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EDITORIAL: Health care under pressure

While Central Health brought a self-care assisted training program for home dialysis treatments to Fogo Island in 2015, the dialysis patients on Fogo Island prefer to travel to Gander to receive treatment at the outpatient dialysis unit at the James Paton Memorial Regional Health Centre.
While Central Health brought a self-care assisted training program for home dialysis treatments to Fogo Island in 2015, dialysis patients on Fogo Island prefer to travel to Gander to receive treatment at the outpatient dialysis unit at the James Paton Memorial Regional Health Centre. — File photo

It’s one small story out of many, and a familiar one, too.

That doesn’t make it any less difficult or painful, but there may be more situations just like it on the way. Many more.

Residents of Fogo Island want full-time, traditional dialysis service on the island, and it’s easy to understand why: right now, island residents who need dialysis and want the usual treatment face a three-hour drive each way to Gander, a process complicated by weather and the vagaries of the provincial ferry system. It’s a trip that some patients are making twice a week, even though the province has tried to lessen the travel burden by purchasing home dialysis units.

The home units haven’t solved the problem.

“Some people have tried it, but they were very uncomfortable and nervous with it. They have discontinued using this home system to travel to Gander,” Fogo Island Mayor Wayne Collins told The Central Voice. “And with the risk of something going wrong, the patients rightfully don’t feel comfortable doing it themselves.”

That doesn’t mean it’s fiscally feasible to bring full-scale dialysis to the island.

Financially, it’s next to impossible to hold onto the services the province’s health-care system currently has, let alone add new expenses, no matter how much they would benefit residents in need of care.

 “When you look at the expenditures government would have to undertake to bring this here, you can understand where they are coming from, but it still doesn’t do anything to improve the comfort of the patients here,” Collins said. “It’s very unfortunate because the added costs to a patient on Fogo Island versus a patient elsewhere is astronomical to say the least.”

It’s a microcosm of a bigger issue. Health care is the provincial government’s single largest expense, the province is desperately strapped for cash, and as the population, particularly in rural parts of the province, ages and shrinks, the cost per patient grows.

Financially, it’s next to impossible to hold onto the services the province’s health-care system currently has, let alone add new expenses, no matter how much they would benefit residents in need of care.

So what’s the choice?

Reduce services? That would save money, but in addition to putting lives at risk, reductions in rural support services would also move well-paying jobs away, making communities even less viable.

Move patients in need of treatment, or that treatment itself, further and further away from rural areas, centralizing even more? That adds still more strain to patients, who either have to travel for care or make the expensive decision to relocate — a decision that’s even more difficult if they can’t sell their existing homes for a reasonable amount.

With oil prices trending low and the corresponding impact on the province’s finances — and with the fiscal strains of promises like insulating ratepayers from increased electrical costs because of Muskrat Falls — we are more and more going to find ourselves between a rock and a hard place.

We will hear more of these stories.

We don’t have the fiscal flexibility not to.

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