Showing posts with label health issues. Show all posts
Showing posts with label health issues. Show all posts

Saturday, March 13, 2010

Crazy-making cuts instantly increase government costs

The funny thing about the current government is that I often agree with what they say. It’s what they do that makes me crazy.
For instance, here’s the premier in an interview with the Times Colonist last week: "I think it's really important for people to understand that the costs of our health-care system are staggering, frankly.”
Indeed. Health eats up 42 cents of every dollar the government spends. Premier, you’ll get no argument from me on that.
But on the very day that Gordon Campbell was saying that, his government was preparing to eliminate birth-control options for women and men living in poverty, who will soon lose access to IUDs and condoms. It was taking away $50 glucometers from people on income assistance who have diabetes, needed to measure their blood sugar every day. It was cancelling funding for a little plastic adapter that makes it easier for people with asthma to use their inhalers.
And I’m left to wonder: Hey, guys, what the heck are you thinking? And how on Earth did your talk ever come to be quite so far away from your walk?
“Who did they consult? Certainly not a doctor I could ever imagine,” says Dr. Danica Gleave, a Cool Aid Health Centre physician who predicts dire repercussions from the health cuts to people on income assistance. “It just baffles me. These are people who have no backup, no other resources.”
Looks like they didn’t fly the plan past the provincial health officer, either. Asked this week about the cuts, Dr. Perry Kendall wondered whether a cost-benefit analysis had been done. “The impact should be monitored, as this may turn out to be counterproductive to health and budgets in the longer run,” he noted.
Hopefully a journalism teacher has latched onto the press release announcing the cuts. It’s a fine example of modern-day propaganda. (As was Budget 2010; there must be a new communications mandate that all bad things are to be restated as good.)
The headline: “Province protects services for low-income clients.” The opening paragraph: Changes will be implemented “in a manner that is fair to all British Columbians and supports children and families.” The cuts to birth control, glucometers and asthma adapters are needed to “ensure these programs will be available to meet the most medically essential needs of clients.”
Well, except for impoverished people in their fertile years, diabetics and asthmatics. And the ones who no longer qualify for “ready-made” orthotics - insoles, braces and the like, which have also been cut. Oh, and the ones with HIV, hanging onto their health with the help of $20 worth of bottled water every month.
Doctors at the Cool Aid centre typically prescribe IUDs to at least a dozen women on income assistance a week, says Gleave.
“We see all kinds of women who benefit from an IUD - sex workers, people with developmental disabilities, people who have behavioural issues that make it hard for them to be compliant with taking a pill every day. These cuts are being made on the backs of the most vulnerable people,” she says.
“The cuts will result in an increased number of unwanted pregnancies. It will increase emergency-room visits for people with asthma. Every diabetic needs to have a glucometer - it’s a huge safety issue for insulin-dependent people. We’re robbing Peter to pay Paul.”
There are no savings to be had by denying access to IUDs, says Island Sexual Health executive director Bobbi Turner.
“The IUD is the most cost-effective form of birth control out there. Something like the Copper T costs $60 and lasts three to five years,” says Turner. “IUDs are not part of the ‘compassion program’ that drug companies have to provide free birth-control pills to these women, so this change cuts off a really effective form of birth control.”
I tried to get Health Minister Kevin Falcon to talk to me about this, because it’s obvious that the cuts in Rich Coleman’s Ministry of Housing and Social Development will increase health costs almost immediately. But it appears the government doesn’t like to talk about such things, because I just ended up routed back to the MHSD communications staff.
Maybe I should try for Mary Polak next over at the Ministry of Children and Family Development. The cuts ultimately mean more kids in care for the women who end up pregnant. But she’s probably too distracted right now, what with the $12.3 million in community cuts already going on for non-aboriginal children and families served by her ministry.
Or maybe just straight to the top. Premier, do you really want to get a handle on health-care spending? You have to know you’re never going to get there this way.

Friday, August 21, 2009

Stereotypes getting in way of good care for seniors

This is a column about my mom, and the crazy things that can happen when you take ill at 83.
My mother is a retired nurse who has done everything right in terms of looking after her health all these years. Despite mobility challenges since being hit by a car in a crosswalk seven years ago, she’s still very much a “tough old broad,” as a friend once described her.
But as our family has now come to see, in the eyes of our depersonalized and harried health-care system, she’s just Old Person No. 347,050 on a very long list. And from what she’s been hearing from her friends, that’s just how it is once you cross some invisible line into old age.
She has no chronic health conditions. She isn’t on any long-term medication. Up until two months ago, she was travelling, cooking dinner for one friend or another virtually every night she was home, and was an active, engaged community volunteer.
Then we went on a family holiday to Tofino in June. She got too much sun one day and went to bed feeling sick. Perhaps she slept too heavily on her bad arm - the accident left her with a broken shoulder and severe limitations in the use of her right arm. At any rate, she awoke the next day with major pain in her arm.
It’s been one strange ride ever since, starting with the prescription drug she was given to reduce inflammation - which lived up to its potential to cause “a general feeling of illness” as one of its side-effects.
By the time she figured that out and quit the drug, she’d developed blood-sugar problems and was showing diabetes-like symptoms. (With any luck, that was a side-effect of the drug as well, because they’ve since stopped.)
And wouldn’t you know it, my mother’s trusted family doctor retired just as all of this got underway. That put her into the care of the doctor who’d just bought the practice.
They’d never met before my mother came in about the pain in her arm. The physician knew nothing of the vigorous, active woman my mother had been just a few days earlier, and didn’t bother to ask. I’m guessing the doctor just saw a tired, sick 83-year-old with a bum shoulder - one who had yet to come to grips with her pain and illness as the byproducts of aging.
OK, I get that. So does my mom. She recognizes that she’s in the countdown. She won’t be looking for medical heroics when her time comes.
But there’s a fine line between expecting people to accept the aging process and relegating them to assembly-line care that presumes they’ll soon be dead anyway. That’s how it has felt for my mother these past two months.
Her saga was complicated by a much-anticipated cruise to Alaska in early July, which she desperately wanted to go on. The x-ray of her shoulder found nothing untoward and the doctors didn’t seem too interested in exploring the issue further, so she mustered her strength to go on the cruise. She still didn’t know whether the diabetes-like problems she’d experienced were a reaction to the anti-inflammatory she’d taken, but figured results from the blood-sugar tests would be ready when she returned.
And they were. But by then she’d caught some terrible flu-like thing that had morphed into a secondary bronchial infection, as had her sister on the final days of the cruise. (Could it be swine flu? My mother is on Day 21 of what she describes as the worst illness of her life, and nobody has even suggested she be tested for it.)
So the bronchial infection was the more pressing issue by the time she got home. In B.C., you’re only allowed one health concern per visit these days when you go to the doctor, which meant her doctor listened to her chest but then refused to review her blood-sugar results until a later appointment.
Her active life has ground to a halt over the past two months. Depression crept in. Fortunately, all those friends she cooks for have come through for her. And the really good news is that so much time has passed since her arm first started to hurt that the original problem appears to have resolved itself. I think she’s going to be fine.
I wouldn’t say the system failed her; she got drugs, tests and an x-ray. But all of it came grudgingly, as if done just to silence a frail old lady who hadn’t come to grips with her own mortality. Come on, docs - look past those aging bodies to the people who are still very much alive inside them.