Better health is possible for Canada

Brooklyn-born, Ohio-raised surgeon and author Dr. Atul Gawande has eloquent and informed advice that we here in Canada must heed to renew our health-care system: “Better is possible. It does not take genius. It takes diligence. It takes moral clarity. It takes ingenuity. And above all, it takes a willingness to try.” The Canadian Medical Association (CMA) agrees, and backed by our more than 83,000 physician members and our 31,000 Demand a Plan public supporters, we believe now is the time to act. Seniors today account for 16 per cent of Canada’s population. By 2036 that figure will be up to 25 per cent. Our system was created over half a century ago to meet the needs of a much younger population and we have not adapted to meet the growing and evolving needs of aging Canadians. Make no mistake; our system cannot continue to lurch along, struggling—and all too often failing—to provide high-quality care where and when patients with complex and chronic conditions need it. Fortunately, Canada’s doctors see a new a new approach in Ottawa when it comes to health. While not everything we hoped for was included in the recent federal budget, the government did reaffirm its commitment to a new multi-year Health Accord focused on improving access to home care and mental health services; supporting pan-Canadian innovation in the delivery of health services and making prescription medications more affordable and accessible. The CMA views a new Health Accord as a key opportunity to address critical gaps in seniors' care, which builds on our work from last fall in advocating for a national seniors strategy through the Demand A Plan campaign. CMA believes that discussion on a new Health Accord provides a critical opportunity to set a vision and direction to address the collective challenges that face all health care systems in Canada. We must remember that each and every jurisdiction—provincial, territorial and federal—has its own unique challenges and responsibilities when it comes to the strengthening the health of Canadians. So how do governments meet this challenge? How do we ensure that our next Health Accord does not just buy time, but builds a truly revitalized and robust system able to meet our nation’s present and future needs. In short, it begins with vision and will. The CMA is developing a new vision for Canadian health care, one that is based on the internationally-renowned Institute for Healthcare Improvement’s (IHI) Triple Aim Framework to optimize health system performance. This vision will focus on three clear outcomes: Improve the patient experience of care (including quality and satisfaction) Improve the health of populations Achieve better value for money invested in health care Guiding this vision is the belief that every Canadian deserves a health system that provides quality services in a timely, safe, effective, evidence-informed way that respects individual choice. Systems of services must be integrated so that health promotion and protection, disease prevention, assessment, diagnosis and treatment and end-of-life care work in concert across home, community and hospital settings. Every Canadian must have access to a family physician and affordable and comprehensive prescription drug coverage. The CMA vision is inclusive. It is founded on collaborative work with other health and non-health organizations and aligned to the principles to guide the transformation of health care in Canada. This vision will help ensure that the health system enables physicians, nurses and other health care professionals to provide the highest-quality, team-based care to their patients, guided by peer-led review and fully incorporating patients in decisions. Finally, if we are to truly improve the health of our citizens, all levels of government in Canada must work together to improve the underlying social and economic determinants of health of all Canadians. As discussions begin in earnest on a new Health Accord, the time to act is now. As a first priority, renewal of the health care system must focus on more at-risk patient populations: Indigenous populations; those living in remote areas; in poverty; inner city populations; those with addictions and mental health problems; the elderly; and patients managing multiple conditions. The commitment of Canada’s health-care professionals must now be matched by our elected leaders. During the election campaign last year, Justin Trudeau galvanized Canadians and exhorted us all to believe that “Better is possible." We do believe that. All that remains is for all of us all to muster the will to get the job done. Dr. Cindy Forbes is president of the Canadian Medical Association. The Hill Times