Cost of living: Keeping people alive is expensive

By Dr. Michael Moreton, a retired physician living in Lindsay.

There is understandably an increasing amount of discontent with the health care system in Canada. What used to be an outstanding aspect of Canadian life is degenerating. The recent COVID pandemic has strained a system that was barely coping into one that’s failing.

I practiced for years in a system of which I was very proud and must point out two of the problems that have led to the present situation. Those are: the increasing expense of new medical advances and the greying of the population. Both have put immense burdens on the system.

When I was an intern in the early 1960s, a heart attack was an easy admission. I would get a call from the emergency room (ER). Usually, an older man was in the ER complaining of chest pain. When I arrived, the electrocardiogram technician was already present and busy getting an ECG reading. I examined the patient and the ECG, ordered a chest X-ray and enzyme studies and gave the patient a shot of morphine for the pain into his arm and a shot of heparin intravenously. Then he was admitted to the ward and for the next three weeks he spent the time on total bed rest. There was little treatment except ‘resting the heart.’ In spite of this, many patients died.

Within a few years it was realized arrhythmias, abnormalities of the cardiac rhythms, were causing many of the deaths. Continuous cardiac monitoring, cardiac intensive care units, and one-on-one nursing was introduced. Many lives were saved but the increase in the cost of care was enormous. Keeping people alive is expensive.

Some older people would get osteoarthritis of the hip. They got three things then: a walking stick,  hip pain and a limp for the rest of their lives. Then after the pioneering work by Dr. John Charnley, hip replacement was developed, which was followed by rehabilitation. Not cheap.

In obstetrics, my world, the introduction of fetal monitoring, epidural anesthesia, caesarean sections, and the advent of neonatal intensive care units led to safer births, healthier babies and a reduction in the neonatal mortality rate – but at a massive expense.

Other patients developed cataracts. They had the cataract removed and were prescribed Coke-bottle thick glasses and were often then legally blind. Now they have more extensive surgery, the lens removed and a plastic one inserted and full vision is restored. More expense.

Truly the advances in medical care have been staggering in the last 50 years but with them has been an equally staggering cost to health services. In the 1940s the life expectancy was about 68 for males and 71 for females. Not a lot of post retirement care was needed. Now we are living into our 80s or 90s with many chronic illnesses.

The amount of medical care increases with age and this burden is stretching the system to near breaking point. If we are to continue advancing in medicine through technological breakthroughs, extending our lives, then quite simply we must be prepared to fund it adequately.

There is talk of encouraging more private medicine to fix our system; that is a cop out. It would be akin to abandoning one of the things that makes us Canadian. It’s time to improve health care, not sell out.