Since I started writing about medical issues and the health care system over 5 years ago, I've said many times that health care planning must be looking ahead twenty years out.
Short term planning is all very expedient and politically correct and even necessary to some degree but the trouble is this usually leads to a culture of IBGYBG ("I'll be gone, you'll be gone"). I give full credit to the Economist's Matthew Bishop for this acronym and it is possible he found it somewhere else but for now I'll refer you to his article in The Economist, "The World in 2010- Now for the long term".
What about the here and now? Most assuredly, we must deal with realities at hand and decisions meant to improve current conditions are not only needed but quite noble. But misplaced nobility is not usually a good thing and has all kinds of unintended consequences driven by fully intentional and usually self-serving motives.
Heading into 2010, my hope is that health care leadership will understand the stark realities of a new economic world and the new financial realities facing our country and our Canadian health care system.
We cannot continue to spend the way our politicians have spent in the past several decades. This is not to say that public health care in Canada must be scrapped-definitely not--but we must understand that good citizenship requires more than paying taxes to government to have it spend it for us in a way that it sees fit. Good citizenship at all levels requires more understanding of how to be a responsible consumer or maybe even a "frugal consumer" of health care.
This "responsible health care consumption" will require education and expectation of the public regarding the new realities.
Let us not avoid uncomfortable short-term decisions but take action knowing that they must be part of the bigger long-term picture.
An article by Paul Vieira in the National Post today, "T is for Taxes", is well worth reading and refers to Generation T, where T stands for tax. The article describes what many Americans may be looking at in the future as value added taxes are looked upon as part of the solution there.
Although Canadians may not see the same sad face staring back at them when it comes to looking at their financial situation squarely in the mirror, we must similarly be aware that our fate is tied directly to the US.
If the past decade was the "Decade from Hell" as Time Magazine has described....pack some ice, the next 10 years are likely to pose some challenges that will require cool heads and long term vision.