The elephant in the room is old, diabetic, depressed, and waitlisted for a quadruple bypass. With a Provincial election pending, any discussion of public finance must start with our extraordinary tab for health care.
Every hour of every day Newfoundland and Labrador’s dedicated, talented nurses and doctors save and improve lives. Public health care is justifiably cherished.
But we live where late capitalism won a decisive battle with society; market forces prevail, we are now customers as much as we are citizens. Like everything else, disease has been monetized and there is simply more money in sickness than there is in prevention and wellness.
The provision of medical services is a volume business. If someone is in need of medical care for an extended period they are a greater generator of income for the pharmaceutical industry, suppliers of medical equipment, and services and health care professionals.
Analysis of health policy is an industry in itself, one perhaps fatally compromised by its parasitic relation to host institutions and The Academy has become a preserve of orthodoxy, the last place we turn for radical new ideas.
There is no financial incentive for the medical industrial complex to make the population healthier.
No surprise then that despite steadily increasing expenditures on health we in Newfoundland and Labrador are the least well people in Canada. It should be here that the health care system first faces the revolutionary change demanded.
We recognize that acute care is wildly expensive yet go to the Health Sciences Complex during visiting hours and you see parts of the facility standing in for the town square or the public house. A rich social network is universally recognized to be preventative medicine unequalled by anything in tablet form but we spend more on the consequences of its absence than to foster it. How much would ultimately be saved by investments that improved our diets, our sleep, that kept our bodies and minds active?
Physicians widely acknowledge there is over testing, over diagnosing and over treatment and that we spend the greatest sums treating those who are, regardless of intervention, certain to soon perish.
There is abundant evidence from south of the border that privatizing health care services will only compound the problem by adding further profit-taking to the system.
The remedy must be something more fundamental.
We somehow have to take a qualitative as opposed to quantitative view of life, accept death, and refocus on wellness, a change in outlook that will take at least a generation.
Unchecked, health care costs will metastasize to consume our entire treasury. It’s our most urgent public policy concern but one of such sensitivity none seeking office possess the courage to tackle it. It’s the same nature of electoral Kryptonite as tax increases. Perhaps the best we can do, a first step, is ask that those with their hats in the ring acknowledge that health care itself is killing us.