A health care system can remain public and universal all while allowing entrepreneurs to compete to provide services and attract clients, instead of leaving patients trapped in a public monopoly that fails to respond adequately to the demand for treatment. But first, we have to get over our fears concerning the role of the private sector in health care.
Yes, we do ration healthcare in America. It's just that those affected the most are those who have the least income. In America, we have become oddly blasé about income inequality and its consequences, increasingly willing to let those without simply do without. But the mere hint that a needs -- or evidence-based -- process might be used to allocate scarce or high-priced healthcare raises an outcry from those accustomed to getting what they want, when they want it.
He'll learn, if he follows the money, that two thirds of health dollars spent are public dollars, yet two thirds of health dollars consumed are by private health providers, which includes specialists and family physicians operating their own private practices. This means he isn't so much the commander of a "health system" as he is at the apex of a "health industry". In short, the secret to really getting things done is: incentives, incentives, incentives.
The dismantling of our emblematic health care system is happening beneath our very noses. We are assured that it is in or best interests, and that corporate, multi-tiered health care, like corporate globalization, is inevitable. Nothing could be further from the truth. Each promise about corporate healthcare is false. Comprehensive documentation shows that a "two tier" system is inferior to a universal publicly funded system, by any measure.
Having spent 15 years studying these alternative medicine techniques I clearly see how the body can be receptive to such suggestions. It is more than just positive thinking. Having done this type of work to heal myself and having helped many others, I can attest to the fact that it is truly a journey.
Recently, a scathing report on the United States' health care system was issued. Surprisingly, little was made of this report in Canada. This was a shocking oversight, given that our performance on this same report was abysmal. Our health care system ranked second last in the study. How did our once-vaunted health care system become such a very expensive failure?
As consumers of an amazing medical system, I see the benefits of what we have to offer. At the same time I do see the shortfalls. I often wonder if we had a system which emphasized prevention, nutrition, meditation, breathing, routine exercise, living life from a heart based existence and more -- would we have such an expensive health care system?
Expenditures on public health care in Canada appear to be slowing, raising the possibility that the health care cost curve is finally being bent and the system transformed. What does this mean? The economy will eventually recover and relax provincial health expenditure constraints, but federal health transfer growth will be reduced starting in 2017.
As a practicing family doctor, I have always been fascinated with health and healing. Over my 20-year career, I have marvelled at the resiliency of the human body. Most of us are taught that our bodies are basically stuck with a disease and there is little hope. My questioning mind and search for more has taken me down a slightly different path.
I spent eight months in and out of hospital, received eight operations on my left leg, had my left knee joint replaced twice, and had two cataract operations. Managing my care and booking appointments by phone took a lot of effort. I jumped at the chance to use a patient portal, a digital health tool that my doctor introduced me to.
Many countries offer sophisticated medical care and universal coverage and yet have very different health-care models. And, more importantly, several of these countries achieve better health outcomes. To be fair, international health care rankings never offer a consensus on which country truly has "the best" system. But there is one area where these rankings are consistent: they usually place Canada and the U.S. mid to low pack. I believe both countries can do so much better.
The report of the Ontario Social Assistance Review Commission, released October 24, offered some important steps toward health-focused change. Its release was set to spark a badly needed discussion on reform of a broken and anemic system. The surprise resignation of Premier Dalton McGuinty changed that -- this debate has been conspicuously absent.
The Canadian Medical Association's 145th annual meeting is taking place this week. The mantra of the meeting is health equity, and Sir Michael Marmot, the white knight of social determinants, undoubtedly provides the human and scholarly element the issue of inequality deserves. There may be no better person to articulate Canada's barriers to better health outcomes.
The Harper government may choose to believe that a divided society is not bad for the economy, or that wealth will trickle down. Canadians from across the country may have to assure him that health will surely not. Canada has fared better than other nations in the global economic crisis, but success stories have not followed those who prescribed austerity.
The implementation of Obamacare seems anything but straight forward. Costs have soared despite the fact that most reforms don't kick in until 2014; several states have effectively rebelled; one basic reform (the long-term care insurance) was already scrapped. The debate over American health care seems no closer to resolution.
Harper's unilateral offer promises increases in federal funding that are unsustainable. With health care set to eat up 80 per cent of provincial budgets by 2035, if no substantial reforms are implemented we will have serious consequences for the ability of provinces to spend on departments other than health care.