Over the last few months, journalists and even economists have been talking about the Harper government, and the way, despite hiccups and scandals, it seems to be moving in concert with the things that Canadians worry about most. Economic security and crime rank high on the list for Canada’s aging population, and the federal government has been positioning itself to claim it is addressing those issues.
But there’s one issue that the federal Tories have been staying away from — except to push responsibility for increased costs more and more towards the provinces. And that’s health care.
Some observers call health care the elephant in the room, saying that more than a third of Canadians expect deterioration in health care over the next five years. In Alberta before the last provincial election, 51 per cent of people polled cited health care as the top issue in the election. Thirty per cent of Canadians thought it was the single-largest issue before the last federal election — easily outstripping those who thought the economy was the greatest concern, at 18 per cent.
But ask anyone who is facing health concerns themselves — or more to the point, anyone who has a loved one who is depending on the health-care system — and you’ll find there’s not another concern that even comes close. There’s no other concern that even matters anymore.
Handling this newspaper’s letters to the editor, I read a lot about issues people are upset about, and, in the process, I hear from a lot of upset people.
In my experience, there is not one single issue that people get more upset about — and stay upset about — than health care, particularly health care for their family members. Medical mistakes, poor treatment, delays in treatment and shabby conditions for care don’t rankle for a month or two — they are issues that upset people for years.
Believe me, I know how they feel about the way Mom was treated.
Because, like everyone else, I have a mom story. My mom died in palliative care in British Columbia more than three years ago — but the problems she had with health care and home care still are bright in my memory, and the fact is, she had a relatively straightforward and short time in the health-care mangle.
The pain and suffering was extreme, and almost did in my older brother, who took the bulk of my mother’s care onto his shoulders because the health-care system simply would not. Palliative care, as comforting as it finally was, was clearly overstressed and often seemed to be waiting for the next death to cycle a patient off the waiting list and into a basically still-warm bed. It was a conveyor belt of need and not a pretty one by any means.
With our population aging, there’s going to be more of that need, and less fiscal ability for governments to meet it.
Costs are rising dramatically and will continue to rise as new and more expensive treatments outstrip old, cheaper and less effective ones. As has been the case with advances in military battlefield medicine, we’re likely to see older, sicker patients live longer and cost more. A startling statistic during a report on CNN last week pointed out that five per cent of the U.S. population (the sickest five per cent) accounts for a whopping 50 per cent of health care spending in that country.
As the latest effort by Eastern Health to rein in costs gets underway, we can probably expect to brace for more than a few stories about new cracks and people who fall into them.
There are cracks aplenty across the country: people who can’t
get diagnostic work or other care quickly enough, wait lists that stretch out longer and longer and are only dealt with by solutions that look a lot like finger-in-the-dike, squeaky-wheel-gets-grease short-term special funding top-ups. The root rot is getting worse.
The only surprise is that, so far, the nation’s concern about health care has not coalesced into any sort of voting bloc.
Perhaps the problem is like the difference in this province between failures in the fishery and the closure of a paper mill: when a paper mill closes, one particular area is sharply affected, while with the fishery, a far greater pain (in terms of numbers) is spread out over a larger area, diffusing the direct impact.
Perhaps that’s why paper mill crises get immediate action, and fisheries crises tend to get “let’s wait and see what happens …”
Health care can only be “wait-and-see” for so long. Some people have stories about health care that has gone right, but almost everyone you meet has at least one story about how it has gone wrong, sometimes in small ways and sometimes, in far more dramatic and unforgettable (and unforgivable) terms.
Medical care in this country is a ticking political time bomb, and eventually, that care — or more precisely, the lack of it — is going to focus sharp attention on a government or two, maybe federal, maybe provincial, the way a small boy might use a magnifying glass to focus the sun on an unsuspecting ant.
God help the government when that happens.
Russell Wangersky is The Telegram’s
editorial page editor. He can be reached by email at email@example.com.