Denial: a refusal to recognize there is a problem, often driven by the false hope the problem will go away or to protect one’s vested interests.
The culture of denial in government, specifically in averting the looming health care crisis of an aging population taking up an ever larger proportion of the budget.
It is maddening to realize this when there are plenty of sensible ways to spend health care dollars more wisely. Yet nothing much is done to avert the misery many will experience when we continue on the present course, heading straight for a major crisis.
Compared to other developed countries, we pay top dollar for health care and receive, at best, mediocre value. With exception of the excellent care for acute, life-threatening situations, such as a heart attack or a major car accident, the wait times to see a specialist for serious, but not lethal illnesses are often ridiculous – a year or more is not uncommon. After seeing the specialist, the patient has another lengthy before surgery or investigations.
Then there are the overloaded emergency departments with lengthy wait times. Unless you are lucky, you’re often looked after by stressed out health care professionals struggling to serve their patients well and constantly running into roadblocks in the process. Top of the list: no beds, but also increasingly a shortage of health care personnel and equipment.
Since the inception of our once wonderful Medicare, I have seen a steady decline in the quality of care.
I am not talking about the astonishing technological advances, such as daycare gall bladder surgery – which used to mean getting a large painful abdominal incision followed by a 10-day hospital stay – or the heart, lung and kidney transplant advances, pacemakers, joint replacements, new and effective drug and many more techniques to fix what was unthinkable just a few decennia ago. All this progress has come with financial consequences for the government coffers. The government ‘solved’ the problem of paying for the expensive services by rationing and increasing health care premiums. In other words, we are forced to pay with time and money, yet things are deteriorating.
Those who can and are willing to pay to defray the cost of their own care instead of using tax dollars are denied that privilege by law in Canada and simply go to the U.S., India or Thailand instead. The alternative is to reluctantly join the queue and wait.
Many people who have experienced the shortcomings of our health services are wondering what the future will bring as they age. Is further deterioration inevitable? Not, if we come to our senses and take a hard look how we can allocate the health care dollar in a better way and change our culture of entitlement.
For years I have wondered why we think we need 13 ministries of health, one each for every province and territory, plus another federal one in Ottawa. And that is for a Canadian population of some 34 million people, half of that of France, That country has only one health ministry and runs a less expensive and more efficient system without the wait lists.
Just think of it: 13 health ministers, deputies, secretaries, offices filled with bureaucrats, all essentially performing the same tasks as the one in France.
We also have 13 licensing bodies, with their bureaucracies, overseeing the qualifications and performance of the physicians. Ditto for the registered nurses and all other professional licensing organizations.
Why does anyone think that my competence to look after patients changes when I cross the Alberta border? Why does anyone think that a person in Alberta has a different kind of appendicitis or heart attack than the person in B.C.? Are Alberta doctors held to a different standard than B.C. doctors?
I hope not.
Australia is a federation of different territories, but recognizes one Australian license. All Canadian physicians have to pass the same examination after years of training. Why then 13 different licensing bureaucracies?
We are paying an enormous amount of tax dollars and other fees for thousands of people often earning above average salaries, benefits and pensions for no increased benefit to the rest of us. Fossilized thinking and protecting vested interests are preventing a fresh look at how we deliver affordable health care when we need it, without bankrupting the system with unproductive activities.
Dr. Marco Terwiel is a retired family physician who lives in Maple Ridge.