Last week the Canadian Medical Association released its Voices into Action report summarizing the feedback it received at its public town halls on Medicare. The same three questions provided a framework for discussion at each of the six town halls. The first question asked about broadening the Canada Health Act, the second about good value in health care and the third about patients’ responsibilities for their health now and in the future. None of the questions addressed health care funding or spending. Money is the elephant in the Canadian health care system.

Patients aren’t the only ones left in the dark when it comes to knowing the cost of medical services. Last year at an appointment with a specialist, my husband inquired about paying directly for an endoscopy rather than spending months on a waiting list. The doctor told him that he could get one outside of the country for around $20,000. I found a facility in British Columbia that offered one for $2,000.

It only makes sense that each of us should be responsible for our own health. Each of us makes personal choices affecting our health every day. If I’m going to be vigilant about my health then it’s also important to be vigilant about the health care I receive. Provide me with service and price information. Let me spend my own money on my own health care that way I can compare quality and price and make sure that I am getting good value for my health care dollars. 

Despite decades of political promises, billions of taxpayer dollars and a constant tweaking of Medicare, our access to care continues to decline and the quality of care continues to deteriorate. It’s time for a new competitive and innovative health care system. It’s time for consumers of health care to become customers of health care. It’s time to start talking about the elephant in the Canadian health care system.

The province of Quebec is now funding in vitro fertilization (IVF) treatments. Proponents of government coverage for fertility treatments claim the decision will not only benefit patients but will also provide some cost savings to the Canadian health care system. However, the true cost of this decision remains to be seen.  

The increased demand for publicly funded IVF treatments is bound to create a supply shortage resulting in waiting lists and the prioritization of patients according to government guidelines.

An immediate injection of cash from the government is expected to increase capacity in the system for the short-term, but what about sustainable funding down the road? Other countries providing publicly funded fertility treatments, including the UK, Australia and Denmark, are making cutbacks in funding or services to try and contain costs in their public health care systems. 

As of August 5, 2010, Quebec patients must access IVF treatments in accordance with their provincial Medicare program. Those wanting to avoid the health care bureaucracy and pay for timely access to private treatment will be forced to travel out of province.

Quebec’s decision to provide public funding for IVF treatments raises an important question for patients in the province. Can you afford to wait?

Hospital lottery brochure

All across the country hospitals are facing multimillion dollar budget deficits. As the highest cost of health care spending in Canada, we can expect funding cuts to our hospitals to continue at an alarming pace. One only has to look at the headlines of their local paper to see the astounding numbers. Perhaps the biggest health care deficit I’ve read about so far is the projected $1 billion deficit for Alberta Health Services. For Canadians this means more bed closures, staff cuts, a reduction in the number of procedures, increased waiting times and longer waiting lists.

As our provincial/territorial governments call on their hospitals to do more with less, the pleas for funding from other sources will only increase. Most hospitals in Canada already have foundations that hold annual lotteries and fundraising campaigns. The marketing materials encourage people to buy tickets to help change lives and save lives and in doing so become heroes. What are the ticket proceeds actually buying? The foundations state that the money raised will be used for purchasing life-saving medical equipment.

I was shocked last year when I received a brochure for the Lloydminster Health Region’s Lucky Lloyd Lotto in Saskatchewan where the proceeds were going towards the purchase of an ultrasound machine; a basic piece of equipment for any hospital. I kept the brochure as a reminder of the sad state of our health care system. Their website indicates the region’s recent purchases include tympanic thermometers (electronic ear thermometers) and a mobile X-Ray machine.

Funds from the Millionaire Designer Home Lottery by Vancouver General Hospital and the University of British Columbia Hospital Foundation are going towards the cost of Cardioplegia pumps required for life-saving heart surgery. Also on the list is a portable ultrasound for use in the intensive care unit, emergency department and cardiac surgery and a microscope and retractors for spine surgery.

The Foothills Hospital Home Lottery in Alberta has indicated that they will use their funds to help Southern Albertans with life-threatening injuries by purchasing equipment for Western Canada’s first state-of-the-art trauma operating room. What kind of operating rooms have they been using in the interim?

In my home province of Saskatchewan the Hospitals of Regina Home Lottery is purchasing new bedside monitors for the intensive care units in their hospitals. In Saskatoon, our three hospitals hold a hospital home lottery and this year St. Paul’s hospital is using their share of the proceeds for patient care in areas where no funding is available. It would be good to know which areas of patient care are without funding.

In Ontario the Ottawa Hospital and the Children’s Hospital of Eastern Ontario have teamed up for their lottery by promoting the continuity of care throughout one’s lifetime from child to senior. Their proceeds will go towards state-of-the-art equipment and building new facilities.

Proceeds from Newfoundland’s Health Care Foundation Hospital Home Lottery will support cardiac care for the people of Newfoundland and Labrador. The foundation estimates that $90 million will be needed over the next five years to purchase modern medical equipment and technology. Their list of urgent needs includes heart echo machines for ultrasound images of the heart, heart-lung machines for cardiac surgery and cardiac monitors.

Many of Canada’s hospital lotteries state that you have a 1 in 20 chance to win, however the odds do depend on the total number of tickets sold. What happens if these lotteries are unable to raise the funds needed to purchase life-saving equipment for our hospitals? It seems to me that by entering one of our underfunded hospitals, whose health care providers are forced to make do with outdated equipment, you are already taking a chance. The only difference is that this chance could cost you- your life.

Are you winning the health care lottery?