Tuesday, July 31, 2007

An Unwanted Journey: Day 0614 - Medicare Plus, a Patient's Perspective

Earlier today, I mentioned the Globe and Mail's front-page article about the Canadian Medical Association's hope to spark a debate about the next generation of Medicare in Canada. This evening, I've been reading some of the publicly available material on the CMA's website that fleshes out exactly what the CMA hopes to do

The CMA calls it Medicare Plus. The policy statement was ratified by the Board of Directors in May 2007 and can be examined here. There are 3 key points in the policy statement:

  1. Medicare must be shored up to ensure timely delivery of services.
  2. Guarantees must be put in place for timely delivery of services.
  3. The spectrum of services needs to be expanded.

Essentially, the CMA is saying we need more doctors, nurses, and other health care professionals in the system. We need better health information technology, national care standards and wait times, a blend of public and private insurance options, a nationally funded pharmacare program for prescription drugs, and greater attention to long-term care for the elderly, especially as my generation ages.


One thing that impressed me was the policy principles upon which the CMA's recommendations are built - timely access, equity, choice, comprehensiveness, clinical autonomy, quality, professional responsibility, transparency, accountability, and efficiency. These are exactly the kind of values that need to be articulated and made the bedrock for further discussion.


The catch is political. Will governments support national standards when the delivery of health care is provincially controlled? Will governments consider a blend of public and private insurance and delivery options? Will governments pander to out-dated sacred cows instead of re-visiting 40-year-old ideals that don't make sense in today's world?


The CMA realizes that the public response will be key to political will. An Ipsos Reid poll of the public response has been tabulated and presented in a PowerPoint slide deck readily available on the CMA's website. The poll makes it clear that older Canadians, better educated Canadians, and women in particular support most of the CMA initiatives to improve Medicare in Canada. My hope is that health care institutions across Canada will promote the initiative, engage in dialogue with patients who use their services, and lobby provincial and national governments to take action. Legal challenges will continue one way or the other (Quebec, Alberta and Ontario), but it is far preferable that we all engage in this dialogue immediately instead of leaving decisions to the courts.

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