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.
When it comes to health care, we can clearly see that a cost-cutting approach only works for a while. Given the giant demographic shift underway now, we aren't going to save our way to great health care. Put simply, innovation is not a choice. Improving Canadian competitiveness demands it. Canadians in need of a more sustainable and effective health care system deserve it.
Canada has over 70,000 hospital beds and spends more than $47 billion a year on hospital care, yet accessing these beds when they're needed most remains an important public health concern. Many hospital beds are being used by patients who no longer require the specialized equipment or nursing care provided by a hospital. So what's the solution?
Health care financing in Canada is no small business. With a staggering $200 billion spent on health care services annually debates about health care services financing ought to be taken seriously. We certainly have no shortage of pundits, from the left and the right, weighing in on the state of the Canadian health care system. Too bad the debates aren't often based on the facts. We deserve better. We deserve evidence.
Jacquie was mentally ill, this much was clear, but after age 12 her parents didn't have the ability to force her into treatment, where they knew she belonged. Sure enough, with Jacquie living on her own and untreated, she launched a horrific attack with a saw on two neighbours, a mother and a daughter, who nearly died. Jacquie was found criminally not responsible for the attacks. The two doctors who refused to deal with and treat a severely ill young lady remain in place today. They are hidden deep in a broken medical system that protects them, but also sucks them in as a new kind of unintended victim of a sick health care bureaucracy.
It's the Canada Day long weekend, and though I know we're all enjoying our illegal fireworks and botany-themed pastries, let's not lose sight of another one of our nation's proudest patriotic traditions -- the vapid Canada Day editorial! Still hungry for some patriotism? Well, what could be more proudly Canadian than loudly telling Americans how to run their country?