Better Now: Six Big Ideas to Improve Health Care for All Canadians - Softcover

Martin, Dr. Danielle

Softcover

ISBN 10: 073523261X ISBN 13: 9780735232617

Verlag: Penguin Canada, 2018

Inhaltsangabe

From respected doctor and passionate Medicare advocate Danielle Martin, an important check-up on our health-care system--and what urgently needs fixing.


          Dr. Danielle Martin sees the cracks and challenges in our health-care system every day. In the style of Atul Gawande, she uses real patient stories to illustrate what works in our health-care system and what doesn't. Most importantly, she proposes six big ideas to make healthcare achievable and affordable: 1) a national drug program; 2) change the way we deliver care; 3) reduce unnecessary tests; 4) strengthen primary care; 5) create a guaranteed income program; and 6) scale up successful innovation.
    One of the most urgent reforms she advocates for is a national pharmacare program, instead of the piecemeal provincial pattern of buying drugs. Canada could save billions if drugs were bought in bulk by a single body, which in turn could fund a national prescription program. Patients also need a regular GP instead of overusing hospital Emergency Clinics. Hospitals need to take into account a patient's overall medical history, at every stage from admission to discharge. And since poverty is the greatest predictor of ill health, Dr. Martin argues that a guaranteed income could prevent and alleviate many health problems, reducing pressure on the system and our wallets. 
     Passionate, accessible, and authoritative, Dr. Martin is a fervent supporter of the best of Medicare and a persuasive critic of what needs fixing.

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Über die Autorin bzw. den Autor

DR. DANIELLE MARTIN, MD, CCFP, FCFP, MPP, is a family physician in Toronto and Vice President of Medical Affairs and Health System Solutions at Women's College Hospital. She teaches family medicine and health care policy at the University of Toronto and is a leader in the debate about the future of health care in Canada. In her first year of practice, she helped launch Canadian Doctors for Medicare to promote a high quality, equitable, and sustainable health system. She was named Canada's 8th most powerful doctor by The Medical Post in 2015 and is a regular contributor to CBC-TV's The National. She writes a monthly column for Chatelaine.

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In December 1951, after a three-week voyage crossing the Atlantic, my grandfather, Jacques Elie Shilton, reached Pier 21 in Halifax. He was forty-two at the time, and had shepherded ten family members—three generations—through the rigorous and at times perilous process of leaving Egypt for a better life. My mother, who was three, spent the voyage playing with a doll she still remembers.

Gaping at the five-foot-high snowbanks, they boarded the night train for the forty-eight-hour trip to Montreal. My grandparents had left everything behind—their jobs, their savings, their home. They brought several trunks of inappropriate clothing and the few hundred dollars they were allowed to take out of the country. A local immigrant-support organization helped them find an apartment at the outer edge of the city. At least they spoke the language, but the French of North African Jews stuck out as different, just as they did.

My grandfather measured six foot two. He was handsome, with a strong, calm presence and a baritone voice. He spoke seven languages. In Cairo he had worked for a French newspaper, and later for 20th Century Fox. He loved music and he was a talented musician. In the evenings, he played in a dance band to supplement the family income. His two young daughters had no sense of the weight he carried on his shoulders. It seemed to them that he had the strength of ten men.

In the spring of 1953, he went to visit a friend who was being cared for at the Jewish General Hospital in Montreal. But the steep hill on Côte-des-Neiges Road proved too much for him, and as he sat in the waiting room, he suffered a major heart attack. He spent nine weeks in hospital. So began my family’s experience of Canadian health care in the pre-medicare days.

After the heart attack, Jacques began having trouble with his breathing. Coughing fits and respiratory distress required frequent visits to the doctor, who had to be paid in cash. Medications were expensive. Sometimes he bought them; at other times, he preferred to save the money. He started having terrible pains in his legs. He experienced increasing difficulty walking, but since every visit to the doctor was expensive, he pushed on.

Time passed, and the pain became unbearable. The blood circulation to his legs was so restricted that his doctor told him his life was on the line. There was no effective treatment for such extensive arterial disease in those days. But then they read about Dr. Michael DeBakey, an international innovator in the emerging field of vascular surgery. DeBakey had pioneered an experimental procedure to open up blood supply in blocked arteries, a technique he hoped could help people with Jacques’s problem. He had begun performing it in Houston, Texas. It was worth a shot.

Already crippled by medical debt and his inability to earn a good living, Jacques and my grandmother, Sarah, borrowed money from family members to finance his care, a decision that would taint family relationships for generations. They went to Houston. At my grandfather’s request, and in order to save money, the nine-hour surgery was done on both legs at once. During that entire time my grandmother stayed planted on a chair in the waiting room without anyone coming to tell her whether her husband was dead or alive.

Despite the fact that Dr. DeBakey had decided to forgo his fees, Jacques and Sarah couldn’t afford to stay in Houston for the recommended six months of convalescence. They returned home nearly immediately.

But the experimental surgery wasn’t very successful. The “arteries” that had been inserted served as a pipeline for clots. Jacques was bedridden, and he suffered multiple small heart attacks. He lost fifty pounds and looked like a shadow of the man he had been.

Over the years, the impact on my grandmother was profound. She ate poorly; she had trouble sleeping. The medical bills and the strain of family relationships—ruined now by the borrowed money they couldn’t pay back—preyed on her mind. Jacques’s efforts to work from his bed, the daily injections of diuretics, the pills, and the constant visits to the doctor wore away at her and her two daughters. Eventually, Sarah’s mental health succumbed and she spent six weeks in hospital.

Sarah and Jacques then separated for a time so that they could each try to recover. My mother, who was now in her teens, stayed with Jacques, and her sister went to live with Sarah. The two girls did the best they could to work and contribute to the family income while they embarked on their university studies. And after their mother recovered and was feeling emotionally stronger, Jacques began to court her again. He would bring groceries to her apartment and they would talk about where they might move together in the spring.

But that didn’t happen. My mother found him dead at four o’clock in the morning on March 9, 1966, six days after her eighteenth birthday. He was fifty-four years old. He had stayed up more than half the night working on a French-to-English translation to earn a little cash. Sarah, who’d worked from the time they arrived in Canada as an assistant in a fancy Montreal ladies’ dress shop, was widowed at age forty-one with a pile of unpaid medical bills on the kitchen table.

My mother’s view is that the struggle to deal with financial hardship—along with health problems—destroyed her family. She was studying at McGill at the time, the same university I would attend decades later coming from all the luck and privilege anyone could ask for. She hadn’t yet earned her master’s degree or launched a successful career. She hadn’t yet met my father, a nice boy from a Fine Old Ontario Family who wanted to make the world a better place. She hadn’t yet raised a daughter who would make improving health care in Canada her life’s passion.

There are more stories of course, but this is a glimpse. It’s the story of my family, and also of countless others across Canada who rejoiced when we decided together as a country that it was time to create medicare, a system of hospital and medical care that is free at the point of service for all Canadians.

Health care in Canada isn’t perfect. We face very real challenges, challenges I see up close every day. But I grew up believing, as most Canadians do, that the values on which our system is built are sound. That being sick is bad enough without worrying about having to pay for your care. That the families who lived at the top of the hill in Westmount mansions were no more or less deserving of good health care than Jacques and Sarah were.

Our system will need to change to meet the needs of patients over the next fifty years. But that does not require us to institute one system for the rich and another for everyone else. Instead, Canadians can show that we have the courage to address some real and substantial issues without abandoning fairness as if it were a trend that’s gone out of fashion.

Most doctors (and nurses, and patients, and citizens) who support medicare are not blind supporters of the status quo. To the extent that our commitment to medicare might make us vulnerable to accepting mediocrity, we need to do better. But we can work for change that addresses our problems and still honours our principles.

As a family doctor working in the system, I believe this now more than ever. Medicare is a work in progress, but it’s a work worthy of our greatest efforts. It represents a promise to be the kind of country we can be proud of. This book explains what I think needs to be done to deliver on that promise.
 
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Many books have been written about Canadian health care, and many...

Details zur Ausgabe

• Verlag: Penguin Canada
• Erscheinungsdatum: 2018
• Sprache: Englisch
• ISBN 10: 073523261X
• ISBN 13: 9780735232617
• Einband: Taschenbuch
• Anzahl der Seiten: 304
• Kontakt zum Hersteller: Nicht verfügbar
• Verantwortliche Person: Nicht verfügbar