Post-hospital medicare plan needed: CMA

Canada needs a re-engineered medicare system that offers patients the care they need after they leave hospital, the head of the Canadian Medical Association says.
Canada's health-care funding accord between the federal government and the provinces expires in three years. ((Kevin Frayer/Canadian Press))

Canada needs a re-engineered medicare system that offers patients the care they need after they leave hospital, the head of the Canadian Medical Association says.

In a speech in Toronto on Monday, Dr. Jeff Turnbull said the federal government should tackle the looming health-care crisis the way it fought the recession.

Turnbull told the Empire Club about an 80-year-old Ottawa patient who needed major surgery for an aneurism. Her daughters flew in from Vancouver, she endured a taxing preparation for the surgery and then learned the operation was cancelled. The reason: there was no bed for the patient afterward.

Ontario health care

The Ontario Medical Association urged municipal leaders on Monday not to forget about health care ahead of the next provincial election. The two groups met to discuss infrastructure, including hospitals.

The OMA's policy platform calls for steps to:

  • List calories on menu boards at fast food chains to fight childhood obesity.
  • Mandate physical activity in high schools.
  • Stop children from easily accessing cheap and illegal cigarettes.
  • Ensure everyone in the province has an electronic medical record by 2015.
  • Expand the number of family health teams.
  • Implement a mental health strategy with a focus on young people.
  • Increase long-term care capacity and home support services.

Sobbing, the woman told Turnbull she couldn't go through that again — a telling story, which he said is multiplied at hospitals throughout the country. The system isn't functioning as a health-care system should, he said. 

And a lack of beds isn't the only shortcoming in post-hospital care. Doctors also face patients who don't want to be discharged from hospital because they can't afford a walker, wheelchair or the medications covered in hospital, Turnbull said.

"How comprehensive is a medicare system that denies people the drugs or devices they need to get better?" Turnbull, the president of the CMA, asked in the prepared text of his speech. "The current law governing medicare covers only physicians and hospital care. 

"When the law was written, this accounted for 60 per cent of medical treatment. Today, it's only 40 per cent."

Cost questions

To help solve Canada's health-care problems, the CMA suggests:

  • Creating more long-term care beds for patients who leave hospital but aren't able to look after themselves at home. 
  • Expanding the use of electronic medical records.
  • Focusing on health promotion.
  • Combining purchasing power to ensure taxpayers get the best value for their health dollars.
Canadian Medical Association president Dr. Jeff Turnbull says medicare isn't comprehensive enough to cover the drugs or devices patients need. ((Paul Darrow/CMA))
Time is ticking on renewing medicare, since the 10-year, federal-provincial accord for health-care funding expires in three years.

Turnbull advised Canadians to "choose wisely" at the ballot box but he didn't say whether CMA had a preference.

Another report Monday, by Canadian Doctors for Medicare, says the widely repeated concern about sustainability of public health care is unsubstantiated.

Core Medicare costs have stayed between four per cent and five per cent of GDP, according to the report, titled Neat, Plausible and Wrong.

Other public health care costs have grown at a slightly faster pace, the organization said. Total public spending on health care has increased at an annual rate of five to seven per cent for more than three decades.

"It's a classic case of Chicken Little," Danielle Martin, the group's chair, said in a news release. "Once people started saying it, and put a bit of spin on the numbers, no one stopped to question the facts."

It's growth in private-sector costs that is a concern, the report said, noting drug expenditures are more than three times what they were 20 years ago and private health insurance costs have increased sharply.