This is an interesting dilemma.
I think that each province has its own pluses and minuses. Dr. Brian Goldman hosted CBC's Cross Country Checkup phone-in, and with various guests and callers examined this question.
I think there were few answers, as each caller reflected his or her individual province, or city's healthcare resources. Few see the Canada-wide picture, as few patients have a national perspective. Even fewer healthcare professionals have a national perspective.
Instead of letting exemplary practices drive the system, we allow the politicians to manipulate it individually by province and territory. The kind of care you receive depends upon where you live. And then, it depends upon whether you are rural or urban. In some instances, it depends whether you are educated or not, rich or poor.
The new, recently dictated federal government Healthcare payments of 6%, non-negotiated by our Prime Minister, does nothing to ensure that women in PEI get the same care as women in Toronto.
It is shameful that there are inconsistencies.
It is shameful that provinces, like Alberta, allows for Concierge Healthcare.
It is shameful the number of people who die needlessly, or in pain, or in hospital, due to ineffective delivery of services, and physicians who do not treat individuals but diseases.
Integrative Healthcare Teams
In Ontario we call the Family Healthcare Team (FHT). Family Health Teams who serve rich and poor equally well. In BC they call it an Interdisciplinary Team.
These are professionals (social workers, nutritionists, nurses, NPs, doctors) who counsel those with obesity issues, those at risk for diabetes, smokers who cannot quit. CBC.ca's Chasing Cures, suggested that 25 - 20% of all health issues can be prevented by smokers quitting smoking.
Yet, we donate millions of dollars to charities that suck up our money, without knowing where that money will go.
We know what works
We know what works in health care: prevention, early identification, efficient treatment. Then, when all else fails, we need to be able to die with dignity. Too many suffer, in pain, undergoing useless treatments. We need sensible treatment plans, reasonable measures, and adequate pain medication. I believe that the healthcare system isn't broken, that we need give more respect to the physicians who are models of integrated healthcare, exemplary practices, who tell us the truth about our health. These are physicians who provide palliative care, and honest answers to our questions. (See Questions for your oncologist.)
Millions goes to cancer research, yet we have had few breakthroughs for all the money sunk into research since the 70s. Millions more goes to agencies that lobby the government, or harass taxpayers for donations. Yet, some deliver direct services for those with specific disorders: COPD, heart and stroke, MD, MS, cancer (peer support, transportation) to help those with these diseases.
Research or prevention?
What if we put this money, not into research, but into prevention?
What if we put this money into support for those with addictions?
What if we assign FHTs to helping those with chronic conditions to manage their disease?
(See Get Seniors Moving to Prevent Falls.) (See Hospitalisation for seniors.)
What if the paltry amount given to hospice work, and support for ailing seniors, is supplemented by the millions of dollars syphoned into fruitless research?
Exercise, weight control, sensible amounts of alcohol, low fats, high fruits, fibre, portion control.
Therapy for mental health issues: PTSD, depression (a common symptom of caregivers – been there, got that t-shirt).
Yet, many more are doing research into letting us live longer. We should want to live longer, but live stronger and to be more healthy during the time we have. If you have ever visited a long-term care home with 90-something seniors whose family members do not have time to visit, whose friends have long gone, whose life's work has ceased, you wouldn't wish to live past 100.