The Telegram (St. John's)

Health-care savings can come at great cost

- Brian Hodder Brian Hodder is an LGBTQ2 activist and works in the field of mental health and addictions. He can be reached at bdhodder@hotmail.com.

Anyone in this province who is paying attention is acutely aware that we are in a severe financial situation which shows little sign of improving greatly in the immediate future.

We are carrying a tremendous amount of debt in relation to our population and continue to run budgets with a deficit, adding to this debt. In addressing this situation, it would be all too easy to look at our budget and target the largest expense in this province, namely health care, and there have been calls from some groups to download some of these expenses to the private sector, which presumably can provide them more cheaply. Our present government is already exploring this approach with partnershi­ps to build some hospitals and care facilities, but we should be very cautious about how far we allow ourselves to go down the road of privatized health care.

A look to our southern neighbours can shine some light on the potential pitfalls of such a system. It can create situations that are truly ugly. An incident last week at a Baltimore hospital — which evoked brief outrage and has since mostly faded from public perception — reveals what can happen when health decisions are made based on profit. A woman with mental health issues was discharged from a hospital and orderlies brought her to a nearby bus stop and left her there. It doesn’t sound too bad until you add that this occurred in the middle of the night, it was below freezing, she was dressed in just a gown and socks and was clearly distressed, disoriente­d and bleeding from her face. People only became aware of the situation because a passerby noticed what was happening, captured footage on his cellphone and posted it on social media.

While I’m sure that there is probably more to the story than has been told so far, it appears the primary reason this occurred was because the woman lacked health insurance, which means government programs would have covered only a portion of the cost of her treatment.

These situations are common enough in the United States that there is now a term for this behaviour — patient dumping, or homeless dumping, and it works in a few ways. Patients who lack health insurance and could be a financial burden to the hospital — often the homeless and those living with mental illness — are released into the streets or put on a bus leaving the city so that they are outside the jurisdicti­on area covered by the hospital. In some cases they are put on a bus to places such as California, where it is assumed the streets are warmer and at least they won’t freeze to death. In essence, these human beings are being treated like garbage and are being thrown out and dumped by the side of the road.

I work with people who have experience­d homelessne­ss and mental illness, and watching the video hit me like a punch to the stomach. How can such things happen in the richest country in the world? When financial cost becomes a primary factor in how health decisions are made, what gets lost in the process? What is the moral cost to a society that would treat some of its most vulnerable members in such a fashion? How do the people who are forced to follow such directives and policies live with the emotional burden of treating their patients like a bag of garbage?

While this may sound like an extreme example, it is happening across America and we should keep it in mind as we consider ways to cut costs in our health-care system. Canada’s universal health care may be expensive, but we are all treated equally.

If we aren’t careful and go too far down the private road, we may save some money but pay a much higher cost to our collective soul; if the American example is any indication, it is a price I am not willing to pay.

In essence, these human beings are being treated like garbage and are being thrown out and dumped by the side of the road.

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