Putting Health Back Into Health Care: A Health Advocates Perspective

Queens Park SPECIAL: Patients First Act

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Putting Health Back Into Health Care: A Health Advocates Perspective

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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In this day and age of political spectacle and scandal, we risk losing sight of truly significant legislative and policy developments. Case in point: Ontario Health Minister Eric HoskinsPatients First Act, now approaching its third and final reading at Queen’s Park.

To say Patients First will have a profound impact on the delivery of health care services is something of a vast understatement. Much of it is positive, such as the dissolving of the Community Care Access Centres and recognizing the significance of health equity. Still, there remains one fatal flaw. There is nothing contained in the legislation aimed at transforming our illness system into a health care system.

In particular, there is no definition of health contained in the Patients First Act. Neither are there any objects for health promotion. Both reflect the prevailing mindset that the key to fixing our health care system is to construct more hospitals and hire more doctors. While such investments will be helpful, the reality is unless we begin to address the core factors that fuel the demand for health care services , the hard truth is medicare will cease to be sustainable. It is akin to trying to deal with an overflowing bath tub by hiring more people to be the bucket brigade, rather than turn down the tap.

Bear in mind, of the top ten factors that most impact a persons’ health, ‘access to health care’ ranks tenth. Well below such key factors as income, social support, education. Hence, it should come as no surprise that of the 5% of Ontarians who require 2/3rds of all health care expenditures (pause and let that sink in for a moment), many are poor, malnourished and extremely socially isolated. Quite truly, our hospitals and doctors’ offices have become repositories for much of what ails our society. Many doctors will say as much.

BUT, there is good news. New promising programs funded by the Local Integrated Health Networks are emerging. The North Simcoe Health Link, for example, has reduced emergency room visits, hospital admissions, and costs by just under 40% in the span of just one year. The people they serve have a minimum of four serious chronic disease conditions, 88% live in poverty, half contend with hunger, and 25% have no family or friends. How? By addressing people’s real needs such as providing transportation, helping people access food, and combating social isolation.

Everyone wins. The people receive appropriate support. The net savings to the system far exceed the operating costs. The burden on doctors and hospitals is alleviated since they are no longer alone trying to contend with highly medically and socially complex people. And this latter point is critical, since no one is saying doctors and hospitals are not important. They perform a vitally important role in our health care system, and are often the strongest advocates for health promotion!

Of course, all of this is a mute point if the agencies the Liberals put in place to usher in the transformation of our health care system, Local Health Integrated Networks, do not have a clear legislative mandate to perform vitally important health promotion work, and fund its agencies accordingly. All of which raises the question of leadership. To which, I can think of no better response than that given to me by two brave elderly doctors who supported Tommy Douglas at the inception of medicare experiencing tremendous enmity, both then and regrettably even to this day.

When I asked why they broke rank with their peers, their immediate response, ‘because it was the right thing to do.’ One can only hope that our Premier, Health Minister and all members of parliament arrive at a similar conclusion, by giving the Local Health Integrated Networks’ the mandate to re-orientate our health care system by embedding health promotion into Patients First Act. Let’s put health back into our health care system!

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