Volume Nine, Number Three    May 2004    www.columbiajournal.ca

YOUR HEALTH

Health Care Reform
Dr. Diane Forbes

At the end of April 28, the Vancouver Board of Trade held a “policy forum on health care reform”, where speakers from the Fraser Health Authority, the Cambie Surgical Centre and the BCMA presented their takes on the need for health care reform.  Entitled “Health Care Reform:  Everyone Talks About It, But How Do We Do It?” The presentations covered discussions ranging over topics regarding spending challenges, privatization, increased competition in hospital services and community-based improvements in Diabetes care. 

There was little done to actually address the reform component, rather there was a lot of discussion about the problems with the current system, how the province pays for the health services provided and how to improve the services purchased with health budget dollars.  It was interesting that at the same time the worker of the Health Employees Union were picketing, fighting to safeguard their jobs.  Then later toady the BC Government created back to work legislation sending employees back to their duties with a unilateral decision.

The thing that strikes me about this day is that there seems to be little changing in regards to reform that is not adversarial.  The environment for reform appears to be so negative that it could well be impossible to create true, effective and lasting change when all the stakeholders can’t talk about the problems in a manner conducive to solution.  There is a lot of discussion about creating an improvement to health care by introducing business practices to the health environment, but there seems to be little taken from the study of organizational behavior.  Some of the most successful companies are also ones voted the best employers, and every CEO recognizes that their front line workers can make or break their bottom line.  So why don’t we look at this paradigm as we look to solve the health care problem.

In some ways I think about solving the problem in the way that we think to treat an illness.  It takes masses of coordinated action to successfully fight heart disease.  From start to finish it often takes the participation of many people for the treatment of one person.  Starting with the booking of appointments, the assessment and diagnosis, the referral to hospital, the diagnostic testing, the records keeping that makes sure appropriate information follows the patients, cleaning the care facilities, billing support, transportation and logistics to get medicines to the pharmacy…phew, need I go on.   I would hate to think how the outcome of our health practices would be if there was so little cooperation in the actual treatment of disease.  Not many survivors I would guess.

Probably the hardest part of reforming health care is trying to make sure that everyone gets a piece of the health spending pie that is the size they want. And it is really possible that all the participants in health care reform could get a bigger piece of pie if there was a real endeavor to create positive change, in a cooperative manner. Right now the piece that falls on the floor every time we cut is satisfying no one.  So lets get our act together, and creatively and cooperatively solve a problem near and dear to our hearts, literally.