Harrisburg, the capital of Pennsylvania, voted to file for bankruptcy protection from its creditors in 2011.
Debt had soared, burdening the city with annual interest costs that eventually exceeded its budget. In June, Stockton, California became the largest U.S. city to file for bankruptcy.
Greece’s IOU has been called. To finance its debts, the government has announced new cuts almost daily, because nothing seemed to be enough. Youth unemployment had risen to 54 per cent. Hospital budgets were cut by 40 per cent.
Canada has been held up as the very model of the fiscally prudent nation.
Nevertheless, a downtown Montreal highway tunnel collapsed in 2011. The Champlain Bridge, attacked by road salt, has been slowly falling into the St. Lawrence River, piece by piece. Replacement has been delayed by its cost.
In Sudbury, Health Sciences North recently announced a reduction in scheduled surgical cases due to the slow but steady increase in Alternate Level of Care patients in acute care beds.
Are things better elsewhere? In Timmins, patients with mild and moderate home care needs have recently been compelled to remain in hospital due to the lack of community supports.
In Sault Ste. Marie, community services are not able to respond to urgent situations since they are fully booked and have significant waiting lists. Housing continues to be an issue.
The overall demand for community services grew by 10 per cent last year in northeastern Ontario. The North East Community Care Access Centre received a six per cent funding increase last year, but only three per cent this year.
Our seniors continue to age. The core issue of working conditions and wages for home care workers remains unresolved. The issue of affordable housing for financially disadvantaged seniors remains for the most part unaddressed.
There have been innovations – assisted living and Finlandia. Unfortunately, the scale of the problem dwarfs all the solutions advanced to date.
One number stands out. It is the percentage of total health care spending devoted to community care in Ontario. It is four per cent. To put that number in context, Canadian and US studies have estimated that more than 20 per cent of all health care spending finances treatment in the last six months of life.
Experimental cancer drugs, life support in intensive care units, invasive surgical procedures, and long and repeated stays in health care institutions are very expensive and often end up prolonging the dying process instead of saving a life.
Based on the Ontario government’s financial status, we should expect minor growth in health care spending.
Is this not the right time, then, to begin to re-examine how we spend our scarce resources?
One could argue that less should be spent at the end of life for heroic measures and more should be spent to assist our seniors in living independently and in dignity. Something to think about.
Dr. Peter Zalan is president of the medical staff at Health Sciences North. His monthly column tackles issues in health care from a local perspective.
