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Now Means Now-Time for more patient-driven health care

Posted Apr 09 2009 7:13pm

Well, after a hiatus from my blog with just enough time for reflection on what is important and what is not, it strikes me that the media is terribly good at coming up with catchy headlines and phrases on the economic woes without demonstrating much  solution-oriented substance. I suppose it is a sign of the solution vacuum out there, particularly when it comes to health care.

One cutsie headline reads "Ontari-owe", and another conjures up images of the dirty thirties with rusted out tractors in fields of dust, "Big spending, rusty economy".

As one faithful reader pointed out in the last journal entry, Glen Hodgson of the Conference Board of Canada  suggests that "A lot of people would like to return to the Old World" but the Old World is gone. "This is a catalytic moment for the province," he said and "needed tax reductions would not see the light of day until Ontario decides what to do about health-care spending, which is growing at an annual clip of 8% to 10% and is the single biggest expense item in the budget."

It is clear to me that what we have so far in health care transformation is not patient driven. Government sells the changes as patient centred...but let us not delude ourselves. Taking tax dollars, delivering some form of rationed health care while we pretend we have universal, portable, equitable, comprehensive care doesn't make health care patient-driven. Just because it is seen to be "free", doesn't make it patient-driven.

The public is going to have to understand the cold hard facts at some point in the very near future. Right about Now would be a good time.

Tim Hudak, a contender for the provincial PC leadership points out several facts:

*It took from Confederation to 2002 for the Ontario government to take the provincial budget to $68 billion

*This year Dalton McGuinty will oversee spending skyrocket past $100-billion

*Ontario's debt burden is more than $170-billion

*Program spending has increased 50% to $87.4 billion, or 8% per year, since 2003

*the Liberals have installed excess spending that now exceeds $17 billion a year-spending that will now drive the province into serious deficits

*experts like Warren Buffet are warning that a return to high inflation could result from quick-fix solutions ending in skyrocketing borrowing costs and deepening the financial hole

*Public services, especially health care, are only beginning to grapple with the surging demand and increased costs stemming from the retiring baby boom generation

Hudak suggests we need to cut taxes, reduce red tape and make government more productive, responsive and efficient.

I would suggest that all three options above are necessary in health care but instead we have seen more government driven transformation that involves more red tape, more taxation and which has resulted in a complacent physician work force content to believe that they will be taken care of and lulled into their roles as gatekeepers for government.

Doctors for Medicare is a prime example driven by the concept that what is needed for improved health care is more taxation and that the rise in GDP will sufficiently offset the costs of future health care. How wrong they are likely to be.

What is needed is for patients and the public to fully understand what is ahead and to prepare and take responsibility. Now if only somebody would tell them.

Richard Florida, McGuinty's advisor, may well believe that the future of Ontario is in creative endeavors. He may be right but as long as we cling to the old way of doing things and the old structures in health care that stifle creativity and are government driven, we are destined for a downward spiral. Ontari-owe may turn  into Ontari-ouch.

Thanks for reading along and Happy Spring!


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