By G.D. Maxwell
It’s spring. Officially. I know what you’re thinking. Spring rolled around a couple of weeks ago. March came in like a lion, left like delicate, perfect pink lambchops, leaving only sunshine and creamy spring skiing.
Sorry, I was busy. Didn’t notice. So sue me.
But spring has inarguably sprung. The maniacal metallic warble of varied thrushes has filled the morning air for weeks. The first non-polluting hummer buzzed me in the back yard, frantic to find a feeder not ravaged by a hungry bear. A hungry bear ransacked garbage bags left unthinkingly in a neighbour’s pickup truck. Long buried bulbs have sent up shoots once again. Clocks have changed.
And the perennial rumours have started. What would spring be without yet another ugly rumour about the World Economic Forum coming to town. Generally reliable sources tell me this time it’s a done deal. Little Pauly Martin, casting a wide net to deflect growing criticism over the scandal du jour, and our own witless Slash Gordon are reputed to have closed the deal for 2006.
Wonder if any of our local leaders have heard this rumour? Wonder if they’ll wait until I go to council and ask the question before they dig into it?
I’d have gone earlier this week to ask them about it, listen to the budget presentation and watch as they dodged and weaved – wove? – on approving the nosebleed budget for the new library but I was tied up… literally.
My Goddess of Physiotherapy, Allison McLean, shoehorned me into an already full schedule. Crying on the phone might have helped convince her to lengthen her already long day and pretend there was an opening in an appointment list that looked more like a page from a phone book. Whatever works, eh?
I’m desperate. More desperate than usual. My seasonal stint at the MotherCorp is rapidly drawing to a close and with it, the modest insurance reimbursement that postpones choosing between paying for physio and frittering my hard-earned bucks away on something frivolous, perfect pink lambchops, for instance.
More importantly, the very availability of miraculously talented physio care, at any price – something we take for granted in a town where so many miraculously talented physios practice – will come to an end when I pack up and head out for Smilin’ Dog Manor. As hard as it might be for Whistleratics to believe, the outside world is filled with physios who didn’t seem to pay much attention after the lesson about the kneebone being connected to the legbone.
And without Allison’s insightful ministrations, I’m not certain I could make the transition from winter sports to summer sports. The insults and injuries of youth are morphing through the lens of age into new, more complex insults and injuries. What feels like mechanical failure is actually crossed wires, rogue nerve impulses. Were it not for her understanding of the wiring as well as the mechanical bits, I’m certain I’d have pleaded with an orthopedic surgeon long enough by now that he’d have had me prepped for an unnecessary surgery.
That’s not a dig at surgeons. Surgeons are a bit like the man whose only tool is a hammer. To him, everything looks like a nail. When what you do is surgery, all solutions look like operations. It’s only natural.
But surgery is expensive. Way more expensive than physiotherapy. And there’s a long wait for a surgical date. More things can get out of whack as your body compensates for the malfunctioning part while you wait for the fix.
But surgery is covered by B.C. Med; physio isn’t since Slash decided that was a logical place to save money.
Logical?
At least as logical as saving money by not changing the oil in your car and putting those funds aside to help pay for the engine replacement you’ll need because you didn’t change oil.
Hard, logical choices – harder than we’ve ever been forced to make – are really the only thing that is going to rescue Canada’s national health care system as we move toward the inevitable collision between supply and demand.
Demand is growing at an incomprehensible rate. In the U.S., eight people join the Junior Geezer Club – turn 50 – every single minute of every single day. Applying the convenient Canadian Math, i.e., whatever happens in the U.S. happens one-tenth as much in Canada, with the possible exceptions of productivity gains and violent deaths, 0.8 Canadians turn 50 every minute. Fractions being harder than regular math, that’s still more than 1,100 Canadians a day passing into the abyss; too old to keep pretending they’re hip, too young to pretend they’re eccentric.
A year and a half ago, Roy Romanow delivered his report on the future of health care in Canada. It called for a number of platitudinous reforms, all of which were tied to stable funding. The report was roundly criticized for dodging the issue of exactly how that stable funding should be realized. Both God and the Devil are in the details.
In the 18 months since, one thing has been made abundantly clear: the cost of health care, whether measured as a percentage of GNP or on a per capita basis, is continuing to escalate faster than any other category of expenditure. Faster than education, faster than infrastructure, faster even than the Liberals can waste money on programs that don’t work and outright fraudulent transfers to well-connected friends.
Finally, this week, the Globe and Mail reported the federal government is considering a new tax on Canadians to fund rising health care costs. Surprise!
So the issue of how to fund sustainable health care is about to be engaged. But without a spirited debate on what gets funded, it is just another misuse of the word sustainable. The hard reality is this: no amount of funding will be enough. Advances in treatment, advances in drugs, advances in biotechnology will continue apace. Aging will continue apace. Funding is finite. The bulk of medical expenditures take place in the last three years of a person’s life.
What is clearly needed is a debate on the hardest choices a society can make: the choice of who lives and who dies. The choice of what gets treated – at what age – and what gets left to the inevitable endgame of nature. Necessarily included in that debate is how we choose to treat self-inflicted ill health. Do we replace hearts and joints and lungs and livers of people who have abused their original parts through bad diet, bad habits… or extreme sports? Do we cut treatment off at a certain blending of age and overall healthiness and retreat to palliative care, ease the pain of inevitable death?
Don’t look for that debate to begin any time soon. Some things are just too hard.
