We must all work to find ALC fix - Dr. Peter Zalan

The Ontario Hospital Association’s trending data as of September 2010 shows there has been no overall improvement in ALC rates for Ontario hospitals over the past three years, despite significant efforts from the government, LHINs, hospitals, CCACs and community agencies. Approximately 17 per cent of hospital beds continue to contain ALC patients who could be better served and less expensively in the community.

We keep hoping that government will find a funding fix that will reduce public health expenditures while leaving patients satisfied with their level of services and out-of-pocket expenses. But we cannot leave it all up to government to find the way. Individuals must share some of the work.

Advocate for what you believe is important. Perhaps:
- a greater emphasis on caring in our health care institutions; this means higher staffing levels to permit time to be spent with patients;
- better pay and working conditions for personal support workers; 
- the construction of affordable supportive housing and group homes to care for our elderly and handicapped;
- timely access to a family physician; 
- shorter wait times for surgery and diagnostic procedures; 
- shorter wait times in the Emergency Department; 
- a much greater emphasis on physical fitness in school;
- a gradual restructuring of our communities to facilitate physical activity in our daily lives; and 
- the taxation of unhealthy eating and drinking choices and subsidies for healthy eating choices.

Then think about how to pay for these new services and infrastructure — because there is a big issue with a shortage of money to pay for it all. Ontario already spends more of its wealth on health care than most nations and the economy is in a downturn.

The Canada Health Act promises to deliver, at no cost to the patient, all hospital and physician services that are medically necessary — a financial commitment without limit.

A British Columbia surgeon, already operating a private orthopaedic hospital, has filed suit in a B.C. court for the public to be allowed to buy health insurance for private delivery of medically necessary procedures. If you have the money, you can jump the queue in Vancouver. Do we want Ontario to go down that path?

Alternately, do we want to develop sensible limits to the Canada Health Act? The government would fund all services that will lay within those limits. The individual and the private sector would deliver those services that lie outside the limits.

Ask yourself some questions. Does Ontario spend too much on health in comparison with other societal needs, too little on the education of our young and on caring for our elderly, too much on expensive individual health needs in comparison with less expensive public health needs and too little on enhancing the quality of life? Should Ontario raise taxes or incur more debt to fix our health care system? Should there be an expanded role for the private sector to fund what the public system cannot afford? If so, what role should the private sector play?

That is a lot to think about.

Dr. Peter Zalan is the president of Sudbury Regional Hospital’s medical staff. This is the sixth and final weekly column Zalan has written about the city’s ALC crisis.