All eyes on Alberta

Roger Collier

doi:10.1503/cmaj.109-3165

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Rearranging the deck chairs
Ross C MeElroy

Posted on: 12 March 2010

Posted on: (12 March 2010)
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Rearranging the deck chairs
Ross C MeElroy, Tavistock ON
Attempting to address Canada's clearly financially unsustainable health care system by focussing on centralization or regionalization is analogous to rearranging the deck chairs on the Titanic. A reality check! Between 2000 and 2009 the Federal Government's revenue increased 41% ($165 -$233bil) (1), the Ontario Government's revenue increased 44% ($63-$90bil) (2) and Ontario's health costs increased 85%($22-$40.7bil)(2). R...
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Attempting to address Canada's clearly financially unsustainable health care system by focussing on centralization or regionalization is analogous to rearranging the deck chairs on the Titanic. A reality check! Between 2000 and 2009 the Federal Government's revenue increased 41% ($165 -$233bil) (1), the Ontario Government's revenue increased 44% ($63-$90bil) (2) and Ontario's health costs increased 85%($22-$40.7bil)(2). Regionalization or centralization has only modest potential to address the underlying causes of financial unsustainability.
Contributing to unsustainable health care expenditures is the exponential growth in 3 main areas ie. investigative technology, surgical and medical treatments, and pharmaceutical products. Another very major contributor is a free comprehensive, health care system that encourages both patients and physicians to perceive of "limitless essential services". Unfortunately,there is not "limitless funding". Finally malpractice concerns might account for 15-30% of physicians' investigations and referrals(3).
Clearly there is a necessity to limit services to those that clearly improve outcomes, to approach the final stages of life more honestly, to introduce tort reform, to regulate drug costs and to require all physicians to follow justified practice patterns. In addition there needs to be more patient responsiblity to follow healthy life styles and to be more patient financial responsibility for health care premiums, for drugs and for received health care. These financial payments could be paid for at income tax time for the previous year's health care services. The maximum amounts paid by patients (18 years and older) for premiums, for prescribed drugs and for health care received would be determined as a fair and reasonable percentage of the patient's income above the poverty line. Thus the poor don't pay and low income families very little.....very fair...very Canadian!
Ross McElroy retired GP/FP
Tavistock ON
references:
1 www.canada.gc.ca Department of Finance Canada, Budgets, 2000 & 2009 2 www.ontario.ca Your Government, Ministries, Finance, Budgets, 2000 & 2009 3 Speculated range provided by former GP/FP colleagues.
Conflict of Interest:
None declared
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Competing Interests: None declared.