Doug's Blog

Living Forever

I am beginning to think that, not cancer, not aids, not obesity, but rather healthcare is the plague of the 21st century.  I am sitting in the Legislative Assembly listening to some discussion about the issue and I am beginning to fear that there may be no cure for this plague.  Everyone seems to have a different solution to the challenge.  The Liberals want to spend more money to keep it going, but as a colleague of mine just pointed out, how much is enough?  Healthcare spending has increased by over 10% a year for over a decade and still it’s not enough.  It grows also in its share of provincial spending every year.  When will we draw the line . . . when it accounts for 40% of the provincial budget, when it accounts for 50%, 60% or maybe we wait until it takes the entire budget and we have nothing left?

I think the problem we have, however, is deeper than any question we have been asking.  For instance, there are inefficiencies in the system, just as there are in every system.  Will finding those be the solution?  I think it will help the system and free up dollars for more healthcare, but it won't reduce the overall costs for healthcare and will not cause a decline or levelling off in the constant rise in healthcare spending.  Once the inefficiencies are found and the dollars spent we will return to the same rate of increase that we had before year after year.  That's when it stuck me.  The problems with healthcare are not about public versus private or about inefficiencies or even about what doctors or universities are doing.  The core of the problem, or rather the situation we find ourselves in, is greater demand.

You see, despite healthcare being a sacred cow that no one wants to touch, though it is eating everything up in its path, the challenge we have is that . . . well, people have the highest of expectations when it comes to healthcare.  We want everything and we want it now.  In this province we see the government flush with cash and we think we can and should have everything we want, not realizing that for every dollar that we have extra, we have seven dollars of demands on what to do with that dollar.  Healthcare is worse however, because it is not just about what we want, thinking it will make life better for us, it is about life itself.

I read 20 years ago that the challenge that North America faces, more than any other culture now or in the past, is that it fears getting old and fears dying.  Magazines and Hollywood are proof positive that we crave beauty which is the aesthetic equivalent of health.  We want to be well and happy and expect to experience no pain.  Drugs take away pain and colds and disease.  Hospitals make us better.  We want beauty and health and we don't want to, or don't expect to, suffer anything.  Drug commercials convince us there is a cure for anything that ails us, and we want it . . . now.

So, demands for healthcare are relentless, and despite all best efforts I don't see it slowing even remotely.  Healthcare is the fastest growing sector of the world's economy because the more affluent a populace becomes the more healthcare they demand . . . the more expectation that life will extend and improve.  What is the solution?  My instinct says that when healthcare is in such high demand and it is presented as 'free' demand is exacerbated and there will be no end.  If there is some direct cost to consumers of the service it forces choices, sometimes tough choices to be made, but it may help reign in demand.  I don't know if that is accurate, but it is a thought. I am always open to new ideas, and I really hope there are some other ones out there. 

Regardless, the thought that we all can and will live forever free of pain or discomfort is an unrealistic notion that may well be the root of the exponential demand for healthcare that is driving the costs up for virtually every jurisdiction in the world.  The point I make is that the demand is the cause of the rising costs and somehow demand has to be managed, or in short, we will lose all other programs, such as education and social services and environmental enhancement, as healthcare eats up more and more budget.