Quality health care comes at a price - Dr. Peter Zalan

How does the Canadian public view our health care system? The Environics Institute recently addressed this question. The institute conducts public opinion surveys on important issues of public policy.

Here is the first question: “What is the predominant problem with our health care?” The public believes that it is poor management rather than inadequate funding, because our country is said to have an expensive, underperforming system by international standards.

Another question asks: “Should Canadians be given the right to pay out of pocket for faster access to procedures such as surgery and MRI?” The 1,500 surveyed individuals were evenly divided answering this question.

This is a practical question. There are long wait times for many types of elective surgery that are not singled out for special funding. We now have unemployed surgeons who graduate from their training programs, but cannot find a position at a Canadian hospital.

Hospitals cannot provide potential surgeons and surgeons who are already on staff the necessary resources to shorten wait times. Health Sciences North (HSN) has operating rooms sitting idle for this reason. I am sure no one would design such a system on purpose.

Nine in 10 surveyed agree that government drug plans should provide coverage for any medication that patients and their doctor agree are the most effective treatment. This would dramatically expand current benefits and increase costs.

Less than 50 per cent express support for raising taxes. Only 24 per cent endorse cutting back on the types of services that are currently free to the general public. In plain terms, Canadians would like more services without paying for them.

If that is the case, who will pay for increasing the quality and capacity of home care services and nursing homes? In Sudbury, there are wait lists for home care, long-term care and home physiotherapy.

Think about the potential needs of folks who did all the right things: avoided cigarettes, drank and ate in moderation, got lots of exercise. Their life expectancy in Ontario is now estimated at 90.

Will their personal savings and pensions for 25, 30, maybe 35 years after retirement prove sufficient to provide a safe place to live and a wholesome diet? Many will require help to enable them to live out their lives in dignity.

Who will pay for progress? In HSN, we have just inserted our first implantable cardioverter/defibrillator (ICD). An ICD uses electrical shocks to help control life-threatening heart rhythms, especially those that can cause sudden death.

A rare procedure called ECMO was used to save Terrence Sutherland’s life at HSN. ECMO is a process where the patient’s blood is circulated through a machine that pumps in oxygen.

The patient’s lungs were too infected to do the job. In the past he would surely have died. Mr. Sutherland went home. He is 33 years old.

Believing that you can get more services without paying for them is not a credible option.

Nevertheless, Canadian political leaders remain very reluctant to raise with voters the difficult questions around the need for higher taxes, user fees, and/or limits on publicly financed services.

After all, the public plainly does not support these policies. Thus public announcements focus on the need for system re-organization and increasing efficiency. These are worthy goals, but nevertheless, insufficient goals.

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.