Most sensible people will recognize that even if you work hard and earn a good income, it is all for naught if you consistently spend more than you earn.
You may be able to postpone the inevitable for a while by borrowing and maxing out your credit cards, but eventually bankruptcy looms.
The same holds true for a country like Greece. After many years of generous salaries, pensions and a plethora of social benefits without generating sufficient funds for to pay for all this, the chickens have come home to roost. Suddenly, the culture of entitlement has ended and is causing a lot of grief and disruption for the overwhelming majority of its citizens; a vivid and tough example of short-term gain for long-term pain.
Are we at risk in Canada of suffering the same fate? Collectively, during the past few years we have been spending billions of dollars more than we have collected in taxes, substantially increasing our national debt. The government decided that this was a necessary evil to ward off a deep recession. That approach seems to have worked, even though many people are still struggling. The government’s plan is to reduce our spending over the next few years to the point where we will once again have a balanced budget.
One of the major contributors to our budget deficit is the ever-increasing cost of health care. When the economy grows at a rate of one or two percent and health care expenditures rise by six per cent annually, it does not take a genius to figure out that eventually the system becomes unsustainable unless we limit the increases in health care spending to the growth of our economy. Currently, we have a health care system with limited resources, despite generous annual increases. The demand has been growing at a much greater pace and unless we come to our senses the demand for services will continue to grow exponentially, outstripping the resources by a large margin.
In order to make the system sustainable, we have to find ways to limit the demand. That means we have to make some tough choices.
I previously suggested some approaches. These are not necessarily the final solution to the problem, but a starting point of discussion.
Mike Sands, a registered nurse, did not think any of my suggestions would work, but didn’t give any of his own, just repeating the same worn out arguments to avoid having to make any changes.
Let me try and expand some of the suggestions and respond to his arguments.
1) We do have multi-tier health care already. If you get injured at work, are in jail or join the RCMP, you automatically go to the front of the line. Celebrities also get preferential treatment. In New Zealand, they have a sensible system, in which you get to go to the front of the line for your hip or knee replacement, provided you meet certain objective criteria, regardless of income. If one allows those who are willing to pay for their surgery, then there is no social injustice and the system gets extra income.
2) Do we really need one manager for every four frontline workers? I know from personal experience, it takes courage to make some drastic changes and eliminate certain positions, but it will not negatively affect patient care and benefit the bottom line.
3) To bundle the government’s buying power nationwide would reduce the cost of medications. We currently pay more for prescriptions than for physician services.
Better prescription methods would do away with the current tremendous waste of needless or unused or drugs, amounting to billions of savings.
4) Improving people’s lifestyles would save the system enormous amounts. People being people, we will need incentives and disincentives. In other words, use carrots and sticks.
5) Again in New Zealand, they have user fees and their statistics for longevity and mortality are the same or better than here in Canada. Even in the U.S. it is the law that anyone with a life threatening illness is looked after, regardless of ability to pay.
Let us keep the dialog going, and in the end, give government the tools to save our health care.
Dr. Marco Terwiel is a retired family physician who lives in Maple Ridge.
