New Healthcare Prescription Needed

Every medical decision comes with consequence. A prescription course as remedy ideally offers a lesser consequence than the ailment. Patients and physicians make weighted choices on lesser of evils to improve outcomes. Immediate relief is considered against deferred consequence. There is a consideration of compromise with each decision. 

Health delivery systems are driven to make decisions on impossible options. In P.E.I. there is a strain of dispersion overlain with perpetual structural cost increases. It’s a system morphed into administration coordination of human resource and infrastructure. Community-based foundations are relied on to purchase equipment with the province pouring concrete and shuffling people against a tide of slippage that is assured to become more challenged. Prince County Hospital fundraised $1.9 million in 2021 and the Queen Elizabeth Hospital raised $8.9 million.

A popular K-Tel product introduced in 1963 was the Veg-0-Matic. A horizontal series of intersecting blades would be compressed together to serrate any vegetable placed between the press. Health care is perilously between blades of financial constraint and insatiable demands, pressured from both spectrums as the blades of reality squeeze into the flesh of service delivery. 

A new demand is emerging at the speed of cryptocurrency: health-care consumerism. Medicine has moved from a privilege to entitlement. Medicare has morphed from an aspiration in 1957 to a consumable commodity where conflicting information is available on mobile phones and expectation for immediate solution is untenable. A demanding public is seeking remedy rather than responsibility. Consumerism has the attention span of 140 characters or less.

Health-care spending is on an escalation spiral. Growth rates vary but according to the Canadian Institute for Health Information, 2020 witnessed a 12.8 per cent increase in required investment. The pace of health spending has been growing faster than other aspects of our economy. According to P.E.I.’s provincial estimates for 2022, health is 34 per cent of all expenditures. Having already eclipsed all departments, health continues to absorb a greater share of provincial investment presently using almost all revenues collected from consumption sales taxes, personal income tax and corporate income tax.  

Solutions are rarely contemplated because they are politically uncomfortable. True leadership needs to address the issue because challenge only compounds it. Evaluation of the ratio between service delivery and administration should be measured and service consolidation needs to be considered. Is timely universal access achievable, can user fees curb behavior, is personal responsibility a primary course, are carrots and sticks applied to the right measures, has bureaucracy created bloats of inefficiency and should effort be considered external to the panacea of government? A mindset shift will be needed for correction, but politicians do not have the mindset to make change. 

Health care is no longer viewed as a service. It is an expectation, an unachievable ideal being crushed under its own weight. Professionals and administrators are no longer providing a vocational service but are servants to an insatiable system. The equilibrium of balance has shifted. 

When the most creative solution presented is a medical school that quantitatively can’t be executed, perhaps we need a collective change of focus. There are structural impairments far greater than brick and mortar. A school on the horizon, if ever operational, will not address concealed imbalances. 

This is a difficult and blasphemous conversation and is one that needs to occur. The trajectory of this sacred service has never been more apparent. It’s unsustainable. There has been enough bad medicine of administration. What is needed is a new societal pact, including public re-education and expectation, more early intervention and channelled public investment.