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Diagnosis psychosis 

"Health-care system near collapse," shrieked a headline from the Halifax Herald. "Health-care apocalypse," shouted a Daily News columnist, while a Herald scribbler howled that the NS health system is "quite a train wreck." All this after the release last week of a turgid, 384-page consultant's report crammed with industrial-strength jargon. The one-million-dollar communique from the bean-counting firm Corpus Sanchez was entitled: "Nova Scotia's Health Care System: Creating Sustainability Through Transformation." Translation: The NS government is spending way too much on health care. The system is in crisis. It can't go on like this much longer, and the sky is falling. Main recommendations: Set up a slew of task forces and advisory groups and conduct four major studies to figure out how to move to more community care and disease prevention. Basically, it's a rerun of ideas from the 1989 NS Royal Commission on Health Care.

OK, granted, our health system isn't perfect. Many Nova Scotians can't find family doctors; rural emergency rooms are short-staffed; there are long wait times for surgical procedures such as knee and hip replacements; hospital food tastes like shit and Big Pharma keeps jacking up prescription drug prices. But to claim that our publicly funded health system is "a train wreck" ignores an obvious fact. Every day thousands of Nova Scotians receive sophisticated care, free of charge, from highly trained health professionals who use state-of-the-art medical technologies to diagnose and treat affluenza---the conditions and diseases that afflict wealthy countries. Obesity, diabetes, cancer, heart disease and chronic depression. These are some of the worst scourges that affluenza increasingly bestows to rich, consumer societies---societies like ours that pay too little attention to what all the experts agree are the real determinants of health: decent incomes, adequate housing, access to education, social and family supports and a clean environment.

Yep, it's still true that we are spending a hell of a lot of money on the health system---nearly half the provincial budget, and rising. Ninety-four bucks every second! Sounds like a lot, and it is. In Nova Scotia, however, the health system costs us nine percent of our productive wealth, less than one dollar in 10. Even the bean-counting consultants admit that if Nova Scotia's spending per person is taken into account, we're "in the middle of the pack" when compared to most other industrialized nations. They might have added that successive rounds of federal/provincial tax cuts haven't helped either. Nationally, those cuts amount to $50 billion a year in lost revenues, not counting the latest round from the Harper Tories. Obviously, it gets harder to finance social programs if governments keep handing money back---money that mainly benefits the well-off. And here's another astonishing fact: Canadians cough up billions more every year to support their private autos than they spend on health care. In October 2003, I calculated that car owners paid just over $100 billion in ownership charges, operating expenses and fees. But when everything was tallied, including air pollution, accidents and road maintenance, the total cost of supporting the private auto added up to $200 billion a year. In 2005, by contrast, we spent a total of $142 billion on health care---$98.8 billion of which went to support the publicly funded system that our ink-stained wretches claim is hurling us into financial ruin.

In the end, though, the health care debate is not just about money, it's about choice. I'd advise my newspaper colleagues to calm down---no, don't take a Paxil; read a book! In Prescription for Excellence, Michael Rachlis, a medical doctor and health policy analyst, explains how other provinces are reducing hospital overcrowding, cutting wait times and organizing more effective community medicine. Rachlis also points out that good health is about far more than just

treating illness. It's also about the quality of people's lives. In that sense, eliminating poverty would be the best

medicine of all.


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