Doing the right thing and doing it right

I saw this in a story in the Ottawa Sun a few days ago: “The province will invest more than $8.4 million to expand home and community care in Ottawa this year, half of that for The Ottawa Hospital’s YouCare@Home program … [and] … The announcement Friday by Merrilee Fullerton, minister of long-term care and a former family doctor, is intended to relieve the overcrowding that has seen patients left on beds in hallways or storerooms for lack of space.

Gorilla - How's my pose?

I’m not going to use this as a hook to revisit my thesis that the Canada Health Act is the 800-pound gorilla that will, eventually, smash all provincial budgets. Instead, I am going to argue that Premier Dough Ford, working within the deeply flawed federal system, is doing the right thing and that he’s doing things right, too.

Thankfully, I have not been to a hospital emergency room for many, many years ~ I think my last visit was almost ten ago. I try to eat well, exercise and do things in moderation so that I will live a longish, healthy, trouble-free life … trouble-free for my family and for the struggling health care system.

My last visit to an emergency room was when my late wife was dying. We had kept her at home until almost the very end. We were so lucky that she had a group of close friends, nurses like her, who volunteered to help with her care ~ but we insisted upon paying them. Even though they would not accept a proper wage, providing nearly round-Y-HOSPITALS1-superJumbo-400x273the-clock, high standard care cost us hundreds of dollars a day. Not many families can afford that … especially not if they a mortgage to pay, car payments to make and need to send their kids to university. Anyway, I recall that the emergency room was bedlam ~ we had come in an ambulance and it was very clear to the nurse that my wife needed a bed right now … and she got one. She only needed it for 36 hours. (I was going to say “Sadly, she only needed it for 36 hours,” but, in fact, we chose home care because my good wife knew, as a nurse, that hospitals are the worst place to treat dying people. But good hospice care is too scarce.)

When my late mother died, a few years before my wife, we also went to the emergency room ~ an aneurysm on her aorta had ruptured and she was, slowly, drowning in her 5882385_origown blood. She was in her nineties and my wife (a registered nurse), aided by some paid nurses, had been caring for her in her own apartment …  again not something everyone in Canada can afford. Fortunately, again, the ER nurse saw the problem and she was sent, for a couple of days, to the ICU because there were not enough palliative care beds. Luckily the palliative care team found us a bed in a great hospice ~ the May Court Hospice in Ottawa ~ which provided wonderful support for the few days she had left.

What Minister Merrilee Fullerton has announced is a good, common-sense solution to just one of the many and varied problems that face the health care system in Ontario. Making home care cheaper and easier will reduce the stresses and strains placed on our hospitals. But more needs to be done. Many people in Ontario, here in Ottawa, at least, find it impossible to have a regular “family doctor.” The problem existed 20 years ago when I retired from the military … it was difficult then, it’s nearly impossible, in some places, now.

Groups like Appletree are filling the part of the void. They are walk-in clinics, similar in many appletree-medical-group-officeways, to the military medical system I was used to in the 1960s and ’70s ~ but without the advantage of soldiers, called Medical Assistants, who, after a few months of training (vice years for a registered nurse and a decade for a doctor) could do many of mundane tasks, freeing doctors and nurses to do the difficult work. Young doctors, often burdened with hundreds of thousands of dollars in student loan debt, can work for Appletree for a salary and avoid the costs of starting up their own private practice. Appletree is NOT like a community healthcare centre nor is it a group practice. It is a business, essentially it is a “practice management” firm that lets physicians be physicians, not businessmen. It is successful because it, very clearly, fills a need in Ontario. I don’t know if companies like Appletree are good or bad; I just know that they, and private clinics, too, are fast-growing David_Peterson_(2005)Bob_Raebusinesses that are obviously filling a need. Some of Ontario’s problems are self-inflicted wounds; back in the late 1980s (David Peterson was premier) and 1990s (Bob Rae) the Liberal and NDP governments decided that the main reason healthcare costs were rising too rapidly was because they were told that were too many doctors! They cut back on the number of medical school enrollments and made it harder for foreign-trained physicians to be licensed. The end result was the when people could no longer find a family doctor they filled emergency rooms until we see, today six and even ten-hour wait times. The ER has become, for many Ontarians, the only place they can find a doctor ~ Appletree isn’t everywhere and not everyone can afford a private clinic.

Premier-Doug-FordScreen Shot 2019-08-17 at 20.56.50It is obvious than in seat-rich Ontario Justin Trudeau is running against Premier Doug Ford. It is a wildly dishonest campaign that uses lies, in the main, to try to frighten voters in the 905-belt around central Toronto. he uses Premier Ford as a surrogate for Andrew Scheer and compares both to Donald Trump. It is doubtless working well in downtown Toronto, Ottawa, Hamilton and Windsor, where few people ever voted Conservative, but I’m not sure it is going to work in the suburbs. People know that Premier Ford is, actually, spending more on healthcare and education than did Premier Wynne and they can see that he is making incremental improvements. Cuts have to come. Dalton McGuinty and Kathleen Wynne left Ontario in financial distress. Cuts will come and some will hurt some people but Premier Ford, who was NOT my choice to lead the Progressive Conservative Party of Ontario is governing in a more-or-less utilitarian manner: trying to do the greatest good for the greatest number. No one, not even y-those in the Conservative ranks,  is going to like everything Premier Ford does but this recent announcement by Minister Fullerton will reassure many that Justin Trudeau’s chosen bête noir is actually doing the right thing and doing things right, too.

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