Tuesday, October 03, 2006

Conversation on Health


I am writing in response to your forum on health. I applaud the government for taking this initiative, which I think is long overdue. The fact is that our current health care system simply isn’t sustainable and the reason is one of demographics.

I am a 40 year old who has lived most of his life in British Columbia. I have an 80-year-old mother, a wife who is about to turn 41 years old, a ten-year-old son and a five-year-old daughter. I have watched the accessibility of our health care system steadily decline over the last twenty years despite the fact that every government be it Socred, NDP or Liberal has increased Health care budgets year after year.

I remember looking at some statistics a few years ago that said the average 18 year old costs the BC Health Care system $800 per year while the average 80 year old costs the BC Health Care system $21,000 per year. The fastest growing demographic in BC are those aged 80 and above.

Thanks to our relatively mild climate, British Columbia is the retirement destination for many people right across Canada. But now the front end of the baby boom has just turned 60 and as they retire they are flooding into BC.

The problem is that as retirees the amount they pay in taxes will be far less than what they paid when they were working. Conversely the amount of public health care services they will consume will steadily increase up to the point that they die.

Recommendation # 1 So every retiree who moves to BC is in effect helping relieve the health care burden of the province they have moved from while adding to our own. Canada’s system of transfer payments needs to take this situation into account.

Many of the people who move to BC are relatively wealthy. They need to be in order to be able to afford our ever-increasing real estate prices. Yet the Canada Health Act acts to try and restrict people from obtaining private health care in BC. These people then seek private health care treatment in the United States or even abroad in countries like India.

The antipathy towards private health care stems not from any logical reasoning, but from a knee jerk reaction against “US style health care.” Unfortunately given Canada’s proximity and insecurity regarding our neighbour to the south it has been virtually impossible to have any sort of intelligent or realistic discussion about reforming Canada’s health care system.

The fact is that if we could tear our myopic gaze away from the United States we would see that virtually every other nation in the Western World has some form of mixed private and public health care system that provides health care to all its citizens and often far more efficiently than does Canada’s.

Recommendation # 2 We need to look at Australia and Western Europe and their models of mixed private and public health care in order to come up with a health care system in BC that is both accessible and affordable.

There is a joke that the best place in Canada to have a heart attack is in a taxicab because odds are the person driving the taxi is a doctor from some other country. As Shakespeare wrote centuries ago, “much said in jest said in truth.”

The fact is that Canada’s current health care associations and regulatory agencies act as a huge impediment to health care professionals being able to actually practice medicine here. Time after time I have come across instances of people who either gave up on Canada and returned to the United States, Europe or wherever, or who ended up switching careers and who became accountants, lawyers and yes taxicab drivers because they gave up trying to get licensed to continue working as doctors or nurses.

Recommendation #3 The protectionist policies of both national and provincial health care professions and regulatory agencies have to come to an end. Health care professionals who move here from other countries should have the process of being certified expedited rather than face an insurmountable wall of red tape and delay.

It has been said that freedom begins with choice. As self-employed person if I am injured I am expected to remain and suffer on a public surgical waiting list even though this may mean the loss of everything I own. However if I am an employee, and the Workers Compensation Board covers my injury, then I am whisked into a private medical facility so that I can be treated right away.

This is because if I am waiting for surgery as a worker WCB has to pay me for my lost wages, but as a self-employed person I receive no such coverage. This is both discriminatory and hypocritical.

Moreover it is no more moral to let a person die because they were on a lengthy medical waiting list than it is to let them die because they could not afford private health care. The best health care systems are those that allow the wealthy to access private health care while freeing up space and resources for the rest of us less well off citizens.

In fact in smaller communities a robust system of private and public health care dollars would allow for greater synergies and economies of scale. Thus a community that could at present support only one orthopedic surgeon on the public rolls may find sufficient work two support two if those people were also allowed to practice private medicine as well.

Recommendation #4 Canada needs to amend the Canada Health Act to allow for the full development of private health care facilities and services here in Canada.

This last recommendation of course will have certain people ranting about US style health care, but in fact what I am advocating is European style health care.

In closing I hope that not only the Government of British Columbia, but the Government of Canada will listen to these recommendations. Far from being a threat I see the recommendations as saving our health care system.

Without such change then our public health care system will surely collapse under the weight of our aging boomer population base. As it collapses, a lot of people will die and not all of them will be Octogenarians. Some, as we have seen already, will be young people in the prime of their life who needed urgent medical care but were unable to receive it in time because of overflowing emergency wards.

Thank you for providing me with the opportunity to share some of my thoughts regarding our beleaguered public health care system.