PAGE'4,WHTBY FRE PRES, WEDESDAY, OCTOBR 2d, 1989 Medical advances also bring Health care: expectations that can't be met By Trudie Zavadovics Canada's health care system, envied by other countries, is on shaky home ground with growing unrest with the provincial government's cost controls among health care providers and patients. In his speech to the Canadian Club of Durham on Oct. 10. Dr. Tom Dickson a member of the Canadian Medical Association board of directors, said that although medical advances have been astounding, they have brought with them great expec- tations that, under existing con- ditions, can't be met. "Diphtheria, small pox, polio, scurvy, cholera, typhoid fever are I I 9 but a few of the diseases that have been virtually eliminated in Canada. We can't even find cases to teach our medical or nursing students,»said Dickson. "Kidney diplysis or trans- plants, where the heart is stop- ped, replaced tempqrarily by a machine, repaired and started up again, total heart transplants or liver or lungs or hips or knees. The list goes on. He said there is almost "no limit" as to what the public expects from medicine. "The public perceives there is, or should be, a cure for every injury, affliction or disease a ecting mankind. Pain is un- *ITROCKIN - . 9 . 99 -rtadvice "Your healh and health care are too important to leave in the hands of politicians or doctors.» Fér ýl&îe#dly ýýerviçç acceptable, unnecessary and should. be eliminated im- mediately. Cure, perhaps not 100 per cent, but close to it. Perfect results are to be anticipated and not the exception. "Of course,".he said, "this is not true but it should not be surprising that public expec- tations have reached that un- attainable level. Even scientists, physicians and other health care workers who know better have been swept along in the current of high expectations. "The resulting problems are magnified in Canada by our popular health care insurance and delivery system," said Dick- son. «Canadians believe they have one of, if not the best health care system in the worid. They believe the quality of health care services in this country generally ranges from good to excellent. They believe they have the right to unlimited access to an unlimi- ted supply of all the best that medical science and health care have to offer, and completely free at the voint of service. "Thà t's why Canadians have been shocked in recent months by newspaper headlines and TV newscasts reporting that people have not been able to get the health care they needed or wan- ted." Dickson said Canadians can't understand why entire hospital wards are closed for months to achieve a balanced budget, when patients are waiting for admis- sion into hospitals. He noted the recent decision by Princess Margaret Hospital to service only its cancer patients who are curable and to no longer prolong the life of the palliative patient. "Plans for the new Princess Margaret Hospital should have been done years ago," said Dick- son. "Provincial governments have been increasingly practising cost restraints. Hospitals have been forced to control costs in as many ways as possible including con- trol in the number and the sal- ary increases paid to staff. At the same time patients are being discharged earlier." He said that negotiations bet- ween physicians and the provin- cial government have been nothingshort of "cyclical confron- .tations," resulting in somewhat frequent strikes and a decline in new people entering the medical profession. "This year medical school enrolment is the lowest since 1977 and the nuiiber of im- migrant doctors entering the country is severely restricted. "It is a fact," he said, "that the federal government has on four occasions since 1976 changed the federal/provincial cost-sharing formula for health care that has resulted in a decline in the rate at which federal government con- tributions have increased. "Ottawa now pays about 38 per cent of provincial health care costs as compared tao 48 per cent a few years ago. That's a long way from 50/50." According to Dickson, the 1984 ban on extra billing has also contributed to skyrocketing medical costs. "Twenty-seven per cent of what the government collecta goes to physicians, most of the rest goes to the hospitals. If you put t he health care system in a straitjacket and don't control anything, we are going to spend aur way into big trouble." Although current probleme have not y et reached crisis pro- portions, Dickson said that un- iess the public can demand and force governments and health care providers ta get together and find solutions, a criais may be in the offing.