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March 26, 2004
Health care on seniors agenda
Cost control and economic growth necessary to sustain medicare:
Hansen.
CYNTHIA RAMSAY SPECIAL TO THE JEWISH BULLETIN
"We blow through about 1.3 to 1.4 million dollars an hour
to fund the health-care system," B.C. Health Minister Colin
Hansen told a crowd of some 160 people at a recent forum hosted
by the Jewish Seniors Alliance of Greater Vancouver (JSA) and the
Jewish Community Centre Seniors department.
The Sunday afternoon event was potentially hostile territory for
Hansen, as seniors groups have been vocally critical of the Liberal
government's health and other policies. The information tables at
the back of the Wosk Auditorium at the Jewish Community Centre of
Greater Vancouver, where the forum took place, featured the government-published
health guide, the most recent JSA newsletter, as well as promotional
material from groups such as the Canadian Health Coalition (CHC)
and COSCO (Council of Senior Citizens' Organizations of B.C.). In
their literature, the CHC spelled out its anti-privatization views
while COSCO questioned the closing of St. Mary's Hospital in New
Westminster and provided a two-page list of what they felt to be
broken Liberal promises.
Hansen, who has been health minister for approximately two and a
half years, touched upon some of these issues in his speech that
stressed the concept of a sustainable health system. Twenty years
ago, in 1985, the budget for all health services in British Columbia
was $3.5 billion, said Hansen. "Today, it has increased by
three and a half fold, just in those short number of years. On top
of that, we face cost pressures of seven to eight per cent a year
in growth in health expenditures."
The minister emphasized his support for medicare – public funding
for medically necessary services (mainly hospital and physician
services). He said that when the program started some 40 years ago,
the only limit to what was funded was what was possible to do from
a technological viewpoint.
"Times change," he added. "And what's changed most
importantly is not the underlying principle [of medicare], but what
is medically possible, because now we can do great things."
He pointed to such diagnostic devices as magnetic resonance imagers
(MRIs), surgical procedures such as hip and knee replacements, and
cancer survival rates as examples of how medicine has progressed
since medicare began. There are now more than 20,000 different medications
doctors can prescribe, compared to 638 in 1968, said Hansen. He
noted that life expectancies have increased and, while this is good
news for most of us, it has serious budgetary implications, as the
average cost of providing public health care to a person over 90
years old is $20,900 a year.
"The big question that we have to ask is," said Hansen,
"is the Canadian medicare system as we know it sustainable?"
Health spending now consumes 42.3 per cent of the entire provincial
budget, Hansen continued. "In the short term, we can divert
funds from other ministries to put it into health. And that's exactly
what has happened in the last two and a half years." He said
that money has been taken for health care and education from such
ministries as labor, and energy, mines and petroleum resources.
Over the long term, either costs need to come down or the economy
has to grow so that we can afford to spend more, said Hansen. He
ruled out the option of running a deficit because the ratio of seniors
to workers is increasing. The implication of this remark is that
there will be fewer taxpayers in the future to pay off any deficits
incurred now and health care is not becoming cheaper. "We cannot
afford to pass that burden on to our children in the future,"
said Hansen.
In order to create a more sustainable system, the health minister
outlined a few actions that his government has taken, such as the
closing of hospitals. He explained that, over the years, the number
of outpatient procedures performed in hospitals has increased and
the length of hospital stays has decreased, therefore, "we
have to have new types of hospitals, new facilities to replace the
ones that may have met our needs in the past but will not meet our
needs going forward." Smaller hospitals, such as those in Kimberly
and New Westminster, were closed to be able to better support financially
other facilities, he said.
Hansen also discussed other government reforms, including assisted
living for seniors, making Pharmacare more fair "so that those
with lower incomes actually get more financial support," increasing
premium rates for those who could afford it, more prevention programs,
the use of evidence-based decision-making and increasing the number
of surgical procedures performed in the province.
"It's not just about bringing costs down," said Hansen.
"It's also about doing more." He provided some statistics.
"There's been lots of talk about wait lists for things like
hip and knee replacements and yet last year we increased the number
of hip replacements by 14 per cent," he said. "We increased
the number of knee replacements by 11.2 per cent. We increased the
number of cardiac surgeries in the province by 13 per cent. And
yet more still needs to be done."
Hansen concluded his speech on an optimistic note. He said that
it won't be possible to bring costs down to a point where the system
will be sustainable, unless there is also economic growth. Then
he gave a few examples of how growth is taking place here, pointing
to new investment, new businesses, an increase in housing starts
and, for the first time in six years, a net in-migration to the
province.
In the question-and-answer period, Hansen responded to concerns
about home care, saying that home/community care needs to be expanded.
He defended the government's current ad campaign by saying that
people need to know that services are being increased, because many
are under the impression that health-care spending has been cut.
He assured people that the government "will not compromise
the privacy of health information" in its use of a private
American company to help make the processing of health forms, records,
etc., faster with computerization.
In response to a question about privatization, Hansen defended medicare
while pointing out that Canada's health system has always been a
public-private undertaking – currently the public sector accounts
for 70 per cent of health spending, and within that there are private
providers (physicians, for example) who are paid from the public
purse. Hansen fielded several other questions.
While some forum attendees remained skeptical of the government's
health plans after Hansen's talk, the crowd was polite throughout
and the afternoon passed pleasantly.
The March 21 forum was moderated by radio personality and retired
physician Dr. Art Hister – his contribution supported the event's
title Laughter is the Best Medicine! JSA president Serge Haber opened
the event and the Hon. Val Anderson, MLA of Vancouver/Langara, also
said a few words of welcome. JCC Showtime Entertainment put on an
energetic and engaging performance after Hansen's speech and forum
co-chair Sharene Jansen gave the closing remarks.
For more information on the JSA, call Jennie Virtue at 604-257-5100.
For more information about the JCC Seniors, call Linda-yael Iny
at 604-257-5111.
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