OP ED: Health Care – how to control the costs

health care
OP ED: Health Care – how to control the costs
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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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Today health care consumes 42 cents of every dollar spent on provincial programs. This increased from 35 cents since 1998, and barring a major course in direction, it is estimated that 50 cents of every provincial dollar will go to health care by 2030. Most would agree this is neither desirable nor sustainable given its impact on other vitally important social programs.

Now, one might be able to justify our ever increasing investments, if Ontarians were reporting higher levels of health and wellbeing. The trouble is we are not. While we are living a little longer, we are sicker. And we are getting sicker at a much younger age. In fact, this is the first generation of youth to report lower physical and mental health status than any other generation.

Several major chronic diseases are increasing at alarming rates such as type 2 diabetes. This entirely unacceptable since 90% of lung illnesses, 80% of diabetes, and one third of cancers are entirely PREVENTABLE. There is for good reason the Auditor General slammed the provincial government in her latest report for the complete lack of leadership and proper investments in health promotion work.

All of which begs the question, why? Short answer, Ontario doesn’t have a health care system, but an illness system. Its investment in health promotion and prevention is so miniscule as to be laughable (either that or crying, take your pick). The fact that our hospitals are experiencing such immense pressure is largely a self-fulfilling prophecy generated by poor and short sighted social policy.

Imagine our health care system to be an overflowing bath tub. The smart money would be to invest in prevention and health promotion interventions including wise social policy aimed at turning down the amount of water entering the tub. Unfortunately, the prevailing Humpty Dumpty mindset dictates what is required is better paid doctors and more hospitals to serve as the bucket brigade.

Never mind, there is absolutely not one shred of evidence that you can medically treat poverty, hunger and social isolation. This critical to understand since of the 5% of people who use 2/3rd of all health care expenditures – just shy of one quarter of all government expenditures – the majority are poor, hungry, and socially isolated. Ironically, they can afford health care, but not to be healthy.

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Only here is the thing. Not only would it be a lot more humane to increase investments in such social programs as the Canadian Pension Plan, it would be a lot more cost effective. Does anyone honestly believe it is a good thing for a senior to try and get by on $ 12,000 per year, not be able to afford dentures, and therefore suffer from malnutrition because they are forced to subsist on such fare as ketchup soup? Next thing you know they are in the hospital.

Never mind, what political stripe or ideological persuasion, it is just plain dumb.

Granted, if this was the exception, one might be able to turn a blind eye. But it isn’t. Not by a long shot. As much as some doctors might like to think and carry on like they are Gods, they aren’t. Furthermore, no amount of technology, information systems, or even drugs will make our health care system viable over the long haul. Ontarians need to hear the temperature is fast reaching the boiling point.

In truth, there is only one way forward. And that is to heed the advice of the founder of Medicare, Tommy Douglas who stated, “I am concerned about Medicare, as many people are, not with its fundamental principles, but with the problems we knew would arise.” He continued. “There were to be two phases of Medicare. The first to remove financial barriers between those who provide health care services and those who receive services. The second was to adapt our delivery system as to reduce costs through prevention.”

It says here that the extent to which we pay heed to Tommy Douglas’s prophetic words will determine whether you and I will have access to a health care system worth having at a time when we most need it. There is no other way that won’t involve a death by a thousand cuts for the simple reason you cannot have healthy people in unhealthy communities spawned by a toxic culture.

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Readers Comments (1)

  1. hugh wilkinson says:

    You are absolutely right, of course; we should be directing a much larger proportion of our government budgets towards ‘prevention’ of disease. Common sense would suggest bold initiatives to tackle the obvious factors associated with 1. air quality 2. food and nutrition 3.exercise 4. other environmental pollutants.
    A perpetual issue which confounds easy solutions is that in any ‘market driven’ system demand tends to lead supply, and resultant ‘growth can strain the means of sustainable production.
    Government must thus have tough standards and regulation to make sure the supply of basic essentials for healthy living are in sync. with our needs. Unconstrained population growth can unfortunately put strains on the sustainable supply chain.


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