Sunday, February 26, 2012

Of Umbrellas and Safety Nets: Health Care in Acute and Chronic Crisis

This past Friday and Saturday, a conference called Beyond Acute Care had speakers and panels discussing health care issues concerning the elderly, disabled, and other vulnerable citizens. The illustration of what is currently happening our health care system is something like this: there is an umbrella over top of this population, which takes care of most acute needs. However, when the need for care becomes chronic, the umbrella gets smaller and smaller, with more and more services needing to be paid for out of the pockets of the patients or their families.

These issues are of importance to everyone, regardless of age or health status. Many of us, if we are fortunate, will become senior citizens some day. With the health care system being so precarious now, worrying about what it will be like decades from now is justified. As well, life can change in an instant. There are those for whom an accident, a brain injury, or a serious mental illness suddenly took them off of their current paths and into the chronic health care system. As well, if you are like me, you may become a caregiver to an ill parent, taking precious time from your work time and social life to attend to her needs while being faced with decisions concerning what to do when the situation becomes too medically complicated to deal with, without some outside form of help - help which will likely come with a price tag.

The "umbrella" of which the organizers of the conference speak has another name: the safety net. One with a lot of holes through which the vulnerable fall. For example, an elderly person falls, breaks her hip, and has to be hospitalized. Her acute needs are taken care of: she gets a hip replacement, some initial physical therapy, and during her hospital stay gets medication she needs for the pain. However, due to her injury, she can no longer live at home, unassisted. She either has to get live-in help or move to a long-term care facility - neither of which are inexpensive options. Plus, she has prescription medications that, while subsidized because of her age, still cost a significant amount out of pocket for someone on a fixed income.

So really, when a medical situation goes beyond the need for acute care, things get quite precarious. Even within acute care, a person's finances can be stretched. Prescription medication is perhaps the best example of this. I had an ear infection requiring antibiotic drops a few years ago. The tiny bottle of medicine cost around $35. That is a lot of money for someone on a budget. People who have chronic conditions like MS have medication they have to be on for the long haul. Unless they have good private insurance from their employer (which is getting rarer and rarer these days) or have purchased insurance on their own, they are financially hooped.

Related to this are the ridiculous fees one has to pay to see a dentist, which is also not covered unless you have private coverage. Last year, I had to have two fillings, a check up, and a cleaning. The bill came out close to $1000. I don't have insurance, so the bill caused me quite a bit more pain than my cavities. It was also a reminder as to why I had not been to a dentist for five years. However, infections and abscesses originating in the mouth can lead to death. I can't understand why dental work is not covered by our health care system. Since we're talking about older people, they often need extra dental care and procedures like having dentures made for them.

Another issue affecting our health care system is the pay and treatment of Alberta Health Services Support Workers. The wildcat strike held by members of the AUPE at the Royal Alex and University of Alberta hospitals on February 16 was a wakeup call to many to these workers' conditions. Perhaps it is my OCD tendencies speaking, but I want the person responsible for sterilizing equipment for a procedure to be well-treated and well-paid. The very fact that over 60 elective surgeries had to be cancelled demonstrated the importance of these people to the proper functioning of the health care system. Respect them.

It is a government's job to make sure its citizens are healthy and protected. There is a provincial election around the corner. Pay close attention to what the candidates are saying about public health care. If anyone even breathes the word "privatization" - be afraid. Be very afraid. Because no matter how much they promise that the system will be arranged in such a way that everyone will have access, regardless of their financial situation, invariably it will turn into a situation where those who can pay will get treated first, and better. Instead, choose those who will make our public services a priority and put money where it is needed. After all, like closing speaker Maude Barlow (National Chairperson of the

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