The Toronto Star recently asked health care experts for solutions to Ontario's hallway medicine crisis. Oddly, they didn't ask the Ontario Medical Association (OMA), the official voice for physicians across Ontario. So, I'll give my two cents here anyways.
The fact of the matter is that time's up. I'm looking at my 87-year-old patient caring for his 77-year-old, bed-bound wife by himself since home care can only provide a fraction of what's needed; I'm looking at my 66-year-old mom waiting in pain and disability for months to see her specialist; I'm looking at our hospitals running well above 100 per cent occupancy rates where hallway medicine is now the norm; I'm looking at the 2000s, the last time the OMA protested a wait-times crisis — and less than two decades later, here we are again. I'm looking at my husband, wondering, "Will the health care system be there for us when we need it?"
Our health care system was created in the 1960s. Since then, our entire way of life has changed from the Women's Lib movement, to the invention of the personal computer, to seat belt laws, to the smart phones and social media. Our health care system is archaic, continuing to exist as it did half a century ago. Is it any wonder it's not fitting the needs of people today?
Other experts have offered their two cents. After all, the Ministry of Health has reports, testimonies, working groups, white papers and lobbyists coming out of their ears. What's missing is the political will to do something. We need a government that will not only listen, but will also act.
Because it's not just about putting more money into the bits and bobs of our health care system. More nursing home beds, more hospital beds, more doctors and nurses are part of the solution. It's also about looking at how our tax dollars are spent to provide the health care we need in this day and age.
The Auditor General criticized home care for putting too much money into administration and not enough into the services patients actually use.
For the next year and a half, I'm studying health care systems around the world for my Masters in Health Economics, Policy and Management. I have learned that health care is a service industry where over 70 per cent of the budget pays people — doctors, nurses, PSWs, RTs, physiotherapists, etc. — to care for sick people. The rest goes to drugs, procedures, hospitals and clinics.
In Ontario, we know that this rule of thumb no longer holds true. The Auditor General criticized home care for putting too much money into administration and not enough into the services patients actually use. We also know that overall health care administration has grown over the past decade from the Ministry of Health to the establishment of LHINs in 2006 and now to the establishment of sub-LHINs in 2017. These are all purely administrative bodies. While management is important, one has to ask why Ontario has more health care bureaucrats than countries with six times our population?
This bureaucracy has invaded the doctor's office. Knee-jerk policies like OHIP+ came about when all three parties were leapfrogging towards universal pharmacare. OHIP+ now has doctors wasting hours filling out convoluted forms to get coverage for medications like antidepressants and anti-seizure drugs. Each hour spent on forms means an hour less of patient care. It is an unacceptable trade-off.
Think of health care funding as a pie. More pie for administration means less left for face-to-face patient care. Nine years into my practice and already, I've noticed how much harder it is to get my patients the services they need. I'm not the only one. In a survey by Canadian Association of Retired Persons, nearly half of people aged 50 years and older believe that the next generation will get less access to health care than they did. This degradation of service is not OK.
We know what Ontario needs.
We know that the best care happens when information and services are shared and coordinated within the circle of care. Witness ePrescribe, a pilot project that was never scaled up.
Let's see if June 7 brings a government that will finally walk the talk.
We know that 10 per cent of the population consumes 67 per cent of health care dollars. This high-need, high-cost 10 per cent includes patients who have serious disabilities, who are near end-of-life, who have multiple serious illnesses, or who have a long, slow decline from dementia and/or frailty. These are people who live by getting significant help from others. To help them, we must refine primary care and specialty care, caregiver support, rehab services, palliative/ hospice care, self-management education, home care and nursing home services.
We know poverty plays a big role in health. While basic income remains a pilot project, the Ontario government created three working groups to produce a text-book sized report that has seen very little action.
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We know Indigenous communities have significant health needs. Help for them starts with clean drinking water. It's a no-brainer. The fact that the Liberal government had enough money to buy a giant yellow rubber duck but not enough to give Grassy Narrows safe drinking water is infuriating.
We know what Ontario needs.
The public will to reform health care is intense. Health care is a top issue this provincial election. What government lacks is political will. That's why we're stuck with an archaic system built for the way people lived in the 1960s. Let's see if June 7 brings a government that will finally walk the talk.
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