Solutions for an affordable public health system

There is no doubt that Medicare is facing some challenges. But privatizing services and forcing patients to pay more are not our only options. In fact, all the evidence suggests that the best and safest approach is to pursue reform within the public system. We need to support change - but not change that will destroy the system. Here are a few ideas.

Pharmacare - Rapidly rising drug costs are one the major "cost-drivers" in health care. Yet, drugs administered outside the hospital setting are not covered by Medicare. We need to bring prescription drugs under the Medicare umbrella - so that patients can get the treatments they need, and that so the government use its clout as a single bulk-buyer to control costs.

Home Care - We need to decide what care setting (home, hospital, long-term facility) is best for each patient's needs, and fund all levels of care adequately. Home care and long-term care should not be the "poor cousins" of acute care. That leads to understaffing, poor quality of care, and adverse outcomes for patients.

Healthcare Teamwork - We need more teamwork among health care providers combined with alternatives to fee-for-service payment for doctors. However, changing how we pay doctors is not enough on its own. We need to make better use of other providers like nurse practitioners, pharmacists and mental health workers - and do health promotion as well as treatment.

Evidence-based Decisions - Decisions about health care need to be based on evidence of effectiveness, with flexibility to meet individual needs

Health Education and Promotion - More focus needs to be placed on health education and promotion - both lifestyle behaviours and social determinants of health.

Stable Funding - We need to guarantee stable funding for provinces and health authorities. The spending roller coaster that we've seen in Alberta over the past few years - big cuts followed by big increases - has made it very difficult to make long-terms plans.
 
 

The bottom line on reform Canada's health care system is experiencing some problems, but they are not overwhelming and the system is not on the verge of collapse. What's needed is careful reform within the public system - reform that respects the foundations of Medicare and the values and beliefs of most Canadians. The last things we need are user fees and privatization, which run entirely counter to the principles upon which Medicare was built.

Print this page