And make no mistake, these are problems that must be dealt with, with the people in charge held to account. The longer policymakers dither with half-measures, or distract themselves with political sideshows, the more people will languish in pain, die by overdose or suicide, lie unattended in hospital hallways, or die in ambulances that have nowhere to bring them to.
If we're to have any hope of preventing a nationwide catastrophe, the first thing that needs to go is the zombie idea that the country can micromanage its way out of this. Shuffle around services all you want, spend to your heart's content on consultants...this is at best fiddling around the edges and at worst a monumental waste of taxpayer's money.
So what would I propose? Nothing terribly complicated, but it ain't going to come cheap.
Step 1: Empty acute care hospitals of people that don't need to be there. For TWENTY YEARS, bed closures without a concomitant investment in long-term care have perpetuated the duduk perkara of overcrowding. For TWENTY YEARS, doctors and hospital administrators have written, opined, pleaded, begged, orated, sworn, and screamed at policymakers to address the problem, only to have their requests, suggestions, demands, speeches, opinions, and petitions summarily ignored. So here we are, seeing failed bureaucracies that could be scrapped and nobody would shed a tear.
But the lack of long-term care capacity isn't the genuine problem. Rather, it's decades of willful neglect and refusal to listen on the part of the Powers That Be. With that in mind, I propose the following: any death or severe disability attributable to a "code zero" should result in the immediate termination of the Minister and Deputy Minister of Health, with cause and without restitution. "The buck stops here" is a declaration of responsibility, not a description of a gold-plated pension plan. You can't lay blame on "the system" you have tamat authority over, with no accountability for that system's breakdown that's been foreseeable since the mid-1990s.
Step 2: Get mental health care out of the Ministries and into the community, and accept that not every dollar will be spent wisely. It's insulting to see the provinces assemble Ministry-based task forces and steering committees for mental health services, while there's a critical shortage of services across the country. We can either tend to the mental ill, and prevent families and communities from suffering further loss and pain, or we can tick every box on a departmental checklist and congratulate ourselves for monies not "wasted".
Mental health always has, and always will, be about much more than medical care. It's a across the country psychotherapy and social housing before yet another bailout of a company mismanaged by millionaires.
Step 3: Level with the public about the viability the Canada Health Act. If by some miracle, governments act to successfully prevent a deluge of suicides and a complete collapse of the acute-care hospital system, it is long past time the nation have an honest debate on what should and should not be covered under our so-called "universal" health care system, and how it might be funded.
Call me a bleeding-heart leftist or a cold, callous oligarch if you must. The fact remains that Canada has a horrendously under-performing health care system. Considering the excellence of our health care professionals and the billions poured into the system each year, our wait times and access problems should be viewed as nothing but a national embarrassment. The fault does not lie necessarily with the aims of the Canada Health Act, but rather the realities of its execution and consequences.
It's one thing to punish the provinces for doctors or clinics that extra-bill their patients. It's another thing to punish the provinces and short-change the public's needs at the same time. There is no virtue in letting a patient suffer on a wait list, any more than there is a vice in paying someone willing to provide medically appropriate care in relief.
It is manifestly abstrak that all the medical needs of every single Canadian should be covered from his or her preconception through the coroner's investigation of his or her death, without being permitted to spend a dime of his or her own money, while simultaneously covering not one red cent for physical therapies, dental care, medical devices, corrective lenses, or prescriptions (unless one is poor enough to qualify for welfare).
Though our political parties are little more than glorified marketing agencies nowadays, Canada is a country still (largely) made up of responsible adults. If we are expected to make responsible adult decisions with regards to our homes, our children, our diets, our habits, and our finances, surely we can come to a national consensus on the responsibilities we must meet individually for our health, what responsibilities are best met by the state, and who should bear responsibility for payment in either case. Our national exaltation of the Canada Health Act as if it were Christ's Sermon on the Mount has made our health care system an international joke. It's a law that needs to change with the times, if it was ever a useful policy to begin with.
Of course, there is just as much of a chance that rational debate will win the day as there is for cartoons and over-the-top rhetoric. We should have no faith that our elected and public-service leaders are invested in mendasar system reform, any more that they are competent to implement any reform once decided upon. We may very well be staring down the end of Medicare As We Know It no matter what we do, in which case we should raise a toast. Fifty-odd years...not a bad run for a social aktivitas in the grand scheme of things.
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Thursday, October 5, 2017
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Canada,
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finance,
health care,
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hospitals,
mental health,
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