Much has been written and spoken lately about the sorry state of the Canadian health-care system.
The federal government laid down the gauntlet last month by issuing a statement regarding the amount of money they were prepared to spend on health care over the next 12 years. It was a take it or leave it proposition.
Prime Minister Stephen Harper was a no show at the premiers' meeting in Victoria. Apparently he doesn't like these meetings. Evidently way too much leadership is required at these types of functions and besides, his office had already fixed the message.
These activities, or non-activities, lead us to suggest that when it comes to the delivery process in health care, it's about time that self-interest items come off the table. It's time for the PM and the premiers to click in to the idea that this is not about power, it's supposed to be about service.
According to well respected researchers such as Neena Chappell (professor U of Victoria) and Marcus Hollander (National Health Services) of EvidenceNetwork.ca, health care costs as a percentage of gross domestic production haven't increased much, moving from 10 per cent in 1992 to 10.5 per cent by 2007.
The two debunk the myth that a growing senior population in any given province will result in increased health-care costs. They suggest a significant increase in senior citizens translates to about a one per cent increase and they take their numbers from the Canadian Health Research Foundation.
Instead, this duo state they believe higher costs in health care are being driven by technology, increased service utilization among all ages and wage increases.
Administration and political intervention can control any and all of these factors.
Costs in health are not being driven by uncontrollable factors such as population growth. They state that what the system really needs, is good policy, management and will.
Home care costs less than residential care, but is home care versus integrated long-term care more costly? There are good models to study.
Often a patient or client merely needs supportive care at the care site. The visit doesn't always require a doctor or a registered nurse.
Lately we have seen administrative models that reduce hospital time for economic reasons, but as the researchers are now telling us, if you push the patient out the front door of the hospital too soon, they end up at the back door two days later with further complications, thus increasing costs, especially if the home-care service and costs are cut too quickly.
The researchers are sending out a message that medicare works when there is a willingness to make it work and that's where the politicians mess up the picture with their own ideas of private services paid for with public money. They have their agenda. Predicting the demise of medicare is premature, it seems. Instead, we should be seeking more value for what we're already spending, and that's where administration and management come into the picture. We have lots of it in the medical system, unfortunately, and apparently a lot of it isn't very good.
But with the right political intervention with more honourable goals in mind, and with refined administration at work minus self-interest and power ... we still have a model of care that works just fine. We just need the right people to run the show.
Unfortunately it has become quite clear that the long sought leadership isn't going to be found within the federal ranks since the current regime in Ottawa is disinterested. The premiers are left to flail away at one another, embedded in their own motives that relate directly to the provinces and territories they serve.
So while politicians and administrators in Canada have the platform and the power, they are still missing that all important skill set and will.
