Is Health Care An Expendable Item?

Following the recent budget cuts announced by the Vancouver Island Health Authority to tackle a $45-million budget shortfall, one might ask, "Is Health Care An Expandable Item", not unlike chessboard pieces?

Inspite of the fact that VIHA received an extra $95 million in provincial funding toward its $1.7 billion 2009/2010 budget, it still wasn’t enough to prevent seniors facility closures, to reduce long elective surgery wait lists, or to ensure an adequate number of beds for the mentally ill.

With more than half of the provincial government budget devoted to health care spending, there will be increasingly difficult choices to make in the future about how to balance the budget and how to meet the ever-increasing health care demands of the population.

While VIHA health executives indicate that balanced budgets will be a challenge over the next three years, in light of an anticipated 23 per cent increase in health care expenditures, they know that a higher demand for services from an increasingly aging population is outstripping their ability to meet the needs and expectations of the public.

James Bay, Victoria’s oldest neighborhood and one with the largest proportion of seniors population, is certainly not immune to the negative impact of the health care budget cuts.

It was announced that a $127,000 VIHA funding cut to the James Bay Community Project’s Primary Health Care Centre, will result in the elimination of one nursing position, leaving the facility with no nurses to provide care to approximately 2,650 individuals, of whom 650 are over the age of 75. 

Over the past few years, the clinic has faced significant funding cuts while facing increasingly complex case loads with the help of nurse practitioners. Last year however, in response to budget cuts, the Michigan Street Clinic had to eliminate these positions. Now, with the latest round of cruel cuts, many are wondering whether there are sufficient resources to sustain the operations of this much-needed facility in the community.

The idea behind the James Bay Community Project Clinic’s innovative non-profit model has been to integrate nurses, family physicians and other practitioners into a multidisciplinary team to manage chronic health conditions more prevalent among aging patients not to mention undertaking routine tasks such as patient charting and nutritional counselling as well as prescribing medications and ordering lab or diagnostic tests. In this model, the Ministry of health pays the clinic a lump sum fee per patient, rather than paying the physicians a fee for service, and the clinic has also received some additional funding to hire nurses over the past seven years. Not only was this model designed to improve patient health outcomes, but also to reduce pressures on the health-care system, resulting in less need for expensive hospital care.

On the one hand, we are told that as a society we face unprecedented challenges in providing quality health care in the face of soaring costs for highly-sophisticated medical equipment and testing procedures, skyrocketing health care salaries, not to mention providing multi-million subsidies for costly pharmaceutical products. On the other hand, we are told that it is our growing frail and elderly population over the age of 85 that has 10 times the health-care needs of a 40-year-old and consumes $20,000 in health-care resources annually.

The measure of progress in a society, it is said, can be judged on how we care for our most vulnerable members, be they young, be they elderly, or be they unable to care for themselves. It is through engagement of all citizens, in the concern, commitment, and care of one another as well as the health and the well-being of the community, that solutions will be found and new ways will be found forward.

Other News on This Topic:

MDs set the record straight on health-care cuts - Times Colonist, October 23, 2009