The health system we need
TheStar.com – opinion/editorials
Published On Sat Sep 24 2011.
Most Ontarians have been in a hospital emergency room waiting for treatment for themselves or a loved one. It’s stressful and often painful. It’s never pleasant. A political leader who wants to be premier feels a voter’s pain or anger and offers a solution. So it’s easy to see why Progressive Conservative Leader Tim Hudak is promising a wait time “guarantee” with the hospital CEO’s salary on the line, and NDP Leader Andrea Horwath vows to cut emergency room wait times in half — and cap CEO salaries, too.
But these promises are little more than election gimmicks. The real solutions begin long before most people get anywhere near the emergency room door.
The best — and most affordable — health system is one where people get the right care, at the right time, in the right place. It’s not one where Ontarians go to the emergency room instead of a doctor because they don’t have one, can’t get an appointment on the weekend when they’re sick, or it’s their best chance of seeing a specialist quickly.
It is not a system where thousands of frail seniors stay in hospital beds because there are waiting lists at long-term care homes. It’s not a system that allows a hospital to send a patient home without proper supports who will only wind up back there in an even worse state. Nor is it a system where doctors send people for endless “just in case” tests (which they can bill for) instead of spending more time diagnosing a patient (which they generally can’t bill for).
Too many tests, too many drugs, too many hospital visits and too many people sicker than they ought to be — this is the health-care system we have.
Over the past eight years, Liberal Leader Dalton McGuinty’s government has made important progress in health care by hiring more doctors and nurses and curbing generic drug costs. And though it’s still a bumpy road, Ontarians are starting to benefit from electronic health records. But now it is time for Ontario’s next premier — whether it’s McGuinty, Hudak or Horwath — to turn our health-care system in a new direction. We need to restructure it with an emphasis on prevention, early intervention and less costly community-based care.
There are elements in the party platforms that suggest political leaders are starting to get it. In particular, McGuinty’s healthy home renovation tax credit (to install things like chair lifts or hand rails) and enhanced home care for the most frail would help the elderly stay home — and out of hospitals and long-term care beds — longer. So, too, would Horwath’s vow to boost home care and non-medical help (with cleaning or cooking). Hudak promises to spend another $6 billion on health, but just $175 million is targeted for home care. That’s a long way from the forward-looking vision and dollars we need.
Illness prevention, earlier intervention and home care cannot be seen as add-ons to the regular health-care system. They are just as essential as a hospital emergency room if we want a system that can properly and affordably cope with the needs of an aging population. But the idea that these new and enhanced health services should receive substantial money from within existing health budgets is something few politicians are ready to embrace.
Health-care spending already consumes more than 40 per cent of provincial program spending and with current trends it could jump to 70 per cent in just over a decade. We cannot afford continued big health budget increases, as Hudak has already recklessly promised. We must spend what we have smarter.
Hudak is by no means alone in taking the seemingly easy road of promising never-ending health-care increases. Rather than actually debate health care in the last federal election, Prime Minister Stephen Harper (and other leaders) simply promised to increase health transfers to the provinces by 6 per cent a year until at least 2016.
Whoever Ontario voters elect on Oct. 6 cannot use that as an excuse to put off reform toward a more cost-effective, integrated health-care system that will provide better care today and not bankrupt us tomorrow. The next premier must be willing to get Ontario’s health budget under control and fight to negotiate a new 10-year health accord with Ottawa with a strong focus on prevention, early intervention and community-based care.
When deciding how to cast their votes, Ontarians should look past the gimmicky promises of speedy emergency room service. They should judge the leaders on their plans to restructure our health-care system so that it better serves the whole range of health needs.
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