“Welcome, boomers. Let’s talk about health care,” is how award-winning journalist André Picard started his lecture, “Medicare 2050: Rebuilding the Health System for an Aging Society” on March 2 at Ellis Hall.
His reporting for The Globe has been nominated for the National Newspaper Awards eight times and won the Michener Award for Meritorious Public Service Journalism.
“I’m not a medical reporter. I don’t write about medicine except peripherally. I write about health—the politics of health and health policy,” Picard told The Journal in an interview.
Queen’s invited Picard to speak at an annual lecture series funded by Roland Mitchener’s family. Michener was a former Governor General of Canada and Chancellor at Queen’s.
In his talk, Picard addressed the past, present, and future of Canadian health care. It aligns closely with the content of his fifth book, Neglected No More.
“By 2050, there’ll be 50 per cent more seniors than children—12 million versus eight million. That’s what we mean by an aging society,” Picard said.
Canada’s “deeply held” belief that health care should be free stems from its religious roots, according to Picard.
“We see health care as an act of charity, not a business transaction, as is the case in most of the world,” he told the audience at his lecture.
The Canadian military also shaped our health care system. Created for veterans of WWI, Canada’s first state-funded insurance program accelerated talks of universal health care. The result was an administrative structure “militaristic in nature,” he said.
The system was built in the 1950s and 60s for the acute care of patients and hasn’t changed very much since. Canada’s demographics and medicine have changed significantly; the average age jumped from 27 to 47, according to Picard.
“What’s wrong with Canadian health care today in a nutshell is that we’re trying to deliver 21st century care with the 1950s.”
Canada’s health care system isn’t inequitable like the U.S.’s, Picard said. He said comparing Canada’s health care system to its southern neighbors is a “waste of time.”
“We have to stop playing this pathetic little game of comparing ourselves to the U.S. The U.S. is a country that doesn’t have a health care system […] We have to start comparing ourselves to countries in Europe and Scandinavia, that do have universal health care, and much better than us.”
Countries like Denmark or the Netherlands have more extensive coverage and prioritize the health of older people. He said Canada should learn from these countries rather than copy them.
“COVID-19 brutally exposed long-standing weaknesses, particularly in the eldercare field,” Picard said.
One fifth of Canadians not having a family doctor, people being triaged in parking lots, and eight-hour waits for an ambulance are some of the issues the system faces.
Lack of supportive housing and home care for elders is also an issue, Picard said. Costs are increasing as access diminishes and despite technological advances, hospitals still use fax machines.
“The problems we have are largely systemic. Let’s fix the damn system.”
He wants Canadian politicians to make changes by being specific—ensuring Canadians get care at the right place and time, equitably, and by promoting a high-quality life.
“Here’s my pithy recipe for successful health care reform. Let’s start by scaling up all our successes, and let’s stop perpetuating our failures.”
Queen’s is partnering with the Weeneebayko Area Health Authority (WAHA) to create a health care program in the James Bay region. Picard thinks it’s a great initiative, as we need to invest more in Indigenous health.
“That’s one of the great shames of Canada—the way we treat our Indigenous people, and that their life expectancy is poor,” he said. “One of the solutions is to have people from those communities to deliver culturally appropriate care.”
There will be pressures to develop the program in different languages—which might entail flying in instructors, according to Picard. Canada will need to create a new generation of teachers and integrate traditional Indigenous medicine in future healthcare systems.
“We have this upcoming generation of Indigenous youth—a lot of them, a lot of potential. We need young people in our workforce; there’s so much potential for them. We can’t allow ourselves to waste other generations.”
To Picard, taking women from their homes in northern Canada around a month before giving birth and placing them in a big city is a “horror” of our health care system.
“We have to invest in things like midwifery [and] make sure that people have decent treatment—that in case there’s an emergency, there’s some kind of service there that can handle it,” he said.
Investing in preventative health care is important, especially in Indigenous communities, he said.
“Politicians are very fearful of health care […] It’s fear that they’re going to pay a price if they try and do something differently.”
Picard thinks the general public doesn’t focus enough on prevention and the economic realities of health care.
“I think we read way too much about medicine and fantasies […] I wish we wrote much more about the things like the social determinants of health.”
The social determinants of health are a part of good economics. Picard believes there are two big revolutions underway for the future: technological disruption and consumerism.
The pandemic accelerated a shift to virtual health care. Technology will replace some people and free up doctors doing routine paperwork to dedicate their time to talking to people. AI will allow the continuous collection of data—which will help the government realize the links between health, education, and housing.
New “convenience” clinics are popping up in Walmarts and Superstores, allowing consumers to multitask—like buying Tylonol while waiting for their appointment, Picard said.
“In the era of digitalized, personalized medicine, health care has to be built around people, bringing the care to them.”
Globe and Mail, Health, Promoting, reform
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