All the while, we continue to hear the same tired arguments made by the same voices. Some say the problem is a shortage of resources (doctors, nurses, MRIs, hospital beds). Others tell us that if we only managed the system better, we would solve the problem. Still others tell us that we should be allowed to buy as much health care as we want. Finally, we are told that if we can only get health providers to work together, both in hospitals and out in the community, people will get the health care they need.
All of these voices have one thing in common: they assume the health-care system is the key to improving our health.
The reality is that with the exception of some public-health measures that have been developed over decades, such as vaccination and water-quality testing, much of the health system focuses on trying to make us well after we are sick. This means that, for many of us, our need to use the health-care system will be sporadic and will likely occur more as we get older. Of course, this is not to say that we won't use it too much anyway, because, like all addictions from alcohol to overeating, we have a tendency to deny that there is a problem. We are unable to stop ourselves.
If Canadians were serious about saving the health-care system, we would admit the true nature of the problem and take steps to beat the addiction. For example, we have increasing evidence that much of the illness that we experience is related to working too much in unhealthy workplaces, not eating properly, not getting enough exercise and not getting enough sleep. We also know that people with fewer resources are likely to end up getting sicker. Yet, for the most part, the health-care system does very little to address any of these issues.
So it would seem that, in order to save the health-care system, we as individuals and organizations need to enroll in a five-step program to kick the habit.
STEP 1: Instead of continuing to insist that we are not getting enough health care, we should entertain the notion that we are using the system more than we need.
Instead of running to the doctor every time our nose is stuffy, we should stay in bed and rest for a day or two. This simple act alone would save the system millions and perhaps make the demand for more family physicians less-pressing. Over the last couple of years, I have tried this and it has worked for both myself and my kids. The catch is that you may have to take some time off work.
Or how about taking the stairs instead of the elevator when you only have a couple of floors to go? I spent 10 years working in a building with health providers who often took the elevator to get from the first to the second floor. Many were visibly on their way to becoming patients.
STEP 2: Create healthy places for people to work.
A key to making this step work is to start treating each other with respect. Organizations have a responsibility to ensure that bad behavior is not tolerated. Given that workplace violence (psychological and physical) and absenteeism have been increasing steadily over the past several decades, the potential to improve productivity should be self-evident. And of course, the family responsibilities of employees need to be accommodated (i.e. physical, mental and family health). But this won't happen unless organizations take a lead role.
STEP 3: Develop communities that allow us to carry out our daily affairs without having to get into our cars to get everywhere.
Several approaches are needed to make this happen. Urban planners need to start putting basic necessities within walking distance of homes. How about including bike trails as part of all new developments? While we can't undo what is already done, we could fix this in areas where new development is scheduled to occur.
All three levels of government could commit to developing strong and convenient public transit. I used to take public transit to and from work. When system cutbacks occurred in the 1990s, taking the bus became so inconvenient that I gave up and went back to driving my car. Developing designated express lanes for buses and extending light-rail systems to developing suburbs would be a good start. And incentives for car-pooling and environmentally friendly cars would appease those of us who can't live without a car.
STEP 4: Put the health back into public education.
Over the past two decades, mandatory health education and physical activity have been reduced, if not eliminated, from public-school curriculums due to lack of funding. Even when I went to high school, daily physical activity was not a requirement. In general, public education about how to stay healthy needs to be pursued more aggressively.
STEP 5: Set an example for your children by getting off the couch and away from the TV. An increasing number of us are spending our evenings and weekends sitting in front of the tube or the home computer. Our children are emulating our behavior by playing video games in the rec room instead of basketball in the driveway. If parents don't set a healthy example, why should we expect children to be different? We are their role-models for life.
In the end, we could go a long way to saving our health-care system by doing things as individuals and organizations that don't require expensive taskforce reports or intense negotiations among different levels of government and groups that make money when we use the health system.
When I recently moved from an unhealthy workplace to a healthier one, I used this as an opportunity to make other changes in my life. I car-pool part of the way to work with my wife and ride my bike the rest of the way. In addition to the impact on the environment and the exercise I get, my wife says she enjoys the extra time with me. Since I am now on the fifth floor instead of the thirteenth, I walk up and down the stairs at work. When either myself or my children are sick, I stay home.
While not everyone is in a position to do these things, I suspect there are enough of us that we could make a major contribution to saving the health-care system. Every day is a struggle, but I'm 'on the patch' and starting to feel better.
Dr. John Church, a political scientist at the University of Alberta, has studied health-care politics for the past 20 years.