Repost from CBC: My father’s death, and why we all need to think about what we cost the health-care system

Repost from CBC. Originally posted March 27, 2018 My father’s death, and why we all need to think about what we cost the health-care system

Your suggestions & ideas are invited!


5 thoughts on “Repost from CBC: My father’s death, and why we all need to think about what we cost the health-care system

  1. Fantastic and challenging conversation to open Donna. Our scenario planning work at S2S has brought us into the heart of Alberta Health Services, primary care networks (PCNs) and the provision of affordable housing for seniors – ALL of which explored the nexus of aging and healthcare. I have also been told that nearly 25% of Alberta’s health spending is directed toward providing care in the last two years of patients’ lives. Taking personal responsibility, prevention, fee-for outcomes, home-based delivery – there ARE ways to make it all better.

  2. The responses to this article were overwhelming. I’ve heard from dozens and dozens of Albertans, on social media, and privately. And, I remain open to hearing your ideas and experience.

    Let me share a few ideas with you, on a no-names basis:

    1. Stop weaponizing healthcare. Stop demeaning healthcare practitioners in cheap PR stunts. Treat them like police, firefighters – they too put themselves on the line mentally and physically to save lives

    2. Patient focused healthcare can reorient the healthcare culture – check out the work of this Alberta based group – Imagine – among other things, they are working to make electronic medical records available not only to the providers but to patients

    3. From the voice of experience: Any “reasonable” constraint on health spending excess will only come when consumers understand that not all intervention is value added for them
    4. A March 29th 2018 poll (how timely is that!) by Ipsos, commissioned by the Canadian Constitution Foundation: A strong majority of Canadians believe that when a provincial healthcare system has failed to provide timely medical treatment, then patients suffering on wait lists should have a Charter right to pay for private treatment.

    5. Follow the Supreme Court of Canada cases. In the 2005 case of Chaoulli v. Quebec, the Supreme Court of Canada ruled the rights of Quebec residents were violated by provincial laws that forced citizens to wait for healthcare, while denying them the right to access care outside of the government system. Chaoulli was ultimately decided on the narrower grounds of the Quebec Charter of Human Rights and Freedoms, so the ruling was confined to that province. Cambie Surgeries Corporation et al. v. Medical Services Commission et al. is a constitutional challenge currently underway in British Columbia to bring patient choice to Canada’s healthcare system.

    Keep your ideas coming!
    Thanks, Donna Kennedy-Glans

  3. Great question, Donna…

    The issue is incredibly complex. It suffers from people positing simplistic answers based on a shallow understanding of how things work; e.g. there too many (or too few) health boards, too many managers and layers of management, doctors are overpaid, etc. And my knowledge is also shallow.

    As you write, suggestions to change the current model inevitably are met with fierce resistance. There is distrust—much of it legitimate–of what it could lead to, including a breakdown of the basic principle of universal and equitable health care.

    What do we know? Health care costs keep growing at a rate far exceeding population growth and inflation. They’ve become the single largest budget line entry in provinces. If we don’t start taking some action now, the problem will continue to grow.

    Science has enabled us to live longer. But at what cost? Is cost not a factor? It seems taboo to even suggest that it should be. But how much $ should we put into treatment (drugs, surgery, radiation, chemotherapy), esp. when the disease is fatal and/or the patient is suffering… or for treatment that has not been shown to be effective. Science will continue to deliver new treatments, patients (and esp. their families) will want to try them, doctors will oblige. Talking about this opens up a real hornet’s nest, but IMO needs to be discussed.

    We seem to lurch from one model to another every 5 years. That doesn’t help.

    I think we need..
    1. to look at (and adapt) models elsewhere
    2. have a better balance of preventive care and actual care
    3. have tough discussions re end-of-life care
    4. have more flexibility in terms of who’s allowed to administer care and treatment
    5. be open to the greater use of alternative (i.e. non-govt) solutions

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