I wasn't able to make the Public Policy Forum's annual testimonial dinner on April 28th when André Picard, the Globe and Mail's Health Reporter received the Hy Solomon Award. However, those who attended were unanimous – his short acceptance speech was brilliant. Here it is, with André's permission.
The Five Mantras of Healthcare Reform
The fine folks from the Public Policy Forum have asked me to say a few words on my pet topic – Canada’s health system. But they have said I have to keep it under five minutes.
So, in the 300 seconds I have, I would like to share five mantras for healthcare reform.
(Mantra is a Sanskrit word meaning “instrument for thinking.” Mantras are short phrases designed to focus the mind – and, Lord knows, we could use some focusing of the mind in the health field.)
Mantra #1. Medicine is the easy part of healthcare
It’s just plumbing with more expensive tools. We need to invest in things that will make the population healthy – education, housing, the environment, community building, meaningful work.
And when people are sick or wounded or demented or disabled, we need to get our priorities straight: Hold their hands, listen to them, comfort them, help them navigate the care journey, and help them remain members of their community.
And, of course, we need to continue to do good plumbing.
Mantra #2. The law is an ass
We must stop hiding behind the Constitution in such a cowardly fashion. Health is not a provincial responsibility, nor a federal responsibility; it should a universal goal and a fundamental right.
In the provision of healthcare, we need to be guided by values, not shackled by anachronistic laws fashioned in – and for – another time.
Mantra #3. To quote the legendary economist John Kenneth Galbraith: “If you don’t count it, it doesn’t count.”
We need concrete health goals, to be guided by evidence, to measure results, and to reward success.
To do so, we need to invest in technology; we need to make a culture of safety a priority; we need to embrace innovation, and; we must make patient-centered care a mission, not merely a public relations catchphrase.
Mantra #4. You can’t deliver 21st century care with a 1950s system.
Our health system was designed for the delivery of episodic acute care by physicians, principally in hospitals. The reality today is that most patients have multiple chronic conditions and they can be treated in the community.
We need to fundamentally re-shape the system to reflect their needs. That means an emphasis on primary care, on team-based care delivery and creating a continuum of care.
Our ultimate goal: A good life and a good death.
Mantra #5. Stop whining. Start doing.
The poet Shelley said of his mother-in-law: “She has lost the power of communication but, sadly, not the power of speech.”
That describes well my feelings about far too many our elected officials, business titans and community leaders and my frustration with their seeming inability to articulate a vision for healthcare.
The lobbing of rhetorical hand grenades like “unsustainable,” “out-of-control spending,” and “an aging population that will bankrupt us” is tiresome and counter-productive – not to mention that these Chicken-Little-like warnings are fallacious.
Leadership is about finding solutions, not embracing failure. Make the system work, don’t assume it is unworkable.
Have we lost sight of the raison d’être for medicare? It’s just, it’s fair, it’s efficient, and it’s cost-effective.
We can have these social and economic advantages and be financially responsible.
Leadership means not only articulating these values but giving them life.
No, medicare cannot be all things to all people. For me, the starting point is defining what medicare should cover – and not cover – in the 21st century.
To be deserving of the title “leader” you have stop whining and start acting.
If I have spoken for too long, I apologize. But I hope my comments have been stimulating and maybe even discomfiting.
In conclusion, I want to thank you again for bestowing this great honour, the Hy Solomon Award.
It falls in the category of lifetime achievement award, but I want to serve notice tonight that I’m not dead yet: I plan to be around a lot longer.
I also plan to become increasingly cantankerous and obnoxious on behalf of the Canadian public, which is demanding that our leaders embrace and implement healthcare reform.
As Martin Luther King Jr. said: “Our lives begin to end the day we remain silent about things that matter.”
Healthcare matters. We owe it to ourselves to get it right.
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