3 big ideas to save Canada’s healthcare system

By on June 11, 2014

If the definition of good governance includes the sound management of public monies and resources, then Canada has very bad governance.

The manufactured healthcare crisis is a case in point. Solutions to challenges of cost, quality, and access are fairly straightforward but wilfully ignored, and current trajectories towards c are leading us in the wrong direction.

If the challenges are responsibly addressed, every Canadian will have access to exemplary healthcare, based on need rather than ability to pay. Additionally, Canadians will save money, and the economy will be positively impacted.

Dr. Danielle Martin – family physician, vice president of Medical Affairs and Health Systems Solutions at Women’s College Hospital, and assistant professor in Medicine and Health Policy at the University of Toronto – is eminently qualified to offer solutions.

She argues that we could immediately implement “Three Big Ideas” within an expanded medicare system. Martin describes these ideas as follows

“20 Drugs To Save A Nation”

“Less is More”

“Sick With Poverty”

The first idea, “20 Drugs To Save A Nation” would save lives and improve the economy.

Currently, one in 10 Canadians cannot afford their prescription medications. Consequently, their medical conditions often worsen, which invariably leads to more expensive care, including hospital admissions. A study by the New England Journal Of Medicine, appropriately titled “Dead Man Walking” , shows that when heart attack patients fail to adhere to their prescriptions, they are more likely to be readmitted to hospital.

National public drug coverage also saves lives. According to Alan Cassels, and expert advisor with evidencenetwork.ca, public drug plans screen drugs for value and safety better than their private drug plan counterparts. He explains, “ . . . out of the top 50 most costly drugs covered by private drug plans, several of them wouldn’t merit coverage by public drug plans because of their poor value: they were branded drugs which had cheaper equivalent generics.”

The tragedy of Vioxx resonates with this opinion: according to the Toronto Globe and Mail, premature release of the brand drug caused between 4,000 and 7,000 deaths in Canada.

Bulk buying through a public drug plan also means that one purchaser (versus many) can secure lower prices for medications. New Zealand, for example, pays 2.4 cents for one Lipitor pill, while Canada pays 32 cents for the same pill.

A national pharmacare program with first dollar coverage (a best case scenario) would save Canada as much as $10.7 billion per year, according to the Canadian Centre for Policy Alternatives.

Martin’s “20 Drugs To Save A Nation” plan would be a first step towards national pharmacare. She argues convincingly that we could start bulk-buying 20 generic drugs, and that such a step would not only improve patient-adherence rates to medications – and their health – but it would save a substantial amount of money.

The next idea, “Less Is More”, would also save money, and lives. According to Martin, numerous medical tests, treatments, and procedures are administered more often than necessary. Consequently, health outcomes can be negatively impacted, and additional costs accrued.

The top five tests, treatments, and procedures that are done more often than necessary are:

-Electrocardiograms (ECG’s)

-Imaging tests for lower back pain

-CT scans and MRI’s for headaches

-Bone density tests (DEXA scans)

-Antibiotics for sinusitis

The final big idea, “Sick With Poverty”, explains that poverty is basically a disease. The corollary of this is that if poverty can be eliminated – and one in seven Canadian children lives in poverty – then we will be a much healthier (and productive) society.

A 2013 study by the Canadian Medical Association, “Health Care In Canada. What Makes Us Sick?” identifies four social determinants of health:

-income

-housing

-nutrition and food security

-early childhood development

Canada’s failure to understand this aggravates and perpetuates an unnecessary situation – poverty. If all Canadians had adequate income, housing, nutrition/ food security, as well as early childhood education, our population would be healthier, societal costs for healthcare, policing, and other social services would be reduced, and we would collectively be more productive.

Evidence shows that Canada would save $7.6 billion per year on reduced healthcare costs alone if the lowest group of earners moved up by one “quintile” (to two) on a scale of earnings with the top quintile being five.

Clearly, we have the tools and the funds to make Canada a better and stronger nation, but it won’t happen until the current theology of predatory economics that is poisoning the economy, and our collective mindset, is rejected.

Instituting Dr. Martin’s “Three Big Ideas” would be a huge step in the right direction.

 

Troy Media columnist Mark Taliano is a writer, activist, and retired teacher.

 

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