Comments on Local Decisions & the Health Care System

Report of the Commission on Medicare and Local, Democratic Control

by Garth Herman
President, New Green Alliance  (renamed "Green Party of Saskatchewan" in 2005)
Arcola, Saskatchewan, July 10, 2022

The Health issue is complex. It is ALWAYS easier to blame people than to find solutions to prevent the problem from happening in the future. Specifically, we need to:

1. Change the health district boards so that more decision making power is at the municipal level for all decisions about education, health, infrastructure, etc. Local doctors, nurses, and municipal governments should have the AUTHORITY to make decisions. As a society we need to try to reduce the emphasis we keep putting on the concept of "bigger is better". If communities in co-operation with nurses and doctors are allowed to make the decisions about health care, they can be more responsive to the health-care professionals that live and work in the community. In discussions with health care professionals the message I'm getting is that no one is listening to them. In a local community there is a much more direct and responsive feedback loop. Essentially, with our present system we have destroyed this self correcting feedback loop.

2. It is beneficial to have MRI's. However, it should not preclude the use of simpler and cheaper local health care. A friend of mine had ALS for 8 years (80% die in the first two years). His doctor, who had approved massage three times a day, moved away and Sask Health said he didn't need the massages any more. Nobody would listen to him and he was dead a year later. It is unfortunate that the former deputy minister of health also died of ALS, partially because our system is not oriented towards holistic health. Instead, the pharmaceutical companies who spend $10,000/year/doctor have influenced most of our teaching institutes and hospitals that drugs are the primary answer. Obviously, technology has played an extremely important role in our health system. However, at the moment there is too much emphasis being placed on the concept of bigger is better, with the resulting lack of consideration for personal care and lifestyle issues.

Asthma has increased 60% since 1982. Allergies are increasing. Cancer is the number one killer disease for people ages 25-44. All of these problems are issues that modern
medicine can only have a partial impact on. All of these diseases are contributed to by harmful substances in our air, water, and food. Just one example of what could help reduce this problem would be encouraging more organic farming (again, the interconnected aspect of the different aspects of our society.)

3. I have a degree in computer science and have seen many technological solutions to problems that didn't correct the problem. I know two senior people involved with computer technology in the health field. Both of these individuals have the concept (like many other individuals
who perceive things in a linear manner) that their particular field has the solution to the problem. They believe that a computer infrastructure is the answer. In a 10 year study of numerous computer technology implementations the conclusion was reached that the net
effect for all these implementations was zero. Some implements were positive and others were negative. Technology is NOT the answer in itself.

4. I also recently got an honours degree in psychology with a thesis on cancer and psychology. When I phoned in November 2000 as member of the general public and asked if I could be involved in public consultations because I wanted to contribute, my name and phone number were taken down and I was never allowed to participate. Why? Because anything at a
provincial level is too cumbersome to allow everyone to participate. It is especially interesting that the powerlessness that contributes to the development of cancer is the very thing that you are doing with your centralization of power in the decision making process for health care.
One in three Canadians will develop cancer during their lives, but the factors that CAUSE cancer are not being addressed. Instead we focus on providing more expensive drugs to try and treat it. We do nothing to promote organic farming, we do nothing to promote solar heating, we do nothing to promote empowerment of people, we do nothing to promote the sale of local goods (instead we have numerous health regulations that prevent local farmers from selling their eggs or vegetables in the local grocery store.)

5. In conclusion let me give you an example of the difference between a local rural hospital and an urban hospital using case studies. If you happen to disagree with me, then you will dismiss this as anecdotal evidence. The reality, of course, is that the case studies in totality are what constitute the real situation in well being and health care.

Here are some of the differences. The food used in the local hospital kitchen is grown locally, not shipped in sterile packages from Toronto or Edmonton like it is at the General Hospital in Regina. There are two or three doctors who share responsibility in the local hospital. In Regina, the father of a friend of mine went into the hospital for a pacemaker. After 24 doctors and 8 weeks he was dead. On numerous occasions people forgot to feed him, as he was passed from one specialist to the other.

Our regulations prevent me from giving blood at the local hospital. Our regulations have resulted in more workers organizing trade unions to try to prevent the abuse of workers. This in turn has lead to inefficiencies in home care nursing, where someone 50 kms. away gets priority for nursing over someone next door.

There is no easy solution, but the present method of disempowering people in education, in health, and in numerous other ways is resulting in a more costly and less effective systems. The interconnected aspect is ALWAYS neglected in these studies.

For example, has anyone considered the impact further centralization will have on prostitution? As you put more jobs in the cities, you put more people in the cities. To my knowledge there are no prostitutes living in towns of less than a 1,000 people. This is just one simplistic example to try to illustrate the difficulty with linear decision making in education, in health, and in all the other numerous policy areas.
Another example is the study the government is funding on social cohesion in rural Saskatchewan. I would be surprised if the members of this committee are involved with this study. Yet the decisions you are making on health care are impacting our local communities. If the government would return the decision making power back to where it belongs at the local level we would get a lot better results. It has worked in industry and it can work in government.