Lots of health promises but how healthy is debate?

Hey there, time traveller!
This article was published 01/10/2011 (5453 days ago), so information in it may no longer be current.

Greg Selinger says he will hire 200 more doctors and 2,000 more nurses if he’s re-elected premier.

Hugh McFadyen would add 2,165 health professionals, including 250 new doctors and 1,700 nurses.

The NDP’s Selinger would open three more QuickCare clinics and three more ACCESS centres, which provide both health and social services.

The Conservatives’ McFadyen would invest $20 million to improve the NDP’s ACCESS centres and keep them open for longer hours.

The list of health promises by the leaders of the two main parties in this election campaign goes on and on. (The pledges can be viewed on the parties’ web sites.)

Health care is a top priority with voters, those vying for office acknowledge, and so no would-be premier wants to be seen short-changing it. It’s also the province’s largest spending category with an annual budget approaching $5 billion.

But are the politicians properly diagnosing what is ailing the health care system? And is an election campaign the best time to be setting health policy in the first place?

Alan Katz, a University of Manitoba medical professor and associate director of the Manitoba Centre for Health Policy, said politicians have been seizing upon popular, easy answers on health rather than offering sophisticated solutions to what are complex problems.

“What’s absent is a detailed analysis of the changes that really need to happen to the health care system, like innovation, restructuring,” he said.

Katz questioned the spending of large sums of money on bricks and mortar — such as the ACCESS centres that both major parties seem to be in love with. Three more ACCESS centres promised by the NDP during the campaign have a combined price tag of $21 million.

Instead of building a clinic, he suggested, why not work out a system in which a nurse practitioner assists, say, four family doctors in a practice? It would allow for more patients to receive care.

But to make such changes you may have to reform the current fee-for-service billing regime, which is the basis on which most doctors are paid in Manitoba. “It’s a huge issue,” Katz said, but not a simple one to deal with — especially during the heat of a political campaign.

Political scientist Jared Wesley said complex solutions to difficult problems — in health care or any other field — are almost impossible to deal with in an election campaign. “It’s difficult to talk about a complex issue in a 30-second-sound-bite world.”

Opening up the issue of how doctors get paid, for instance, would cause an enormous backlash from a host of interest groups, not to mention physician groups themselves. Such difficult tasks are probably best done in a bipartisan fashion far away from an election campaign, Wesley said.

“I think we may be expecting too much from (election) campaigns to think that they should be about big policy debates,” said the University of Alberta political expert, who used to teach at the University of Manitoba.

While some health issues are difficult to tackle in an election brochure or a TV ad, others are more straight forward. Yet, they, too have largely fallen off the political radar screen in this campaign.

Skyrocketing drug costs are a major health issue but the political leaders have been silent on it. The Manitoba government spent $392 million last year on drugs alone. One way to control drug costs is to advocate for a national drug plan. “I heard an (NDP) promise to pay for cancer drugs but I didn’t hear a promise to negotiate a better deal,” Katz said.

Other key areas on which politicians have been largely silent include addictions and mental health.

Nicole Chammartin, executive director of the Canadian Mental Health Association’s Winnipeg branch, said the Conservatives have made some promises on mental health, including a review of the Mental Health Act.

But the critical concern of advocates is a lack of resources compared with other areas of health, she said. Physical diseases such as cancer always get the attention of political parties. But year-long waits to see a psychiatrist don’t rate the same attention.

The last time it was measured, mental health got a 4.9 per cent share of Manitoba’s health-care dollar. Yet, it’s estimated that one in five Manitobans is affected by a mental-health issue. “A problem affecting 20 per cent of the population is getting less than five per cent of the funding,” Chammartin said. Advocates are pushing for mental-health spending to be at least seven per cent of overall health spending.

larry.kusch@freepress.mb.ca