Press Release
**For Immediate Release**
From the Atlantic Centre of Excellence for Women’s Health and the Canadian
Women’s Health Network:
New Publication Claims Canadian Health Care Crisis Is About Values, Not
Money
As recent reports from the Kirby Senate Committee and the Romanow Commission
highlight, our Canadian Health Care System is in crisis. But this is not
just a Canadian problem. All health care systems in the world are in
crisis. The same forces and issues creating the crisis in Canada are
operating elsewhere. In Europe, there is fear health costs could spiral out
of control, even in countries that have not experienced much of an increase
in health’s share of the GDP. Most European countries with two-tier health
care, along with Australia and New Zealand, are experiencing erosion in the
public portions of their systems along with escalating costs of private
health insurance. That bastion of the free market the Untied States is
in more turmoil than most. There the blame is on managed care but the
crises are the same. While there are global social and economic forces at
work here, each country will respond in its own way. The question for
Canadians is what path will we choose?
The immediate crisis in our health care system is not just about money or
inefficiencies. It is symptomatic of poorly articulated values regarding
the meaning of health and health care, the place of health in society and
the role of government in health and health care. The issues at stake in
goal setting are not simply about creating new options for obtaining more
money for health care. There are fundamental issues at stake regarding our
core values how we envision the relationship between health and human
happiness, what we mean by health and what we imagine to be fair. In a
sense, the pressing issues in health care are the issues about a just and
caring society, not only in the here and now but for future generations as
well.
The issues creating crises in modern health care cannot be addressed by
simply throwing money at them. Our policy decisions are moral decisions.
They are issues of justice, care and responsible citizenship. In a
particular way, they relate to the troubling phenomena of the medicalization
of life, the commercialization of care and of the power of the market to
dominate the health care agenda.
How we frame the issues determines in large part our response. If health
care is in crisis, what kind of crisis is it? We have defined the health
care crisis as a resource allocation issue. Once the problem is cast in
these terms the main questions revolve around funding. It’s an all too
familiar litany: the cost of health care is more than the provinces can
afford, there are unacceptable waits for access to technology, costly new
drugs are not being provided for all who might benefit, and there aren’t
enough hospital beds to meet demand. This way of thinking directs policy
toward winners and losers in a grand allocation game. Because of the
pervasiveness of technology and the almost unlimited potential benefit from
medical science, framing the issue this way leads naturally to options that
will increase the money available for these resources through private
arrangements.
We need to reflect on deeper questions: What are the goals of health care
and are the goals unlimited health benefits to all citizens? What kind of a
good is health care? Is health care a private commodity to be purchased by
those who can afford it or is it, in some way, symbolic of community itself?
Is the sustainability of any health care system in a very real sense a test
of the commitment to community? And if so, how do we test this commitment?
What language do we use? What public spaces do we develop and nurture? How
do we deal with the profound and often irreconcilable value differences such
as a foray into public discourse will generate? What concepts of justice or
citizenship do we embrace? Or has the commercialization of health and
health care been so complete in this global world that the hoped-for public
debate on these matters is only some idealistic perhaps romantic and
nostalgic dream? Have the values of the market overrun those of justice and
care?
The Canadian health care crisis is not primarily about resource allocation
but rather about the future of health care as a good held in common and the
possibility of just and compassionate decision making by citizens in a
global world. The challenge is to develop new ways and debate in which
citizens can act together to clarify the values at stake in the choices for
our community.
These issues, and more, are addressed in the newly published book:
What Good Is Health Care? Reflections on the Canadian Experience
By Dr. Nuala P. Kenny
CHA Press, 2002
http://www.cha.ca/publishing.htm
Dr. Nuala Patricia Kenny, OC, BA, MD, FRCP(C), received her BA, magna cum
laude, from Mount Saint Vincent University in 1967, an MD from Dalhousie in
1972 and completed postgraduate work and training in pediatrics at Dalhousie
University and Tufts-New England Medical Center. In 1975, she became a
Fellow of the Royal College of Physicians and Surgeons of Canada, and in
1976 was certified by the American Board of Pediatrics. In 1995, she became
the founding chair of the Department of Bioethics at Dalhousie University
in the Faculty of Medicine. From February to November 1999, Dr. Kenny was
seconded as Deputy Minister of Health for the province of Nova Scotia. Dr.
Kenny has been the chair of the Values Committee for the Prime Minister’s
National Forum on Health and is past president of both the Canadian
Pediatric Society and the Canadian Bioethics Society. She was a founding
member of the Governing Council of the Canadian Institutes of Health
Research (CIHR). Dr. Kenny has been appointed an Office of the Order of
Canada.
To interview Dr. Kenny contact:
Nuala P. Kenny, OC, MD, FRCP(C)
Professor & Head, Department of Bioethics
Dalhousie University, 5849 University Avenue, Halifax, NS B3H 4H7
Tel: 902-494-3801; Fax: 902-494-3865
Email: [log in to unmask]
Or:
Carol Amaratunga, Executive Director
Atlantic Centre of Excellence for Women’s Health
Email: [log in to unmask]
Phone: (902) 470-6751
Website: http://www.medicine.dal.ca/acewh/
Or:
Kathleen O’Grady, Director of Communications
Canadian Women’s Health Network
Email: [log in to unmask]
Phone: (514) 886-2526; Fax: (204) 989-2355
Website: http://www.cwhn.ca
Mona Dupré-Ollinik, BSW, BA
Coordonatrice de liaison/Outreach Coordinator
Canadian Women's Health Network/Réseau canadien pour la santé des femmes
419, avenue Graham, Suite 203
Winnipeg (MB) R3C 0M3
Tel: (204) 942-5500 ext,/poste 13
Fax/Télécopieur: (204) 989-2355
Toll free/Numéro sans frais: 1-888-818-9172
www.cwhn.ca
e-mail/courriel: [log in to unmask]
TTY 204-942-2806
TTY toll free number 1-866-694-6367
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