Selling the notion of transformation of the health care system to governments will involve tough slogging, pollster Nik Nanos told the Canadian Medical Association’s 143rd annual general meeting in Niagara Falls, Ontario, on Tuesday.
Minority governments are generally not inclined to substantive policy debate and the current Conservative government headed by Prime Minister Stephen Harper has adopted a “hands-off” approach to health care, Nanos, the president of Nanos Research, told a special “political action” session on transformation.
Harper sees health care a provincial jurisdiction and the Conservatives can be expected to skirt the issue, as they have in refusing to penalize provinces for violations of the Canada Health Act. “In terms of engaging the conservatives, health care will be a little more difficult than many other issues,” Nanos said.
That’s compounded by the short-term thinking and acrimonious nature of the current Parliament, in which “gotcha politics and mudslinging” is the order of the day, Nanos added.
Canadians will also have to be convinced of the need for reform of the system. “It is imperative that Canadians start to understand what is driving increasing costs … and what are the possible solutions.”
To convince governments of the need for transformation, CMA will need to frame its vision in a way that appeals to Canadians as a “relevant, interesting and aspirational” measure, Nanos added. CMA will also have to careful that the blueprint doesn’t fall into the “administrivia of government-speak.”
To that end, Liberal Senator Jim Munson advised that ultimate message be crafted in the simplest possible terms and widely disseminated across the nation. “It’s what you say, how you say it and when you say it,” he said.
“And your message must be repeated and repeated and repeated,” said Munson.
Munson indicated that CMA will also have to put more meat on the bones of its blueprint but CMA president Dr. Anne Doig indicated that it was a “deliberate strategy” on the part of the association to avoid outlining specifics in the plan as it was believed that more general parameters would serve to engage debate.
Munson also argued that the transformation cause would be advanced if the CMA were to elect its presidents for a two or three year term, so that politicians could more readily associate a message with a single, more long-term voice.
In other developments, delegates passed motions calling for stricter controls on tanning facilities and greater access to prenatal screening tests. But they deferred a vote on a motion that advocated a ban on mixed martial arts fighting in Canada.
A motion calling on governments to “regulate the artificial tanning industry, with a focus on banning access to children and youth under 18 years of age,” passed easily after Ontario delegate Dr. Samir Gupta argued that a tan signifies neither beauty, wealth nor health, while the risk of melanoma increases by 75% for those exposed to tanning salons.
Another motion called on governments to “offer, promote and fund prenatal screening tests for the most common chromosomal abnormalities,” while a third urged installation of automatic external defibrillators in public facilities such as sports arenas “where feasible and cost-effective.”
But the delegates adjourned debate on a motion cosponsored by neurologist Dr. Ian Gillespie, president of the British Columbia Medical Association, that would advocate a ban on mixed martial arts fighting. Gillespie argued that the sport has resulted in a “silent epidemic of brain injuries.”
“By passing this resolution let us make it clear that Canadian doctors believe that any sport that has the intention of disabling an opponent by causing a brain injury deserve to be banned,” he said.
But Newfoundland delegate Dr. Shawn Tiller argued that a ban might backfire. “It will become an underground industry and if that happens, then our ability to monitor and regulate will go outside the window and I think that it will become a more devastating event. It’s not going to go away.”
Prince Edward Island, Saskatchewan, Newfoundland and Labrador, Yukon and Nunavut now ban mixed martial arts fighting, while New Brunswick allows it only in Moncton. Debate on the issue will resume Wednesday.
Footnotes
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Published at www.cmaj.ca on Aug. 25