Critical time for health care says new CMA President

Figure. Dr. Collins-Nakai: A critical time for health care. Photo by: CMA

Although Dr. Ruth Collins-Nakai doesn't officially become CMA's new president until August 17, she has effectively been on the job since the Chaoulli decision.

“It's a critical time for health care in Canada because the way we react to this challenge may determine the future direction of health care,” says Collins-Nakai, a pediatric cardiologist and professor of pediatrics at the University of Alberta. “Personally, I don't ever want to see a situation in Canada where a patient cannot get service because they can't afford to pay. That's unacceptable.”

On June 9, the Supreme Court of Canada ruled in favour of a Quebec patient and Dr. Jacques Chaoulli, who challenged the province's ban on private health insurance for medically necessary services (CMAJ 2005;173:139).

Collins-Nakai, the first CMA president with an MBA, says that in the highly emotional private–public debate “you can move forward ... through the common ground, which in this case is putting patients first.”

“There are practical things we can look at without getting into pros and cons of a parallel private system,” she says.

For example, Canada can set acceptable wait times. As spokesperson for the Wait Time Alliance of Canada, Collins-Nakai says the Alliance's final report, expected to be presented at CMA General Council (Aug. 14–17), will be a “tool box for provinces.”

Other practical initiatives concern reducing some of the financial burden on Canadians who now pay out-of-pocket for about 30% of health care costs. “If we're going to increase private costs then we want to make sure [these] costs are minimized.” This could entail advocating for stiffer regulations for the insurance industry and the generic drug industry.

She also hopes to introduce preventive initiatives to make the system sustainable in the long term. In particular, she'd like to improve the health of children and encourage Canadians to exercise. Collins-Nakai literally walks the talk, wearing a pedometer to ensure she takes her 10 000 steps daily.

“We're going to have lots of fun this year,” says Collins-Nakai. Certainly, it will be busy. Although she's taking a sabbatical from the University of Alberta where she is a professor and clinician, she is beginning a Phase III multi-centre clinical trial involving 2000 patients for a new cardiac drug.