Canada, Laggards in Health Care: OP Ed

health care OP Ed, Commonweath Fund
Canada, Laggards in Health Care: OP Ed
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About the Author

Gary J. Machan

Gary J. Machan

Gary Machan serves on the Community Advisory Research Committee for the Canadian Index of Wellbeing. Through the course of his career he has received several provincial awards including the 2nd Stage of Medicare, Ontario Tobacco Network Innovation Award for Excellence, and Food Champion Award. In addition, Mr. Machan is an associate with the Centre for Inner Freedom where his work was featured by Tom Harpur in his best selling book ‘Finding the Still Point’.

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We’re third. We’re Third. We’re THIRD LAST. So says a recent major study issued by the Commonwealth Fund comparing health care on a variety of measures amongst the most affluent nations.

True, we moved up from second last place. But still, not exactly a feat to be popping the champagne over is it?

That America ranks dead last should come as no surprise given they are an evidence free zone in which ideology ‘trumps’ reality. What should be of real concern is that even though Canada outspends many of the top performers as a percentage of GDP, it has little to show for it at the end of the day. Not as bad as Trump land, but nothing to blow our trumpet over.

And so why are we the health care laggards on the international stage? According to Eric Schneider, Senior Vice President for Policy and research at the Commonwealth Fund, the key domains that are serving as a drag on Canada’s performance are access, equity and health outcomes.

If one takes dental care for example. In most affluent countries, one’s mouth is considered to be a part of one’s body. Ergo, people receive dental care, unlike Canada where many people fall through the cracks. In Canada, the great minds opted to treat the manifestations of untreated dental decay with unnecessary hospitalizations, antibiotics and pain medications.

Of course, this is assuming people can afford medications which isn’t always the case in Canada. Instead, our doctors prescribe medications that many people cannot afford and therefore wind up in our hospital system. People with psychiatric issues are a prime example of a revolving door that has a great cost both to the taxpayer and to the afflicted whose treatment at times can be inhumane.

In this regard, the province of Ontario deserves some kudos. The newly announced Pharmacare program while not being as extensive as one might hope is nevertheless a step in the right direction in so far as expanding the social safety net for those in greatest need of receiving support for medications.
Likewise, through the leadership of the Association of Ontario Health Centres, the province is to be commended for enacting legislation which will hold the Local Health Integrated Networks accountable for placing far greater emphasis on health equity in its planning and delivery of programs and services.

And yet, even here one has to be cautious. It is one thing to pass legislation, yet it is entirely another thing to implement it. In fact, it is not uncommon for governments to defund the very things legislation is telling them they need to do more of i.e. instituting preventative programs, at the same time as increasing funds for those which they are to use only as a last resort.

In this regard, measures that hold funders accountable is of extreme importance. For, as the late great Canadian economist John Kenneth Galbraith once advised J.F. Kennedy, “what you count, counts and what you don’t count doesn’t count”. No truer words were spoken.

Bottom line, we need a lot less measures on medical procedures, and a lot more measures on the things that fuel the demand for medical procedures. Things such as income, housing, access to food, social isolation, precisely because of the 5% of people who require two thirds of all health care funding, these are their real issues.

It only stands to reason that dealing with these essential needs will result in everything else will falling into place. Moreover, it need not be expensive. Case in point is the outstanding work Community Health Centres do to combat social isolation and exclusion. Work that is but a fraction of the cost of acute hospital care, far more humane, and far more effective.

Ultimately, the key finding is its health equity.

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