The important relationship is with government and citizen, not doctor and patient
When talking about the Canadian Universal Health Care System, the most important relationship is not between doctor and patient, but rather between government and citizen. The fiduciary responsibility of our government is ensuring families avoid bankruptcy because of sickness. All future planning, policy application, and Best Practice programs must be designed to secure proper funding to meet this expectation. Yet, as the system is seen to be failing, the standard talking points keep us maintaining the same old relationships and recognizing the same old practices of medicine. We all understand status quo is no longer copacetic nor sustainable, so why must our leaders stick to the same old talking points.
Talking points moralizing over our not-for-profit system being sacred are contradictory. This is understood by dissecting the relationship family doctors have within our system. These health professionals are private contractors working outside the very system they are allowed to control. Every visit to the family doctor is accessing private services. Just because these fee-for-service practitioners are paid through public funds does not take away the fact they are entrepreneurs who must cover clinic expenses.
The system is built on doctors providing private services within a publicly funded structure. We need our leaders to stop talking about saving our “not-for-profit” system when we have never really had one. The fact family doctors are denying services to complex patients emphasizes this health professions’ nonalignment and independence. Some are seen making business decisions over patient care.
Striving for every Canadian having a family doctor is no longer best practice. It is unreasonable, unrealistic, expensive, and completely ignores the scope of other allied health professions. We need talking points such as Dr. Jane Philpott's recommendation of universal access to a community primary care team which has provincial systems adapting what appears to be the nursing station model used by the Federal Government. This idea recognizes new research suggesting every Canadian needs access to a highly educated multidisciplinary collaborative health care team focused on their individual wellness, sickness, and education. In this environment, the community has a team working for them, not just one overworked entrepreneur.
The current system fails to recognize the importance of the shared responsibility between government and citizen. The fact our diets are so susceptible to and influenced by big business is an example of government neglecting citizens’ wellness. Recently, I heard consuming highly refined diet sodas instead of highly refined sugary sodas, is considered harm reduction. That is likened to accepting huge food manufacturers into the Canada Food Guide. The amount of money being made on sickness makes me sick. No amount of sin-taxation will pay for the damage done by these highly refined food products.
One way to fix this, is by investing in a formal public school health and wellness curriculum. This would go a long way to preventing big business from manipulating our food supply, because properly educated citizens will stop buying highly refined foods. However, this path makes a poor talking point, because it would take a generation to accomplish its goals.
Our family doctors are educated and motivated to use pharmaceutical substances - medicines - which the government has tagged with individual drug identification numbers. Accepting just these recognized substances, made by big pharma, ignores new research. Applying ideas such as Professor Janna Champagne advocating for universities to start teaching the science of the Endocannabinoid System, or Dr. Lynda Balneaves research in medical and non-medical cannabis is how we maintain Best Practices within our health care system.
When a citizen chooses to not follow the current path, they are seen to be following alternative therapies. Any relief, and or benefit gained is generally ignored by the system and not funded, because the fee-for-service family doctor relationship was not part of the equation. An acceptable therapeutic should not receive government recognition only because a patient accesses a family doctor who practices medicine by providing pharmaceutical products. We simply do not have enough family doctors to maintain this and it puts citizens in jeopardy as seen through the lens of Dr. Jennifer Anderson's son’s cannabinoids needs for his seizure disorder. The current definition of what is medicine is too expensive when other substances and practices have proven to be effective and cheaper to use.
If we continue to follow the old principles of the family doctor being the overseers, the primary focus and funding will continue to be on sickness. Depending on the illness or the injury, our relationship with our family doctor can be replaced by another allied health practitioner. The unbreakable relationship is truly that of the government and citizen, therefore the burden of maintaining the Universal Health Care System is between these two partners. The strength of any relationship depends on this shared understanding. A better educated population will make better choices which logically decreases the need for future sickness focused funding.
Government needs a healthier relationship with its citizens. The current scheme is failing because of old thinking and the path we are on is unsustainable. Following Best Practices is more than a just a talking point, it means applying new research which will eventually take us down new pathways. The real sacred cow is not maintaining this current so-called-not-for-profit system but rather, keeping my house while at the same time, not bankrupting the state.
KN