People and health care — what governments miss

Russell
Russell Wangersky
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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 rwanger@thetelegram.com.

Organizations: CNN

Geographic location: Canada, Alberta, British Columbia U.S.

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  • Ron Tizzard
    June 10, 2012 - 09:59

    It's a rare mortal, who is actually able to go through life without visiting his/her MD; and/or being treated in/admitted to hospital. These services locally, my opinion (a mature senior) , do a spectacular job...albeit, not all can be saved; nor can Medical services generally be held liable for the abuses 'rational humans' thrust upon their own bodies via absolute share neglect through killer life-styles, food selections and general disregard for their own responsibility for care and repsect for their own general health and well-being. People, we should hold ourselves accountable, more often than not, for our need to visit heath care practitioners and facilities in the first case. Medical Practitioners are not magicians; nor are health facilities places for providing miracles...while all of us, in truth, have witnessed, or have heard stories of rea/virtual miracles happening from time to time...and we thank God for our hospitals and statf. We just completed the Janeway's annual fundraising telethon (another tremendously, successful event). That telethon was, among other things, our vote of confidence in our children's health care system, in this province. As many miracles happen daily, as well, throughout our adult oriented health care systems; could there be improvements; for sure, they are services and facilities created and operated by humans...never perfect! But, grossly more often than not, they get it right...'real' medcal services and staff are not creations of Disneyland...in the real world, medical staff, and their sciences deal with mis-adventures brought upon individuals themselves through poor diets, lifestyles and heredity. That's the human side of things! The other side is the political side i..e. the political system's provision of sufficient statt and opportune services to provide services. It is very important that one makes that differation in ones' criticism's The bottom line truth...is that the vast majority of our own visits to hospitals are as a consequent of our own mis-adventures and neglect of our physical well-beings. Most times, from a medical perspective, we are our own worst medical-caretakers. Guaranteed...the hospital and staff will be waiting for you as you mess up, or God-forbid you have a crtical medical incident. Systems are systems, systems are in constant states of review and upgrades. I would suggest that the health care system, our health care system provides a tremendous service...if you are in doubt..do a self-analysis; what is/was your role in any dis-service? I would suggest that you not try to mix politics with health care topics... health care will get lost every time in the political vageries of that "dust-up".

  • David
    June 03, 2012 - 09:02

    What you're missing --- not governments --- is the reality of health care as a political issue. At any one time, not enough Canadians are affected by the outright bankruptcy and poor opertiaons of it to hold government acocuntable. Young people don't care at all, older citizens who are still healthy delude themselves that they would get timely treatment when needed (or that they're actually immortal...a similarly unlikely outcome), and most sick people are too scared at that point to 'rock the boat'. So empty promises at election time are all that's needed to get what politicians want......et voila: Canada's Health Care System. A mythical national symbol, a political football like no other, an inevitable revelation waiting for each one of us when the time comes.

    • Ron Tizzard
      June 11, 2012 - 08:02

      I hear you David...and gree with your broad 'political interpretation' on our, or for that matter, any health care system in the democratic regions of the world. From my perspective, however, a local-issue comment, I stand by my comment . One could argue, from a global perspective that any system, let alone Health, and as a domain of 'public service', would be subject to variable degrees of 'suspect re: integrity and 'soulful' provision of best care or intention (the latter particularly' in this instance i.e. is government e.g. our government taking 'best care' of us. Politically, opinions are wide open from an individual perspective i.e. one's own particular health status, our communities', our local provincial/national status vis a vis provision of health care. Viewing health services through a global political 'lens', one is always suspect due to the variability of 'frames of mind' i.e. ones degree of wellness on any given day. That said, I agree with you 'from a political perspective'; 'as an individual, lying in a bed in our health domain I feel safe in suggesting that our health care provisions are second to none...most particularly due to the very high levels of competency and 'personal care attention' offered by our health care providers..second to none I would suggest. I state that strongly, not as an afront to you at all, but from personal perspective...having worked within the systems, and from the 'high esteem' to which our health care systems are held, particularly by those who have had to rely on the services. Generally, I respect your comments...'by the each' as we often say...in this province.