Rebecca Walberg

The death of a homeless man in an ER waiting room last fall, who spent 34 hours waiting for care (and likely was dead for the last 10 of those hours) before medical staff took note of him, is only the most recent outrageous ER death in a series that have occurred under the Winnipeg Regional Health Authority.  Despite this, Health Minister Theresa Oswald has a Teflon-like ability to let mismanagement and lack of transparency slide off her.  The failures within the WRHA that led to this, and other, deaths are being investigated and remedied.  Not so for the political and bureaucratic failures within Manitoba Health.  Here’s my argument for why Oswald should resign.

In the National Post today:

When Conservative MP Rod Bruinooge, new leader of the Parliamentary Pro-Life Caucus, suggested there are more laws protecting organ transplants in Canada than fetuses, he gave the abortion debate shock therapy. One predictable outcome was disdain, and a call to focus on important things, namely the economy, in these uncertain times. Yet there is an economic angle to the abortion debate. In Canada today, abortion is available and publicly funded at any stage of pregnancy, for any reason. That’s our tax dollars providing free and timely elective surgery, in spite of the waiting lists and chronic resource shortages that plague our health care system in many other areas. Based on abortion statistics and the cost of the procedure in clinics and hospitals, that translates into $90-million a year, as a conservative estimate.

Read the rest here.

We’re accustomed to thinking of Canadian healthcare problems in terms of splashy failures and gross inefficiencies - people dying in ER waiting rooms, cancer victims who have to pay for their own chemotherapy, 18 month waits for surgery.  The problems with our healthcare system are pervasive, though, and cause a lot of problems that don’t register on the radar for most of us, but nonetheless cost the system time, money, and sometimes lives.  If all Canadians had an Electronic Health Record - think the medical equivalent of a credit report, with the basic facts easily accessible by anyone you allow to acces it - we’d spend less money, repeat fewer tests, and get treated more safely and effectively.  More on EHRs and the high cost of not investing in our system sensibly here.

A “wish list” for meaningful healthcare reform, at Canadian webzine c2cjournal.ca, is here.

And a column that I wrote two weeks ago, giving the outline of the election’s events and priorities for an American readership, is online here, at the website for The American, the magazine put out by the very influential American Enterprise Institute.  If I were writing it today, I’m not sure I’d be as optimistic.

This weekend, Brian Sinclair, a 45-year-old Winnipeg man with a complicated medical history, died in the waiting room at Winnipeg’s major teaching hospital after waiting for 34 hours. He was referred to the ER after being seen at a clinic four blocks away. Nobody at the clinic saw fit to help him get to the hospital, beyond putting him in a taxi, despite the fact that he was (obviously) hours from death. The ER has stated that it is the responsibility of the patient to get in touch with the triage desk, and claims that Sinclair failed to do so. Since then, it has been disclosed that Sinclair died of complications from a bladder infection, and that a catheter change and antibiotics would almost certainly have saved his life.

Already, the great responsibility shuffle has taken place, with spokesmen for the clinic and hospital tacitly or explicitly blaming the victim, the system, and anyone but themselves. While the medical inquest, which will be overseen by a doctor who isn’t afraid to point fingers, may identify individuals who are at fault, there can be no question that poor management of ERs is largely culpable for this death. My editorial on the topic, published in the Winnipeg Free Press today, is here.

Bill Murray (not that Bill Murray) was 57 years old when the province of Alberta refused to pay for his hip resurfacing, which would restore his mobility and greatly reduce joint pain, because he was too old to benefit from it. This is going to happen increasingly often to the Boomers, as they enter their peak medical care consumption years. Single payer, universal healthcare means that the market does not guide supply or demand. This means that bureaucrats do. Inevitably, this means that somebody other than you is going to decide what medical care you are entitled to. This should frighten all of us, and nobody more so than the entitled, wealthy and aging Baby Boom generation. Pajamas Media has my column on the Murray case, and others in which life, not just quality of life, was at stake, here.

The question of when to fight to keep a patient alive and when to let nature take its course is very difficult, and it’s one that we will all have to face as the Boomers age and enter their peak healthcare-consumption years.  Usually, patients, their families and their doctors can arrive at a mutually acceptable solution, and the majority of elderly patients on their deathbeds are under no illusions about the possible benefits of heroic medical interventions.  When patients can’t express their own wishes, though, or when doctors wish to disregard the wishes of patients or their advocates, the problem gets very ugly.

Another deeply disturbing trend, seen in the Schiavo and Golubchuk cases, is the description of removing a feeding tube as “withdrawing care.”  This may be technically accurate, if the hospital considers the provision of the necessities of life to be “care”, but most people who agree that they don’t want extra measures to be taken to prolong their life in extreme cases probably don’t understand that they may be consenting to be starved to death.

Here’s the conclusion of a column I wrote for the Edmonton Journal about the more troubling aspects of the Golubchuk case and the issues it should raise in the minds of all Canadians:

The role of doctors is to provide advice and expertise. Administrators are charged with organizing and regulating health care.  Whether a given person’s life is not worth living is not a medical decision, much less an administrative one.  It is a moral decision, and a deeply personal one, and any attempt to put this decision in the hands of doctors, bureaucrats or judges, instead of individuals and their families, must be very closely scrutinized.

Read the whole thing here.

While I have hope that the current Tory government (or possibly a Tory majority in the near future) will make and encourage substantive change to healthcare, so far the national debate has been along the lines of “should we keep everything the same and boost health spending by 10%, or should be keep everything the same and boost health spending by 20%?”  It seems to have escaped most people’s notice that all this extra money is buying us very little.  I have a column in the Saskatoon Star-Phoenix today looking at specific changes that might pay off.

The amusingly named head of the WHO’s AIDS department issues the following words of wisdom, confirming what a lot of people have known for a while, but weren’t allowed to say:

Kevin de Cock, who has headed the global battle against Aids, said at the weekend that, outside very poor African countries, Aids is confined to “high-risk groups”, including men who have sex with men, injecting drug users, and sex workers. And even in these communities it remains quite rare. “It is very unlikely there will be a heterosexual epidemic in countries [outside sub-Saharan Africa]“, he said. In other words? All that hysterical fearmongering about Aids spreading among sexed-up western youth was a pack of lies.

The sad reality is that it will take a long time to undo the damage that’s been done by a couple of decades of AIDS hysteria. Public health educators put a tremendous emphasis on condoms as the best way to minimize risk of AIDS, leaving untold numbers of teens and young adults unaware of the diseases that can be sexually transmitted even with a condom, including HPV, a precursor to cancer. This emphasis on condoms and AIDS avoidance is also in no small part responsible for the increasing perception that only vaginal intercourse is sex (well, partial credit also to Bill Clinton) and the escalation of other forms of sexual activity amongst ever younger kids.

In a more abstract sense, the preoccupation with AIDS, condoms, and physical safety led to the increased commodification of sex, and an emphasis on sex as a physical act. It’s not a coincidence that a generation who was taught all about the physical details of sex, and almost nothing about the emotional or moral implications of it, proceeded to create the hook-up culture. By all means, let’s do everything we can to minimize unplanned pregnancy, STDs, and non-consensual sex. But if we’re serious about making more responsible choices, we have to ask people to consider their hearts, minds and souls, and not only their bodies.

We should also learn from this the folly of directing healthcare spending according to fads and crazes. AIDS kills far fewer people than cancer, heart attacks, and car accidents, as well as suicides, and for those under 35, homicides. An honest evaluation of who is actually at risk for AIDS would enable us to focus education and prevention where it will help the most, give kids in health class accurate and helpful information, and avoid needlessly scaring people who were never at risk to begin with.

Crossposted to ProWomanProLife.