Vancouver Province
for February 15, 2001

Of course Medicare is safe. No need to worry our pretty little heads about that. Haven’t our left wing health economists assured of us this? And Allan Rock, the scourge of Cassandras like Alberta premier Ralph Klein, pooh poohs any notion that we can’t afford our system. And Shirley Douglas, the daughter of the sainted Tommy tours the talk, shows bashing the right wing infidels as she calls up her Daddy’s spirit to make us all feel good about long lineups and no nurses.

The theory is that the system just needs a bit of fixing here and there. More money, of course, but mostly just a little tinkering.

I hate to be the bearer of sad tidings but if we’re in any trouble at all with health care in this country now, as the man says, "you ain’t seen nuthin yet, folks."

Hearken to this story out of Great Britain. A man, on the stage to give a lecture is so vigorous that he disdains the microphone and prances up and down before his audience and in a booming voice that decries the use of a microphone, looks and sounds like a man half his age. Then he pulls from his pocket a little electric gizmo and it’s like Jekyll and Hyde – he presses a button and suddenly he is a quivering mass of all but uncontrollable protoplasm, barely able to speak such is his shaking. The audience begs him to press the button again which he does. Moments later he is back to the man of vigor and vitality.

What’s this all about, you ask?

Well, the man suffers from Parkinson’s disease and his skull has been implanted with a "deep brain stimulator" which, when activated, permits him to be as if he was free of the dread disease.

Is there a cost involved here?

Well … yes. In fact about CDN $50,000.

In Britain there are about 120,000 sufferers with 10,000 added each year. Canada, with half the population would, one assumes, have 60,000. Even assuming that not all would be candidates you get the gist of what sort of money we’re talking about here.

It’s going to get worse – better medically but a hell of a lot worse financially. It’s only a matter of time before we have mechanical heart and other organs and, presumably other implants will be discovered for other terrible afflictions. And you can bet that under the Charter of Rights and Freedoms people rejected medically for extraordinary treatment like organ transplants will demand what is their "right". In Australia they’re presently arguing whether doctors can, as they wish, deny new hearts and lungs to smokers on the ground that these organs are too precious to be wasted on those who abuse them.

It’s not just exotic medical procedures that are driving the cost of health care up of course. People who would in former times be content with their doctor’s diagnosis based upon a physical examination are demanding hugely expensive scans and further advice from high priced specialists.

The problem is, we have never decided just what care it is we’ll pay for under a publicly financed scheme. Will it be such that guarantees a reasonable national level of morbidity and mortality? Or is it whatever comes down the pike from medical science? Even if it’s the former, consider this – it’s thought that by 2020 50% of all Canadians will be diabetic mainly because we are surviving or missing the strokes and heart attacks that killed out parents and living long enough to be diabetic. It costs, at a minimum, $100 per month for my medicines and testing strips so you can get some idea of what it is costing the system because we’re living long enough to get expensive treatment for what ails us.

What’s the answer?

I don’t know but common sense says that if it hasn’t already happened, advances in medical science will out-strip our ability to pay for everything out of the public purse. It seems to me that some desperately tough decisions must be made as to who gets what service.

And perhaps, with all due respect to Shirley Douglas and her ilk, we will have to make a deal with private capital – yes, private insurers - when we can do it on our terms and not postpone it until we must do so on theirs.