INNOVATIVE IDEAS AT HEALTH SYMPOSIUM

Monday December 2^nd, 2019’s a
Forum on Health Care was hosted by the Coalition of Concerned Citizens
(CCC).   The purpose was to bring
together actors and stakeholders in the province of New Brunswick to address
the need to modernize the province’s health care system.    While many topics were discussed and
perspectives offered, the primary focus of the day was the importance of
culture as a prerequisite concern for any sort of reform.  The needs of the province have changed
substantially since the formation of the public health care system.     The status quo is untenable, and reform is
needed, but public support is necessary to pursue the drastic action necessary
to prevent disaster.   As evidenced by
the success of the Forum, the potential solutions are tangible.  It simply remains for the people of New
Brunswick to demand that reform be pursued.

Health Minister Ted Flemming spoke directly
about the crisis not only looming, but already present in its nascent stages.   The province of New Brunswick is witnessing
an unprecedented increase in demand on one side, and a decrease in available
resources on the other-the crises at the Campbellton hospital is one
example.   He talked about the percentage
of Hospital Beds assigned to ALC patients.  
When he became Minister one year ago, the number was 25%.   Now it is 31% and growing.     There are tradeoffs.  Either we use Hospitals for people who are
sick and need operations, or do we continue to allow ALC patients to occupy a
disproportion number of beds?   Minister
Flemming therefore underscored that New Brunswickers should not fear health
care reform but embraces change and demand
it from their elected representatives, because the status quo is fatal.

Our key note speaker was Dr. Chris
Simpson.   He reminded us that the health
care system which we now enjoy was designed in the 1960’s with the
understanding that we as Canadians value providing help to those who need it
over help only to those who can afford it.  
He stated that hospitals are actually very specialized institutions with
a distinctive role in the health care system, and are not the panacea we
envision them to be.    Hospitals are
designed to help those with acute aggrievements and provide high-tech advanced
specialize care, but as a result of public misunderstanding, demographic
changes, and an overconcentration of public resources in hospitals as primary
care facilities, hospital have become untenably burdened on treating chronic
illness.

Simpson’s recommendation is therefore to
focus on ameliorating care for seniors in the province, as a vast majority of
chronic illness is associated with senior care.   If we can address the problems in health
care system relating to seniors, we will simultaneously address a vast array of
tertiary problems caused by the current misallocation of medical resources.

He also emphasized the need to reconsider
the manner in which the Canada Health Transfer is calculated.   Currently the CHT is calculated on a per
capita basis, but this disadvantages provinces like New Brunswick who have a
lower population, but a higher proportion of seniors.

Dr. Herb Emery also addressed the role of
Canada health transfers in the function of our health care system, but was
skeptical of the potential benefits of increased spending without first
addressing the issues of incentives.  He
goes on to say that social structures have inbuilt systems of incentives which
may be expressed implicitly or explicitly, and it is only by paying attention
to these systems that meaningful reform is possible.   When considered by the perspective of
economic incentives the reason that any attempt to modify the status quo is met
with resistance from actors and providers with the health care system is that
there is a lack of positive incentives in place to encourage behavior which is
in harmony with system level objectives, and a series of perverse incentives
which discourage efficiency have been allowed to develop.     High performance health care systems
require carefully devised incentives for all stakeholders, monitoring for and
swift elimination of perverse incentives.

Dr. Eric Scheme, an associate professor at
the University of New Brunswick, elucidated on the exciting opportunities
associated with our health care crisis as it relates to digital health.  He believes that the need for radical change
can be leveraged to position New Brunswick as a sort of living lab for
innovation as we experiment to address our new needs.   He goes on to say that implementation of
technological aid in our health care system is not a technical problem, but a
social problem.  The tools exist, it is
simply a matter of discerning how best to use these tools to help people.   Artificial intelligence technology is
forecasted to replace up to 80% of what doctors currently do.  Already, some artificial intelligence
programs are better able to diagnose certain ailments with greater accuracy
than human physicians.

There many more speakers at the forum
including Cindy Donovan, the CEO of Loch Lomond Villa, Deb MacCallum who shared
the personal story of her father’s journey through the health care system over
the course of his struggle with Alzheimer’s.  
Anthony Knight CEO of the New Brunswick Medical Society who talked about
the Medical Society initiatives and improving health care together.   Ken McGeorge who expressed the views and
recommendations of the Coalition.   Dr.
Linda LeBlanc who is a practicing medical specialists from Moncton talked about
the lack of pride in the institutions as well as rampant absenteeism as a
result of abuse of sick leave as a benefit; and moreover the lack of
cleanliness.

My take away from the forum is there is a
myrid of people who have a genuine interest in accelerating reform and will
help in any way possible.    I am positive
we will get there.    New Brunswickers
are proud people and they deserve the best.   

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