More Health Care for Less Money?

The Lieutenant Governor of Newfoundland and Labrador delivered the Speech from the Throne in St. John’s on Tuesday. This is how the general assembly opens for our provincial government. It’s the third session for these folks since we elected this group. Feels like forever ago, doesn’t it?

Happily, there was plenty of attention given to health care. A focus on mental health was highlighted, as government plans to continue implementing strategies from the “Towards Recovery” document, including replacing the Waterford Hospital and initiation of best practices to keep those in recovery from mental health and addictions closer to their home communities.

A new Public Health Act will be replace the document, currently over 50 years old, of the same name. The focus? To “drive improvements in population health”. There will also be a new Healthy Living Action Plan, which will work towards a general improvement in overall public health. These are all very positive initiatives!

And even more encouraging from Lt.-Gov Frank Fagan was the message in regards to finances: “do better with less”. 

I’ll give you a minute to verify that yes, indeed, you did read that right.

How could we possibly have all these initiatives and improvements without increased financial investment and spending in health care? 

I’m glad you asked.

You see, I’ve been working in health care for over 13 years now, and I have to say, we are dropping the ball here. Don’t get me wrong, there are areas in our system that need a tremendous amount of work, I mean a total overhaul. In fact, it’s incredible some areas are able to function at all given their current situation.

BUT, there are plenty of areas where the amount of money being spent is ridiculous. We, as health care providers, have a fundamental responsibility to ensure that we are delivering our system in the most effective and efficient manner possible. Most nurses and others in the system are reading this and are thinking I must’ve had a small stroke, but there are some reading this that know exactly what I’m talking about. C’mon guys, you know who you are.

First of all, I’m a big fan of the publicly funded health care system we have. Yes, I have a private for profit health care business, but that is because I saw an opportunity where people were willing to pay for services when our system didn’t work for them. Is this available to everyone? No, only those who can afford it. Is that fair? Probably not, but who am I to argue with a business opportunity that helps pay for the outrageous cost of my son’s hockey program? It doesn’t take away from the fact that I advocate for a system that is available to everyone at all stages of their lives, no matter what their capacity to pay. Sure, my father probably would have had insurance to pay for his 5-vessel coronary bypass with carotid endarterectomy 15 years ago… but it sure was handy to not have to write that diagnosis out multiple times on insurance paperwork to get it covered! And I speak medical, imagine how most people who don’t would feel!

Back to my point. I’m glad that a surgery that probably costs in excess of $100K was covered for my father. However, he was 58 years old at the time, and really never did return to his pre-surgery level of functioning…. (I say that cautiously, because he is 73 now and still works, so normal “level of functioning” definitions do not apply here). Wouldn’t it have been better if he had never needed the surgery in the first place?

Here’s where it gets interesting. We, as a society, have to decide that it’s okay not to throw more money at the latest and greatest life saving technology. What we DO need to decide on is that our best investment is in preventing illness and morbidity from happening in the first place. Now before you throw stories at me about ludicrous wait times for cardiac Cath lab, orthopaedic surgeries and psychiatrist appointments, please note I have not indicated WHERE the overspending is happening… that’s for another conversation. But please be clear, by no means am I suggesting that these are not vital areas where we have wait lists that are too long. Keep in mind I’ve been an ER nurse for 13 years, I am well aware of these wait times. Enter the Throne Speech from today. A Health Living Action Plan should (I will have to see when it’s released) promote prevention and health promotion. A revised Public Health Act focusing on “improvements in population health” also should (see previous comment) promote prevention and health promotion.

Dare I dream? Does the province of Newfoundland and Labrador finally have a group of politicians who are actually going to put their money where their mouths are and “do better with less”? I am cautiously optimistic. Optimistic, because for the first time in my recent memory, I see a Minister of Health willing to cut one program to fund another, where the money saved here, it was revealed, will be used to give boys the HPV vaccine to prevent cancers), which was a hugely unpopular decision in the medical community because of the risks associated with potentially lower influenza immunization rates. Hell, even I had a thing or two to say about this decision at the time before learning about the end game purpose of that money. However, in the defence of Minister Haggie, he never was suggesting that less flu shots be given. In fact, he insisted that family docs would have more availability to see more ill patients because those presenting only for a flu shot would be off the books and encouraged to go to a walk in flu shot clinic, for free, at any of the Eastern Health immunization clinics throughout the province.

I am cautious because we are two years into this provincial government. Our 50th General Election is tentatively scheduled for October 8, 2019. Are the liberals blowing smoke up our you-know-whats to secure voting in 19 short months from now? Or will the political pressure be too much and they decide that it was impossible to meet all the promises without new spending, dump a pile of money in health care to ensure all these projects they speak of reach fruition, and leave us in an even bigger financial mess after the election than we are now?

Maybe I sound selfish, asking that the health care system still be viable as I get older. Heaven knows, I was a smoker for several years myself and I love take out. But I quit on my birthday last year (props to MUN School of Pharmacy Smoking Cessation Program ), started yoga and running again, and pay more attention to the food I eat. Hey, I’m into the last year of my thirties… I ain’t getting any younger. God willing, I’ve done enough to at least improve the chances I won’t need last minute life saving interventions. 

But I’ve also been a Newfoundlander my entire life. It’s probably why I’m also a Leafs fan- I’m used to being let down despite being viscerally loyal. But perhaps this is the year all that changes. Perhaps this is the year the government actually throws down and delivers on promises, in the same way that perhaps this is the year the Leafs make a real drive for the Cup. A girl can dream.

And all that is great for a laugh, but we all have real stakes in this game of Newfoundland and Labrador health care and politics. It’s about time we all accepting being let down. This is the scariest economic picture I’ve seen our province experience in my adult life. But our population is aging, our youth are leaving, and we all have a real responsibility to hold our government accountable. Segway back to do more with less.

Stop spending money on health care. We have plenty. Do a better job with the money that is already there. Reevaluate which areas get how much. And for Pete’s sake, ask the people working in the system. Trust me, they know.

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