Dr. Mary Fernando has an excellent article in yesterday's Toronto Star about the sickly state of our top-heavy healthcare system.

In Canada, we are not spending our health-care dollars on hospitals, better front-line services, doctors and equipment. Instead, we spend too much money on bureaucracy and the flavour-of-the-moment programs with catchy names, all of which are burgeoning at a scandalous rate.

Indeed. In Ontario alone, we are spending millions tracking wait times for things like cancer and cataract surgeries, instead of actually performing the surgeries. How many various stop-smoking hotlines does this country have right now? There's a federal one, and I know Ontario has one. Does every province have a telephone number you can dial that tells you to make an appointment with your doctor to discuss quitting options? Am I the only one who sees that as being a redundant step? How many people are we paying for the manning and administration of these programs?

Canada's health-care problem is rooted in our pattern of spending. The OECD shows we spend almost one percentage point more on health care than all 30 countries on average, or 9.9 per cent of GDP in 2003.

For the extra money we spend, we get very few resources. Canada has fewer hospital beds, physicians, MRIs and CTs than the average OECD country. We do have more nurses, but Marlene Smadu, president of the Canadian Nurses Association, explains that the lack of investment in nursing will result in shortages in the near future.

It has been argued that drug costs account for our higher than average spending. In fact, pharmaceutical spending in 2003 accounted for 16.9 per cent of total health spending in Canada, below the OECD average of 17.7 per cent.

The Canadian Institute of Health Information (CIHI) is a prime source of data about national health-care expenditures. Based on CIHI figures, the percentage share of total health-care dollars we invest in hospitals and physicians has decreased significantly since 1975, and we have certainly gotten what we paid for: fewer hospital beds, equipment and physicians.

We are spending money creating administrative positions, instead of on the people and equipment needed to do the actual job. More people running information back and forth to the government, instead of running labs and scanners and performing surgery. We don't need project managers, we need doctors. And instead of forming a task force on hiring them, why don't we skip the task force and just hire them?

Governments, both federal and provincial, need their feet held to the fire of accountability by telling us, clearly, how many MRIs, CTs and hospital beds they are buying, how much is being invested in nurses and physicians and how working conditions are being improved. Accountability necessitates that governments put money into delivering the health care they promise us and that they put it in the right place.

Here, here!

Labels: Canadiana, Health