Nouvelles
Daily Gleaner
p. C8, mardi 16 décembre 2008
Health-care reform is going to take political courage
Chronique
Jo Ann Fellows
It sometimes seems that the provincial government doesn't know what to do about restructuring the health-care system so adequate care can be provided at an affordable cost.
In this regard,
If we persist in keeping the older model of delivery in place, while trying to implement the newer model, bankruptcy threatens. We're spending in excess of 10 per cent of our national income on health care at the moment, and the provinces are getting close to spending 50 per cent of their budgets.
What to do? I hesitate to suggest we take the health-care system out of the political arena, and give it to an arms length body, because I'm no more convinced that a bureaucratic organization is going to be any more courageous and innovative than our present political arrangement.
I am convinced, however, that political interference is adding significantly to costs. The present government is proudly proclaiming they have taken decisions on road building out of the political process. Perhaps they could consider taking decisions on health care out of politics as well.
Certainly, the solution tried by the previous administration of creating eight regional health authorities, and giving everything to them to manage, was a disaster. Monsters were created that very quickly got out of control. Annual deficits accumulated and boards were unable or unwilling to exercise any oversight. It came down to no one being in charge.
If the federal government had not offered to pump a significant amount of money, some $41 billion into health care over a ten year period starting in 2004-2005, then we would already be in a very sorry state.
This investment was supposed to purchase reform, but not much happened.
Bickering among the ten plus one simply resulted in the money propping up the current system.
I don't think the province is capable of getting spending under control. I've tried to keep an open mind on the current reorganization, but I hear disquieting rumours. Health Authority "B" combined four of the previous health authorities, and it is now composed of five zones. I also hear seniors managers have been lobbying for more money and more managers. The financial update that's just been tabled in the legislature indicates that a $40 million deficit has been accumulated by the new health authorities. This is not a large number, given the size of their budgets, but there was to be no more deficit budgeting, or so I understood.
I thought we were supposed to be getting a lean administration. Costs were to be controlled through elimination of duplication and wasteful practises. Accountability would see senior managers reporting to somebody, perhaps the minister of health or the cabinet, annually on how well they were doing.
Perhaps the province could try keeping the global health budget at the same level for the next three years. After all, we are expecting little inflation, and possibly even deflation, as our current economic upset plays out.
Reform of health care delivery is going to take political courage. It also takes a special kind of government to back them up while they are doing so.