A significant issue is obesity in Canada. Diabetes is growing at a vast rate, stroke is increasing among young people. Among young people especially obesity is a growing issue.
Poverty is another significant factor in determining health. Chronic illness, cancer, mental health and obesity are all associated with poverty. Single parent families are also specially linked to poverty.
Health is part of a matrix -- poverty, education and genetics -- and treatment of disease, while necessary, is but a part of ensuring health. Medical training focusses on treatment of illness -- there needs to be earlier focus to maintain health. Other issues include when, for example, should emergency rooms be used.
Specific goals should be set. For example, we must minimise time in nursing homes -- move from lifetime three months, on average, to three weeks. Tax structure should be used to incentivize good nutrition. Exercise must become standard -- we need to have policies that makes walking attractive. A typical 14 year old boy weighs about 15 pounds more than a typical 14 year old two decades ago.
Longevity has increased 3 years a decade every decade for the last hundred years -- that says our health care systems has worked. Canadians live longer and healthier than ever before.
Many of the medical problems are solveable but we have to deal with problems in small steps.
Canada has 11 systems -- this allows comparisons to see what works best. This allows for useful research. Evidence based public policy making must be the key to going forward.
Catastrophic drug care? Is it necessary? We should allow more room for experimentation amongst the provinces.
Dementia costs Canada about $15b /yr. Within a decade that will increase to $150b /yr. In fact, Alzheimer's disease is a long term disease with roots in youth.
Private care is already quite active in Canada's health care system. The issue is how to make sure there is access to the system. That said, the US system is private but inefficient. What is most important is that payment is linked to outcomes -- private or public doesn't really matter.
One in five Canadians will suffer mental health illness. A national strategy for mental health is necessary.
Actual medical care spending has remained stable at 4% for three decades. Drug costs, private based, have increased.
Nursing homes are often used even though not ideal because society will pay for it. Alternatives for end of life care are needed.
Decisions should be governed by data not ideology; there is much that can and must be done but all options must be considered.
4 comments:
This issue is very important and will become moreso as our population ages. We have, and are constantly throwing money at, a "Medical Care" system rather than a "Health Care" system. Funding for medical interventions and diagnostics knows no bounds but more effective, less expensive interventions by other professionals are constantly on the cutting board. If we do not change direction very soon, we will have no system at all, as there will be no one to care for the sick following medical interventions and no one to provide counselling and support for those who need help to prevent illness. Nurses are the real primary providers of health care and yet they are rarely consulted regarding policy and funding.
And in other news that the MSM tries to bury well off of the front page;
With two months left to report for the 2009-10 fiscal year, the federal government has a budget deficit of $39.6 billion, whereas Finance forecast a $53.8-billion shortfall for the entire fiscal year. Should the momentum continue, it is possible the federal deficit for this fiscal year could be quite a bit smaller than projected.
http://www.vancouversun.com/news/Federal+government+track+smaller+deficit/2733924/story.html
The one 'natural ruling party" is finished, soon to be in the great dust bin of history, Bob Rae will be your next leader and will complete the disintegration of an elitist arrogant and corruption riddled party.
It is indeed unfortunate that the health policy discussions in Canada have turned away from practical decisions towards ideology. We need to find practical ways to cut health costs that promote personal responsibility where possible and take advantage of the benefits of private health care where it can be delivered more effectively.
Much research has pointed to the benefits of incentives for promoting better health and given the costs of health care, incentive programs would be significantly less expensive than the costs of treatment. However, the political will to promote such policy would be considerably difficult to find as it would likely foster significant opposition in the way that private health care already seems to do.
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