An Ounce of Prevention

I think a lot about systems; about how certain ones succeed, others fail, and most just have a series of tradeoffs. Canada’s health care system provides many opportunities for reflection, since we proudly have a single payer system where no citizen pays out of pocket for (most) health care expenses.

We always have the ready example of fully privatized health care south of our border; a system that seems designed to enrich insurance companies and health care providers, to weaken worker rights due to fear of losing benefits, to discourage small businesses and freelancers, and to engage in small-scale eugenics by making little to no effective health care available to the poor.

What we have in Canada is obviously better, but it’s far from perfect, and there’s always shitty people trying to make our system more like the failure that is USAmerican health care. A huge problem in any public system is cost control, since there tends to be little to no incentive to reduce costs.

When you don’t pay out of pocket for health care, there will tend to be for overuse. Here in Winnipeg, there was a pattern of overuse of emergency services by a small minority, and a pretty great program was set up to provide both better care and cost savings, as reported by The Free Press:

The Emergency Paramedics in the Community (EPIC) program, as the initiative is known, involves specially trained paramedics who work with habitual 911 callers to find out why they’ve begun to use the emergency line as a crutch.

The solution can be as simple as helping a patient reconnect with their family doctor, changing the timing of a home-care visit or having a side rail installed in an elderly person’s bed to prevent them from falling.

The typical Conservative response to issues like this would be to make public care worse and underfunded, while making superior care available to those with the means to pay for it. Instead, the EPIC program has saved over $3 million in ambulance costs alone over the last two years vs the $750,000 annual costs of the program. Preventative medicine is indeed the best medicine, which is something that a privatized system would never implement.


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