Thursday, July 23, 2009

A Few Things We Need To Talk About

Well, for the first time ever, I'm doing a double-blog post. By which I mean writing two different articles in the same day. Granted, I took a break between my last post and this one, but it's still a monumental thing for this blog.

Much like the last one, this is going to be a bit of a hodgepodge of subjects given that some things have come up that I think we should talk about.

Source: CBC News: Commissioner who Refused to Marry Same-Sex Couple Loses Appeal
Source: CNN News: Reality Check: Canada's Government Health Care System
Source: CTV News: Ontario Woman Slams Universal Health Care in TV Ads

The first thing I'm going to do is make a small comment on the case of Orville Nichols, the marriage commissioner who refused to marry a same-sex couple and was then taken to court for violating the couples' rights. Mr. Nichols', who argued that his religious beliefs were being infringed and not protected under the Charter of Rights & Freedoms, lost his appeal to the original decision that saw him pay $2,500 in damages to the couple.

Now, I've written an extensive blog post on the role of marriage commissioners and Justices of the Peace, and their roles and rights to refuse service to someone, so I'm not going to repeat things I've already said. What I will say, is that Mr. Nichols is in the wrong and it's good to see the justice system work in the best interest of the people.

Mr. Nichols' rights, in this case religious rights, were not infringed because he took a voluntary public service post and therefore bound himself to uphold the laws of the Province and Nation, not the laws of a religion. As such, he had no right to cite religious belief as a means to refuse service to a couple who can legally wed.

Hopefully, this loss will put a wrench in the Saskatchewan Party's bill to enshrine the right to refuse service based on Mr. Nichols' defense; as if the courts have their say, it will show that it is not a valid defense in a marriage commissioner's job and does not allow them to deny legal access to marriage to anyone.

With that out of the way, I'm going to talk about the issue that I wanted to blog about in my second blog post of the day.

I like the scan the news sites, it's something I do. So imagine my surprise when I see a headline on CNN saying that an American Lobby group against Universal Health Care found a poster girl in the form of a woman from Ontario.

That person is Shona Holmes. Ms. Holmes discovered that she had a growth in her brain, and was told that she would have to wait months to see a specialist here in Canada. As such, she re-mortgaged her home and went to the USA Mayo Clinic to have the growth removed, to the cost of $100,000.

The ad she is in talks about how she was refused service in Canada and that if she had waited for the government, she would be dead.

Liberal MP Ujjal Dosanjh, former Health Minister, said that this was an extreme case. That serious cases are treated quickly in Canada, but that occasionally, some cases may be overlooked by the system. Even the CNN news report has testimony from a Canadian with cancer, who admitted that the entire process to undergo treatment and diagnosis for him was only a month.

Now, this is where things get a bit dicey and I open myself up for all kinds of abuse from a few people.

In the Canadian news article, Ms. Holmes' condition is only referred to as a growth near her pituitary gland. In the American news article, her condition is referred to as cancer pressing against her optic chasm.

I want to say at this point, that I am not trying to downplay the seriousness of Ms. Holmes' condition. A growth is a growth, and some would say that any growth is a tumor, but none of the Canadian agencies seem to go this far in classifying what was wrong with Ms. Holmes.

So, why do I think American doctors were quick to call it a tumor? Let's imagine for a moment: You go into your doctor and he tells you that there appears to be a growth on one of your internal organs. Obviously there is some worry, but the doctor schedules you to see a specialist in an appointment a few months away.

Now, imagine the worry when the doctor takes away the 'unfamiliar' word of growth and replaces it directly with the word: tumor. Your immediate thought is cancer, and all the things that are linked to it. Obviously, at this point, you would be panicked and not want to see a specialist in a month but now.

Understand what I am trying to say here. Americans seem to have a nation of sensationalizing; look at their media: Which house hold product could be killing your kids?! Did the government let _________ die?! And so forth...

As such, it would seem that they would be the kind of person to jump to the immediate that any kind of growth is a tumor, and that tumor is of course cancer. Whereas, I'd argue, that in Canada we are the kind of people to not jump towards an answer until we're sure it is the right one.

Again, I feel I must say this: I am not downplaying Ms. Holmes' illness. I am not saying that it was not serious or non-existent. What I am saying, is that due to her desire to rush and see American doctors (within this sensationalist ideal) she got an answer that may not be entirely accurate.

There was indeed a problem, a growth, but American networks are treating it as if it were cancer rather than as a benign, non-malignant or malignant/cancerous growth.

I feel as if I've strayed from the topic too much, which is why I'm going to attempt to 'right the ship' as it were. Ms. Holmes' has gone to the USA for medical treatment, and she is not the first, but she is among the first to my knowledge to become involved in a political campaign to attack Universal Health Care within the USA.

This post is not to condemn her or try and explain what she did was wrong, but rather to explore why she had to do this in the first place.

Yes, it is true that we do sometimes have long wait times in this country for medical access. And like former Health Minister Dosanjh said, sometimes serious cases could be overlooked. But does a system where a person has to mortgage their home to pay for treatment, to pay to live in some cases, sound any better?

It's time for me to get on my soapbox again and say what I've wanted to say about the health care system in this country.

To an extent, our health care system is broken. This is due to a few key reasons: politicians, health care workers, universities, and ourselves.

Allow me to explain.

Politicians are a problem because I firmly believe that none of them fully understand the health care system. Whenever there is a problem with health care, politicians are quick to say the usual things:
'Pay with your health card, not your credit card.' OR We've pledged this much money in our platform/budget to help improve access to health care.

The problem is, none of them ever go any further than introducing more money into the system. More money does not help when the system is understaffed. Sure, it may help us buy more equipment and help renovate aging hospitals, but if there is no one to work in these facilities then where is the point?

Now, what about health care workers? How can they possibly be a problem in all this?

Well, some of the problems are there and some of them are caused by others. When was the last time you went to a doctor's office? I imagine you had an appointment, and I also imagine that your doctor wasn't even close to keeping the time you were booked for. In these regards, doctors are a problem because of being overworked it is possible that they are increasing the chances for misdiagnosis and other problems.

We also have problems in that doctors, nurse and other health care professionals seem to be losing the human element in regards to health care. A Time Magazine article quoted a doctor, who trained others, that said many new doctors are treating their job as 'shift work'. That they don't see the patient as 'their patient' and are more than willing to pass on a patient to another doctor just so they can clock out on time.

So, what about universities? How are they a problem?

As a recent University Graduate, I can tell you there is a problem in our places of higher learning. In regards to medicine, look at the idea of 'seats' within the medical program. Only a certain number of people are allowed into the school of medicine each year, and hundred if not thousands more are denied entry into such programs.

In some cases, the applicant is rightfully rejected. Their MCAT score was too low, or their class average in undergraduate studies was too low. But even then, is this enough?

I don't have to tell some of you about the biases of standardized testing (like the MCAT), but I can see where they are coming from. But, there is one requirement which is utterly ridiculous: years of undergraduate study.

I happen to know someone who after four years of undergraduate study, to the best of my knowledge, they were finally accepted into Medicine. The same is true with other 'limited' seating programs like Law; where the college will only seriously consider candidate who have at least two years of undergraduate study. The applicant doesn't even need to graduate, although that looks better, but they need this time to study things they won't need before they can study what they will.

The other problem, is applicants whose rejection is unexplainable. I'm sure there are people with medium to high MCAT scores and decent averages, who are rejected from medical school, despite the fact that the person would indeed make a damned good doctor.

Effectively, universities are the SOURCE for our under staffing of the medical profession. By requiring applicants to have years of undergraduate study, they are robbing lower income students, who would easily perform well in medicine, access to studies by making them waste time and money on a program that does not help them earn a degree.

Furthermore, by restricting how many people can study medicine at a time, we are constantly stuck in a loop of under staffing. I'm not saying there should be no limit, as most professors would argue that it would be impossible to teach a class that numbered into the thousands, but surely we can provide access to more than just the few hundred that are allowed. Currently, the University of Saskatchewan only allows 84 (EIGHTY-FOUR) students to study first-year medicine, with hopes of expanding that to 100 by 2011.

And finally, there's us average Canadian citizens. In the past four years, I'd argue I've been to the doctor's office about, oh, no more than seven or eight times. Only one of those times led to a minor surgery, and even then, the wait time for that was only a matter of a month or so.

However, there are people that tend to be a bit more...Well, worrisome about their health. People who could have, in the four years I've seen a doctor eight times, gone at least fifty if not more times.

The sniffles or a cough, don't really warrant a trip to the doctor. Most of us, at least myself, try a bit of self-medicating with over the counter drugs from the local pharmacy and if those don't help, then we seek medical attention. Why do you think most doctors/nurses take the time to ask you what drugs you've taken in the past day or so?

The fact of the matter is, we are constantly told that we shouldn't self medicate. Or we shouldn't self diagnose what could be wrong with us. In serious cases, this is really great advice. In minor cases, it's something we should ignore.

By always going to a doctor when we don't need to, we are putting undue stress and burden on the system. We are plugging up a system that can move more freely if some of us would try other things before running off to the ER or the doctor.

So, in a nutshell, what did I just say up there?

Politicians think the only way to solve health care problems is to throw more money at the system, which doesn't help at all.

Health care workers are treating it too much like a job, rather than a public service, which increases the chances for mistakes and problems to arise; and worse, these mistakes can happen more often due to under staffing.

Universities add to the problem by not allowing direct admission to Medicine programs and restricting, to a ridiculous level, the number of seats they have in their first year medicine program.

And finally, we ourselves make the system worse by always running to a doctor at the first sign of a problem. Much like the boy who cried wolf, we think that a runny nose or sneezing three times in a row is a sign of a serious disorder that needs to be looked at immediately, rather than just an allergen causing a temporary problem.

Only by addressing all of these problems can we manage to fix the problems that currently plague our health care system.

We do have a great system, there is no doubt about that, but we have complications that prevent the system from functioning as it is supposed to, and only when those problems are fixed can we say that we have a PERFECT health care system.

1 comment:

oxygentax said...

Scott,

I agree with your assessment on the restriction of seats. I also agree with your assessment that nobody goes beyond throwing money at the problems in health care, and that that solution is not doing the job.

The story of Shona Holmes was featured on Hannity last night, and to say the least, it was a clear picture of some of the problems of our system. She gave our system every chance to fix the problem in the timeframe given, even going so far as to come back to give Canada a chance to fix the problem before giving up because of the wait times and going back to get the surgery. She had weeks before she was going to lose her sight, likely permanently. A growth of this nature might as well be cancer, as fast as it was moving.

I could frankly care less about the squabbles and politics of the health care debate. What I DO care about is that people be given the chance to move at THEIR pace, not at the pace of a government bureaucrat. Give ME the option to have diagnosis & surgery tomorrow or in 2 months, and I will happily pay money to get it done tomorrow. That would be my choice, it doesn't have to be yours. I ask only that I be allowed to exercise my choice without having to travel to another country to do so.