Should We Fear the Slippery Slope of a Tiered Healthcare System?
After a moving Territorial Acknowledgement, the 19 who gathered in the Library Program Room welcomed our special guest, MLA Adam Olsen. Adam was accompanied by his constituency advocate, William Kelly, and two legislative interns Rose Williams and Jerram Gawley. He began by sharing something this week that - while emotional - had excited and delighted him: he had spoken to the Legislative Assembly’s release of its Declaration Act Action Plan outlining 89 specific actions that ministries are directed to take to create a better province for Indigenous Peoples in B.C: (https://news.gov.bc.ca/releases/2022IRR0018-000457).
When Adam spoke of this action plan, (https://adamolsen.ca/2022/04/response-to-ministerial-statement-on-declaration-act-action-plan/), he issued a warning to his colleagues that a plan with good intentions but without outcomes is not a success. It is only when these actions have created a measurably-better life for Indigenous Peoples, as well as for all British Columbians, will this plan be considered a success. According to Adam, only when Indigenous Peoples no longer experience racism and can self determine without being harassed by our government will we know if this plan is successful. Using a fishing analogy, he told us that his role as a member of the opposition is to keep tension on the line.
When asked what we could do to help, he asked us to also keep tension on the province to ensure these actions produce needed outcomes - as well as continuing to push federal representatives to get rid of the Indian Act. Write emails and letters over and over again. Adam will use them to continually remind the province that we are all watching and waiting for outcomes.
The first question about our deteriorating healthcare system provided the theme for the first hour of our time together. A participant asked Adam what could be done to help the estimated 900,000 British Columbians who do not have a primary care physician. This participant suggested we sign the petition demanding that our government address this situation: https://www.change.org/p/bring-back-our-family-doctors-and-our-walk-in-clinics?utm_source=share_petition&utm_medium=custom_url&recruited_by_id=1edd59c0-815c-11ec-a96f-cd6331cc0e99). He spoke of the 35 healthcare vacancies on Salt Spring, wondering how the expanded Lady Minto Emergency Room will be adequately staffed.
While this almost a million residents without primary health care estimate may be high, an approximate 20% in Adam’s riding do not have a primary care physician. This discouraging statistic clearly contradicts the promise of equal, accessible healthcare for all. Focused on emergency care and pain management, Adam believes that our province is also ignoring desperately-needed preventative care and early intervention - the smart strategy for patients as well as the financial well-being of our fragile healthcare system.
Much of our conversation fell into two categories: The alarming corporatization of primary healthcare by big businesses and the promise of Primary Care Networks.
Adam worries that our healthcare system is quickly developing into a tiered system that offers better care for those with the money to pay. In his riding, a clinic has recently sent a letter asking his constituents to pay $50 to recruit physicians. While not a great deal of money - and was introduced as an optional fee - his constituents worry that they must pay or be placed at the bottom of the long list of patients.
A far more expensive example is the rapid entry of huge tech companies into tele-heath. Telus is a prime example of this fast evolving tiered healthcare system: (https://www.telus.com/en/health). Fees range from no-charge for video-conference visits with a healthcare professional to the premium LifePlus program that requires a $4,000 initiation fee as well as $3,000 a year: (https://www.telus.com/en/health/care-centres/personalized-care/member/lifeplus).
We learned that Telus has purchased the Copeman Clinics, clinics that raised red flags in the early 2000s for the dangerous precedent they set: (https://thetyee.ca/News/2006/05/11/TippingPoint/) While Telus is a Canadian company with 80.50% held by the Canadian public, Adam fears the sweeping and rapid changes to our healthcare system that loom with this corporate medicine. Fueled by investments of billions of dollars, Adam also fears a provincial shroud of secrecy protecting the enormous investments by a number of powerful tech companies.
Adam continues to place great hope in Primary Care Networks (PCNs). These networks offer a full continuum of personalized healthcare delivered by a team of healthcare professionals, each responsible for clearly-defined and distinct care. The establishment of these PCNs would require altering the physician payment system they were promised in the 1960s when our healthcare system was being established. That promise retained physicians’ independence, also making them responsible for the daunting costs of running their business. This old system forces doctors to pay their bills by retaining the simpler functions, such as renewing prescriptions, to balance their more complex, time-consuming cases.
If doctors were employed by Island Health instead of having to recoup all their expenses from patient appointments, they could focus on these complex cases, leaving the simpler needs to other qualified healthcare professionals. Adam sees this as the hope for our healthcare system, offering all patients a team of qualified healthcare professionals to address their entire spectrum of needs, from preventative and early intervention to urgent and pain management care. He is convinced that healthcare professionals utilized at the appropriate level of care would help the individual and the system.
While Adam continues to support more training and recruitment for the entire range of healthcare professionals, he has hope that, with the widespread establishment of PCNs where healthcare professionals work at the appropriate level, we could more accurately assess our needs for additional healthcare workers.
But, despite this hope for PCNs, before we switched gears, Adam reminded us that rising costs of living and low healthcare salaries are problems throughout Canada, worse in BC, and, with the high cost of housing it is even worse in his riding, and at its most extreme in Salt Spring.
When asked what could be done about the North Salt Spring Waterworks District’s (NSSWD) infrastructure needs, Adam shared his disappointment that, after five years of hard work, an expensive study, and many, many meetings, NSSWD and the CRD had failed to come to an agreement that would allow this Improvement District to access infrastructure grants.
A participant referenced the Transition Salt Spring’s Transportation event the evening before, asking Adam to further explain his comments about acquiring rights of way for bike and pedestrian lanes by offering adjacent property owners tax receipts or tax deductions. A participant asked why the commonly-used expropriation option (https://www2.gov.bc.ca/gov/content/governments/local-governments/planning-land-use/asset-acquisition-disposal/expropriation-powers)was not used locally more frequently. She asked why our local politicians seemed fearful of this legal process.
Adam replied that it was not fear but cost: expropriation is expensive, a cost seldom budgeted by the Ministry of Transportation and Infrastructure (MoTI) when rehabilitating roads. While very cognizant of Salt Springers’s disappointment in the more narrow-than-anticipated 1.2 metre bike lanes on the Ganges Hill project (from the village to Cranberry Road), Adam reminded us that this project is a repaving project - not an Active Transportation project - and, as such, was not adequately funded for significant land acquisition.
Enthusiastically-supportive of completion of the Salish Sea Trail from Fulford to Vesuvius, he also understands the daunting expense of this project. His hope is that our amazing community of volunteers can work with the province, CRD, and Islands Trust to acquire (by donation, tax breaks, and, when needed, expropriation) the rights of way for the rest of the project so that we can get adequate bike and pedestrian lanes on this important route.
Will that spur MoTI to move faster completing the repaving of the rest of Fulford-Ganges? Maybe, just maybe. . . . ?
As 1:00 fast approached, Adam reminded us that the completion of the long-awaited Salish Sea Trail (from Fulford to Vesuvius) will do nothing to make it safer for cyclists and pedestrians on the rest of our roads. It could possibly even make it worse for them by providing a well-paved road that allows drivers to forget that they are on a rural island and that they must Slow Down! He challenged us to better use our existing roads, changing our culture of speeding by implementing smart and creative traffic calming innovations.
With an appreciative Farewell to Adam and his team, and already looking forward to his next visit Friday, May 6, 11-1, in the Library Program Room, we thanked him for his consistently hard work, willingness to fight for provincial accountability, and his wisdom about those issues that mean most to us. (Thank-you, Adam!)
Please join us in the Library Program Room Friday, April 8, 11-1, to welcome CRD’s Gary Holman.
While we follow all gathering protocols, please understand that it is also your responsibility to asses risks. While we hope to see you at the Library Program Room, we also look forward to gathering under the apple trees in the United Church Meadow when weather warms.
And. . .if you join us, dress warmly as we hope to open up the wall of glass
to further enhance our safety.
What do you want to ask him?
Is there any news about BC Housing’s proposal to move the shelter to Drake Road?
Have you clarified that there is enough water to accommodate over 60 at the Drake Road location?
Can you give us any news about the Warming Space?
When will we know who will be renting space at the Middle School?
Is there any progress on the long-awaited HarbourWalk designs?
Can you share any news about your proposed Local Community Commission (LCC)?
There is some talk about convening an Interagency Working Group. What do you know about this group?
And. . . .?
See you Friday, April 8, 11-1 at the Library Program Room to welcome Gary!
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