HEALTHCARE ON THE BRINK
Quality food and water. Good sleep and exercise. Beautiful, trusting relationships. Absence of stress. A` la Julie Andrews, these are a few of my favourite things. They influence how well I feel, and how healthy I am. I’d like to be even healthier as time moves forward, and I wonder what I’ll find helpful in achieving that.
I don’t expect our medical system to be of much help. It does not account for enough of the things that determine health. Its focus is on crisis intervention and chronic disease management. It biases what’s good for the population over what’s best for individuals. Health, and importantly healing, are not what this system is good at.
For everyone to be healthy, and to relieve some of the burdens on the medical system, the sources of what is undermining our health must be addressed.
For example, we know that microbiome health (in our guts and soils) is essential for our health and the absence of disease. Things like genetically modified wheat and the chemicals used in food processing and preservation are messing with our microbiomes and making millions of us sick. This is a source. You’d think that an intelligent, caring nation would ensure that food staples like wheat are nourishing us rather than poisoning us. Addressing industry practices and products and government policies that are making us sick is the level of change that we desperately need.
We must get decision makers interested in addressing health-problem sources. Meanwhile the medical system will concern itself with survival. Changes will come to preserve our ability to provide even limited and fragmented services. Government led changes will come in the form of restructuring service delivery and periodically throwing money at critical areas in a losing game of healthcare whack-a-mole. The nature of the system won’t change. It will still focus on treating symptoms and not sources. It will just be more expensive and difficult to access. Do not expect government to lead us to healthcare salvation.
Government will, however, be willing to partner with communities that are creative and proactive in finding their own healthcare solutions. But it’s the communities that must come up with the ideas and solutions.
What currently backs up the entire medical system is insufficient long term care availability. Too many people requiring full and complex care are waiting for spaces. They wait at home, overloading the vastly under- resourced home and community care sector, exhausting their caregivers and consuming their family resources. Or they wait in hospital, occupying 1/3 to 1/2 of the acute care beds. Acute care patients can live for days in the hallways of ER departments waiting for a bed. That is today’s reality. In 15 years the baby boomers’ need for care will be fully swamping this sector, and could very well topple the entire medical system.
Staffing is critical. If we don’t have people to provide care, we won’t have healthcare. We’re short of providers and have gotten by only because nurses work overtime and have retired later than expected. We’ve also had some success in poaching healthcare workers from other countries. But attracting workers from elsewhere is more difficult now. Alberta competes for healthcare workers with the other provinces and Western countries as well as the private sector.
The cost of living, housing, transportation, and education are major factors in attracting and retaining healthcare professionals. Workers have many choices. They don’t choose locations where they experience toxicity at work and struggle to afford a house. How communities and governments navigate these issues will dictate what areas have healthcare in the future, and what areas don’t. This is already happening in B.C. and Ontario.
We are vulnerable to losing our highly trained professionals to anywhere that can make their work enjoyable. The public system must address its toxic work environments and poor leadership to have any chance of competing. It needs to understand that healthcare is delivered by a person to a person, not by a system to a population.
The message is simply this. (1) Governments in the near future may not be able to deliver on their promises and obligations to provide medical care to all. (2) The nightmare that will be long term care is to be avoided at all costs. (3) Get as healthy as you can, as soon as you possibly can. For when the dog bites and the bee stings, accessing services will be difficult and expensive.
Jeff Harvie
Bluewaterphysio.ca
