing tax returns.
Health care is a form of human capital. Considered in the broadest sense, health care encompasses public education and prevention services as well as the delivery of care when illness strikes. As such, it is actually one of society's critical means of keeping our population productive. Canadians can't afford productivity losses. The Conference Board of Canada reported last year that our productivity level has fallen to 80 per cent of the U.S. level from a high of 90 per cent in the mid-1980s. If we can agree that efficient health care is an enabler of productivity and that productivity is key to wealth, the next steps should be easy
There is an ongoing campaign to convince health care providers, decision-makers and the public that generic medications cannot be trusted and that if you want the real goods you need to pay the brand name price. The line is actually a twist, a re-packaging of some complicated statistics into an easy-to-understand sound bite, but one with the unfortunate weakness of not being true.
Tom, 46 years old and a skilled carpenter, came into my office the other day. He has not worked for the last eight years since he hurt his back in a car accident. He struggles to survive on $600 per month. For him, social assistance has not been so much a safety net as it's been a fish net -- a trap of indignity from which he has been unable to wriggle free.
Recent information counters the prediction that health spending will inexorably gobble up all of our public resources, as has been argued by some commentators. But does this mean that the public health care cost curve is finally being bent and we no longer have to worry about health spending? Can we conclude that public health care spending is now sustainable for the long-term? Unfortunately, the answer is no.
How much a society spends on health care has not been found to be directly related to any health outcome tested. A society that spends so much on health care that it cannot or will not spend adequately on other health-enhancing activities may actually be reducing the health of its population. If a country wants to see significant improvements in its population health, the best public policy is to eliminate poverty.