Public education, combatting complacency are key to maintaining medicare
Clinics, nurse practitioners, and pharmacare combine to offer the forward - Linda Silas, CFNU
[Featuring YouTube video]. The complacency of Canadians is the greatest threat to medicare, according to Linda Silas of the Canadian Federation of Nurses Unions. In an interview with Straight Goods News following her participation in a panel discussion at the Canadian Health Coalition 30th anniversary celebration, she talks about the need to educate Canadians on our current system and suggests ways to leave hospital care to acute care, and focus on clinics and nurse practitioners on healthy Canadians who need occasional care and on health promotion. She also underscores the needs for a national pharmacare program to ensure people are getting the drugs they need.
Linda Silas: The first threat to Medicare, is, as Canadians, we've been lucky to have a public healthcare system, and we take it for granted, and the second threat is the whole privatization agenda. There are some groups and re-groupments of Canadians who believe "If I can afford more, or I can afford to jump the queue, I should be able to pay for it," not realizing the impact it has on the whole system, on all Canadians. Our system is based on needs, and it's not based on the aspect that you can pay more and get faster service.
SG: What is the impact of queue jumping, why is it such a threat?
Linda Silas: Right now queue-jumping is a threat because the way our system works, a physician will decide what is medically necessary for you and the urgency. They will place you, based on your medical evidence, on the queue, if you can call it. But if it's your credit card, the fact that you can pay faster, puts you ahead of somebody who is sicker, it goes against all the values of our health care system.
SG: Isn't it a good thing for people to be able to purchase the health care services they need?
Linda Silas: But what happens to the one who medically really needs it now? You're going to be placed ahead of them because you can pay more money. That is not the way our system is based. Our system is based on treating everyone equally, and treating everyone that is medically necessary and needs care.
SG: You talk about the importance of public education.
Linda Silas: Public education is all about understanding our system, understanding our system is there when we need it. We've been abusing it, we've let go the whole health promotion, health prevention aspect. We don't have an appropriate home care program, we don't have a pharmacare program, and we're the type of society, if we have a common goal, we go knocking at the emergency room. One, because we don't have clinics, we don't have nurse practitioners, family physicians, that are there to help us with the day-to-day. So when we talk about public education,is understanding our system is there for those who need it, and those of us who are healthy, we need to keep working on being healthy and working on keeping that to clinics, not emergency rooms, and realizing that the acute care sector, the hospital, is the most expensive. So let's leave it for the sick, and have another system, I'm talking about health-promotion and prevention.
SG: What kind of public education efforts have you been involved in?
Linda Silas: First, we represent nurses across the country, 158,000 nurses and nursing students, so it's giving them the ammunition on what are the real costs of health care, what are the impacts of the shortage of nurses and doctors and other health care professionals, and encouraging them to talk to their neighbours. Nurses protect our health care system, and we want to see it enhanced. So we need to build better coalitions, better regroupments, with all our friends and families to make sure our system will be there for my grandchildren.
Champions of Medicare was printed two years ago. We wanted to know, and we did interviews with ten different champions, from Kathleen Connors, a retired RN, and Chair of the Canadian Health Coalition for twenty-some years, "Why did you spend your whole career, and still doing it, defending our public healthcare system?" We interviewed Roy Romanow, "Why did you spend your career defending our public health care system?" Monique Bégin, who created the Canada Health Act, why still today in her 70s she defends and wants to see our health care system enhanced? So these types of people were there 40 years ago trying to build our system, and they're still there today. And it's one tool of public education. We also do other, on the web, our website of course, other pamphlets on the value of healthy living, the values of a pharmacare or a program in our country, of a home care, mental health, and of course Aboriginal health is one of our priorities.
SG: Spending on drugs vs. on healthcare professionals?
Linda Silas: We have to realize that in Canada we spend more on prescription drugs than we do on doctors. And we know we have a shortage of doctors, but we don't have a shortage of drugs. We have a shortage of doctors, so when we look at the health care spending, there's about 17% of it that's only for prescription drugs. And that is the health care spending that goes faster than anything else, than human resources, than buildings and capita, equipment, it's drugs. We need to develop a national pharmacare program so everyone would be treated equally, but it would also give the powers to government to buy in bulk, so they would buy cheaper. It would also give the power to government to bring safer drugs to Canada, because they would be able to realize the impacts and outcomes on patients.
SG: Campaigning for a national pharmacare program?
Linda Silas: Yes. In 2004 we dealt with the Premiers, the Council of Federation, and we were very lucky, the Premiers were agreeing, we need to do something about the cost of drugs and we should look into a national pharmacare program. It hasn't moved much since, but it has been continuous. We presented a standing committee on finance, on health, and the Premiers that we need to continue lobbying and finding the real cost of a national pharmacare program, and the impact on Canadians of course.
SG: What kind of response are you getting from Canadians themselves?
Linda Silas: We're getting a very positive response. On the panel yesterday we had a young family that has to pay for the drugs of their two sick children because insurance only pays so much, and if it's charities of other organizations, they wouldn't be able to afford these drugs. So that's not the way our country, our system, works. And if you think, when we talk about prescription drugs, it's part of your treatment. We're not talking about cosmetics, here, we're talking about what a physician or a nurse practitioner prescribed to you to get you better. You need it for getting better. It's just like for a physician or surgeon to prescribe a surgery - that will be paid in Canada. But the drugs, the treatment, won't be paid. And that's where we have to work.