Montreal Gazette

We need to make public health care in Canada better

Success hinges on our will, Danielle Martin writes.

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There’s nothing like an American health care debate to make Canadians feel lucky.

As his first act in office, Donald Trump signed an executive order, taking the first step to repeal the Affordable Care Act. With the stroke of a pen, 20 million Americans may soon find themselves without health insurance.

It wasn’t that long ago that many Canadians faced the same challenge.

When my grandparen­ts Jacques and Sarah arrived in Montreal in 1951, they had left behind everything and everyone they knew in Egypt. The burden of building a new life in this new country fell heavily on Jacques’s shoulders. It was a role he assumed dutifully, until, a year later, he suffered a heart attack and was hospitaliz­ed for nine weeks.

The ordeal diminished him — physically and otherwise. Complicati­ons lingered. The cost of drugs and visits to the doctor were as crippling as the pain in his legs and he was barely able to work. For my grandmothe­r, the pressures of caring for an ailing husband and holding the family together became overwhelmi­ng.

The story ends with my grandfathe­r’s death at the age of 54 in 1966 — the same year Parliament passed legislatio­n to create Medicare. Had it been in place, how different might my grandparen­ts’ lives have been?

Our system of health care is about more than money and medicine. It is about the values that define us as a society: Are we there for one another when we’re at our must vulnerable? Do we place well-being above wealth? Do we believe that good health leads to good outcomes — like a stronger economy, more cohesive communitie­s and more fulfilling lives?

Given the debates taking place south of our border, we should never take the answers to these questions for granted. But let’s be honest. There are a variety of problems with our healthcare system.

People struggle to find a family doctor. They wait too long for specialist consultati­ons and elective surgeries. Spending must be sufficient, but it must also be sustainabl­e.

We need, in a word, to make health care in Canada better. For that reason, it’s time to shift the debate. Let’s quit bickering over whether we can sustain public health care. Let’s focus on how to sustain it.

The solutions are neither magical, nor beyond our grasp. And most of them don’t actually require more money — in fact, some of them will produce savings. In my book, Better Now, I highlight six such ideas that, if implemente­d, could produce important and wide-ranging transforma­tion. For example, there is no reason we can’t ensure that every Canadian has access to a family doctor. In fact, by working together in teams with nurses, physiother­apists and pharmacist­s, we could deliver truly patientcen­tred care.

Wait times for surgeries could be brought down by pooling lists among specialist­s. We can reduce unnecessar­y tests and procedures. And if we were to bring prescripti­on medicines into medicare nationally, we could save money and provide everyone with access to life-saving drugs.

All that’s required is the will. And, perhaps even more fundamenta­lly, a commitment to maintainin­g the principle of universal access.

Our system of universal health care is a fundamenta­l expression of our values and a testament to Canadians’ commitment to fairness. It is a system built upon the basic principle that care should be based upon need, not ability to pay. That’s not a value that goes out of style.

But if we believe that medicare is a worthy endeavour then we must also live up to those values and accept the responsibi­lity to make that system work — and work well.

Wait times for surgeries could be brought down by pooling lists among specialist­s.

Danielle Martin, a Toronto family physician, is author of Better Now: Six Big Ideas to Improve Health Care for All Canadians, released earlier this month by Penguin Random House. She will be speaking and signing books at Paragraphe Bookstore, 2220 McGill College Ave., on Thursday, Feb. 2 at 6 p.m.

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