Health dollars: Down the drain or up in smoke?

TheStar.com – Opinion
Published On Thu May 27 2010.  Dr. David Saul

Issue: Health-care status in Canada.

Problem: Insufficient funding (ain’t it always the case).

Solution: Increased federal and provincial health-care funding (never worked before, but hey, let’s try it again, it’s gotta work this time).

This debate has no shortage of politico/media buzz words: aging population; exorbitant medication costs; excessive wait times; high-tech (high-cost) medical testing; e-records; innovative (read costly) surgical procedures; cancer care; coronary care; dementia care; mental illness care (let’s stop the list here, if I left out any pressing special interest group, just count yourself included, it’s on the house, over here in Canada).

Provincial health ministries are in desperate fear of being crowned (or dunce-capped?) the first to touch that magic number of 50 per cent total provincial budget expenditure directed toward health care. Ergo, new politico/media buzz words: primary care reform; health-care user fees; higher deductibles; private health care; health-care savings accounts.

Here in the world’s most advanced, totally public-funded health-care system (Canada), something must be wrong if the self-care and alternative medical models continue to attract and reap huge financial, out-of-pocket funding from more and more Canadians. Sure, non-traditional approaches provide glowing testimonials, while avoiding specific health claims. Sure, desperation occupies the minds and wallets of families caring for the sick and dying when limitations of traditional medical care hit the wall. And for sure, severe sickness demands the rabbit-outa-the-hat production of “instant” benefits.

Enter inhaled cannabis, a.k.a., medicinal marijuana (MM).

MM is the ultimate in homegrown, self-applied medicine. Totally funded by the patient or family members. Essentially, totally safe (especially when compared with the side-effects and adverse-events of many traditional pharmaceuticals). No pulmonary issues when using vaporizers and various edibles. With potential to modify (doc-talk meaning ‘improve’) some medical conditions: cancer, Multiple Sclerosis, osteoporosis and more. Never too old to use MM, especially given that doctors can prescribe morphine and their derivatives to seniors in intractable chronic pain. Addiction potential so low that it’s not even an issue for the self-medicating chronic pain population. Finally, no need to fret about patients getting “high” and possibly “happy.” If sick people are a little “high” and “happy” as a side-effect of their medical treatment — what’s wrong with that?

An estimated half a million Canucks could benefit today from MM, but is there a savings to the health-care system? Well, yes and no. Health-care costs come from: hospitalization (including all related services, there’s 50 per cent); lab/X-rays/scans/ultrasounds (15 per cent); medications (20 per cent and rising) and doctors’ fees (15 per cent). Looking at just one segment of health care — chronic pain, that’s 35 per cent of the population. Here alone, overutilization of testing equipment, monthly visits to the doctor, along with drug costs averaging $1,000 per month per patient — MM can save big time.

As we speak, at least 100,000 to 200,000 sick Canadians are using MM, the majority for chronic pain disorders. Cannabis is usually obtained from a “friend.” Quietly and secretly. Only a paltry 5,000 carry the Health Canada MM program access card.

Without the card, insufficient, unreliable product is consumed, at a high direct cost to the patient. No savings to the health-care system so far this way.

But start with an overhaul of Ottawa’s MM program, allowing MDs to sign up patients in the office, directly and immediately, plus actively encourage MM authorization by doctors to help in the alleviation of chronic pain and several other medical conditions.

Then, lift the unnecessary police scrutiny of MM Compassion Clubs, perhaps having them serve as outlets for Health Canada, providing a steady, superior supply of useful MM products — at a low cost and directly born by the patient or family members. Then stand back and watch the health savings roll in.

Oops, forgot to mention: Annual drug related, law-enforcement and judicial costs in Canada are still over half a billion bucks — the pot-related component consuming 65 per cent. Plus, to the cops: MM, crack cocaine, crystal meth, heroin — they’re all indistinguishable. That’s not fair. And not right for sick people self-medicating with MM.

Note to politicians: Put a health-care referendum to the people, yay or nay for the active promotion of MM. Let the people decide.

Dr. David Saul is a general practitioner in Toronto with a practice exclusive to fibromyalgia and MM.

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