Don Martin: Alarms going off over health-care privatization? Such an out-of-touch waste of hot political air
Please, let’s not follow the same old formula.
That would be the traditional microphone-hogging parade of premiers whining on national television about having the constitutional responsibility of delivering health care without a fully paid-up federal partner.
That charade would be followed by the prime minister declaring his version of a funding fix for a generation, which will actually only buy a few years of quiet time before the bellyaching ramps up and the next health-care crisis begins.
But, sadly, this appears to be the set-up scenario for Tuesday’s opening round of health care-negotiations where Prime Minister Justin Trudeau, who is badly in need of a political win at any cost these days, is set to deliver billions of new and conditional funding to provinces and territories before everything goes back to normal. Which is to say, broken.
There is, of course, no overnight monetary solution to the intractable problem of caring for an increasingly elderly and unhealthy population with dollars falling behind rising demand and inflation.
Every probe into improving health care over the last five decades has recognized and recommended urgent reforms. But the three wise men – Emmett Hall, Michael Kirby and Roy Romanow – have seen their decades-old recommendations for better efficiencies, less top-down administration, improved fee-for-service and changes to the way doctors are paid all kept inside a single-payer system, basically dusty-shelved.
And still age-old counterproductive realities remain – and worsen.
'A VICIOUS CYCLE'
Without improved home care, you can’t ease pressure on long-term care. If you can’t expand decent long-term care, you just fill up hospitals with people who shouldn’t be there. When regular hospital beds are full, patients overflow the emergency wards. And that leaves paramedics stuck with patients, some with minor ailments, until an overworked physician finds a corridor bed so they can return to their urgently-required ambulances.
And so it goes, a vicious cycle with sick Canadians dying for better care.
Even when staffing resources could be adequate, they’re wasted. Millions of Canadians are scrambling to find family doctors, for example, but those doctors are forced to spend far too much time on paperwork instead of patients. And they work under a compensation schedule which rewards bringing patients into their office for a paid appointment even when an unpaid text message or email response would suffice.
Meanwhile, doctor specialization is rewarded handsomely while family practice and psychiatry are not, despite similar training. Dangling a future as a general practitioner in rural Canada, where hours would be long and vacations short, is a hard sell in medical school.
And yet, what is the unholy holler about in the political realm ahead of Tuesday’s summit? Yup, five alarms going off over privatization.
Such an out-of-touch waste of hot political air that is. If you can’t access an emergency ward and don’t have a doctor, you head to a walk-in clinic which is, like most doctors in this country, a private enterprise.
If you need a hernia fixed in Ontario, chances are you’ll join the 7,000 others who go to the privately run Shouldice Hospital every year.
If you need cataract surgery in Alberta, you’ll probably go to the private Gimbel Eye Centre.
And if you want any diagnostic or scanning done quickly in Montreal, whip out your credit card and you’ll jump to the front of the line within days.
Privatization is a vintage bogeyman. Not only does a government-covered procedure in a private clinic not violate the Canada Health Act, but recent polling shows the public no longer sees the use of a for-profit provider as the axe coming down on the sacred medicare cow.
So here’s hoping Tuesday’s political parade goes off in non-traditional directions with premiers accepting strings on a fair federal settlement to reform, streamline and enhance this ailing system.
The Trudeau government has correctly identified the priority areas where the money should go and is right to demand a way to link their contribution to better results. If successful in these negotiations, Trudeau’s signature accomplishment awaits.
Premiers, in turn, understand they face a fed-up and aging population who see fixing health care as a non-negotiable, vote-defining demand.
The chances Tuesday will end with the blueprint to realistic long-term improvements are only marginally better than believing China’s balloon was simply collecting atmospheric temperatures, but it’s clearly time the 50-year-old dream of medicare as a Canadian birthright stopped being such a nightmare for so many patients.
That’s the bottom line….
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