To Boldly Go FTLComm - Tisdale November 19, 1999 By:timothy W. Shire Aboard the fictional star ship Voyager the problems of medical care have been taken over by a complex computer program that can manifest a tangible being that simulates a doctor and can perform medical treatment and diagnosis on the crew of the ship. Many times when we take a look at fiction, be it a novel, movie or merely a television episode of some dramatic series, the writers like to take on the issues of the time in which they live and the fiction allows them to play around with the problems that seem so formidable to them. The crisis in medical care South of the border is the same as what we were faced with at the middle of this century. Many people paid money to a doctor owned insurance company in monthly payments.( That amount would be in 1999 Canadian dollars about $491 a month for a conventional family of three children) The coverage this insurance scheme gave covered a major portion of the costs of seeing a doctor and the extras that might be needed when and if someone was hospitalised. In addition, families of the province paid into a government operated system called "Hospitalisation" that was in effect, hospital insurance, so that if a person needed treatment in a hospital, most of the costs were met by the plan that cost a family between twenty and thirty dollars a month (converted to the value of money today that would be about $167 a month in 1999 Canadian dollars) Clearly, with people who have jobs, but those jobs are paying salaries and wages close to the minimum wage, and are often referred to as the working poor, the burden at the middle of this century or now in the United States for medical insurance is beyond their means. (a similar coverage for what we now have covered with our taxes would cost a three child family about $659 Canadian a month) For people on welfare in the 50s or in the US now, there are programs that cover their medical needs, but the vast majority of the population are not middle class, or on welfare. They are instead, those people who work hard to make ends meet and their limited income makes medical insurance impossible. In the United States now and it was true here as well up until the arrival of Medicare, medical insurance can be packaged with worker benefits and part of the costs of medical care can be met with contributions from the employer. However, the trend has been toward part time work and nonunion employees who do not receive such benefits. The situation in the United States is that a huge number of people can not afford to get sick or have treatment if they develop some condition. That is the way it was here and in 1962 it ended when this province brought in Medicare, a universal medical care program funded by taxation. The doctors didn't like the idea, because they were making a huge amount of money on the side through their company that was the major medical insurance company. They resisted the program and went on strike. Since then Saskatchewan, and after the adoption of Saskatchewan's medical care programme throughout the country, doctors have continued to prosper earning far more money then they ever did before Medicare. During the reactionary period when this country had a foolish government lead by Brian Mulroney, the national debt was increased so much that a huge number of cut backs had to be made to prevent economic collapse. The legacy of that era is with us now as governments try to learn how to balance budgets and they have went after every expenditure. With Medicare being a large part of government expense, it was an easy target and our worst fears have been realised. The writers for the program Star Trek Voyager, obviously are aware of the tragic situation in their country where so many people have no medical coverage and idealised the process with the computerised doctor. One who treats anyone injured or sick, is neither greedy or demands payment in return for its work. It is the sort of medical system that would be ideal, but is actually not that far fetched. Computerised diagnosis and computer assisted surgery are now used in the practice of medicine. When Medicare was first brought to the forefront of political discussion, it had already been in operation in the Swift Current health district for more then a decade. It worked surprisingly well provided there was no political interference. From 1962 until 1993 with only the brief glitch when Ross Thatcher imposed "User fees" it worked just fine. Waiting lists, hospital closures and nursing cutbacks are a phenomena of the late 90s. The present situation where medical care has risen to 40% of our provincial budget does not make sense, if it were to return to the pre-1960s version of health care would also be as senseless. Partly privatising the present system offers no relief to the fundamental causes of the problems right now. If you have read even one of Mario deSantis' articles in Ensign you will realise that the provincial medical system is its own worst enemy and there is a good chance that the greed of the doctors who went on strike decades ago is still the source of the trouble. The bad organisation and use of the medical system for political reasons is a major cause of over spending and poor delivery of services. The attempt by so many to make Canada as bad a place to live as the United States is perhaps now the major threat to our way of life. There is a solution, it isn't political or ideological, it is involvement. If we individually sit back and expect some leader to come along and sort things out, we will get to experience the 1920s in your old age. The power to preserve and change things for the better is within our grasp, we must assert our feelings and demand that things get better. We have regional health boards and health board members, that's where to start. Along the way, there will be so many who will toss out quick fixes like Ralph Klein's back to the good old past concept and we must ignore outside influences such as undoing the progress we have made during this century to be like our American neighbours. We must instead, start now to build on what we have, make it better, it must cost less and do more.