We all have a favourite health care horror story--a neighbour who spent twelve hours waiting for “emergency” service, or a great aunt who waited twelve months for a hip replacement. Add to these the recent cuts to service in New Brunswick, through which some hospitals will lose their beds and some communities will lose their hospitals, and you will understand why so many people in this province believe that our health care system is in crisis.
Dr. Dennis Furlong would disagree with that assessment. He does, however, believe that the system is in danger of certain bankruptcy if we go on as we are. Increased funding, as proposed by the Romanow report, will not be enough without changing the way the system operates. Medicare Myths is a red-alert, a call to Canadians to save what the finest health care system in the world before it is run into the ground. To do so, we need to change the relationship between then three components of the system: the consumer (patient), the provider (physician) and the insurer (government).
In a book that does nothing to avoid controversy, Dr. Furlong’s most controversial proposal is that patients should bear some of the cost of their health care. Since health care is “free” he argues, people tend to over utilize it. If a consumer had to pay even a small part of the actual cost, he would use the system more judiciously.Patients who run to their doctors at the first sniffle are only one group to come under Dr. Furlong criticism. Apparently believing that it is more important to be right than to be popular, he takes aim at various targets. Walk-in clinics whose doctors practice “one-handed medicine,” one hand on the stethoscope, the other on the door knob. Family doctors who neglect to provide after hour’s coverage for their patients, thereby stressing the emergency care system. The federal government, which has removed vital funding during the Liberal regime. He dares not attack nurses, whom he acknowledges as over-worked, underutilized, and drowning in paperwork. Instead, he passes judgment on a system which has laid off peripheral health care workers and shifted their workload to university-trained nurses. No one can argue with his assessment that highly skilled workers emptying bedpans or photocopying files is a prodigious waste of resources.
The fifty myths of the title don’t appear until near the end of the book. They are listed briefly and without comment: “More spending equals better health care”, “One must see a doctor if sick”, “Hospital beds equal good community health care”, “The system is in crisis”. Seen by themselves, some of his assertions are shocking and many of them are contrary to accepted public opinion. However, taken in the context of the entire book, most of them seem reasonable. This is the strength of Dr. Furlong’s writing. In spite of his often scathing comments about over-utilization, which made me feel guilty for every time I went to the doctor with a sore throat, and in spite of his overuse of bold lettering, which made me feel as if I were being yelled at, his arguments are rational. As a physician and a former Minister of Health, Dr. Furlong represents two sides of the health care triangle and weighs in on this subject with a lot of authority. His book appears at a time when the consumers of health care in this province are marching on the legislature and demanding more. Medicare Myths
offers an alternative proposal, to save the system by demanding less.