I don’t think sustainable is the right word for healthcare. Healthcare will always be here one way or another. I think relevant is a better word. Is our healthcare system designed to have the greatest increase in population health at any given time with whatever resources we have at that time? To be relevant, I would like to see the pendulum swing far over to education, prevention and health promotions, from where it is now hanging, in diagnosing, treating and extending. We’ve neglected populations at risk. We don’t treat those we don’t care about. We fix we don’t heal. For me, being sustainable is ultimately about being fair. It will always be a challenge for healthcare to be efficient, there will be pressure on voters to cut taxes but not services until apathy is addressed. An efficient healthcare produces positive results. We currently have a health care system where programs, services, priorities are added-on. More layers. More duplication. More overhead. Money and time is spent on resources while innovative services and programs struggle for ongoing funding and programs that empower individuals and communities start but they don’t continued, wellness gets interrupted. To be efficient, effective support must be continuous. Healthcare is a complicated system. What should the system do? For a universal healthcare to function it must be realistic and operate at the population level so that it gets the most for the most. I think we have drifting from who and what those “mosts” are. Corporate greed is creeping into health care and I’ve had enough of it. It has set the market value of lived experience at zero, and our healthcare system is shareholder-centric rather than patient-centric. I believe there is an approach that can be the foundation of health care policy and decision making that will stop the creep. What if the vision of healthcare became to fundamentally address the social determinants of health? What are social determinants of health? To me, they explain how some of us are born or destined to poor health and inferior services. According to the World Health Organization (WHO) and this is cut and paste from their website http://www.who.int/ accessed on December 4, 2017. The social determinants of health are the conditions in which people are born, grow, live, work and age. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels. The social determinants of health are mostly responsible for health inequities – the unfair and avoidable differences in health status seen within and between countries. To elaborate further The Public Health Agency of Canada, again cut and paste from their website www.publichealth.gc.ca accessed on May 27, 2014 illuminates: Key Determinants – click on links to learn more 🙂 Income and Social Status Social Support Networks Education and Literacy Employment/Working Conditions Social Environments Physical Environments Personal Health Practices and Coping Skills Healthy Child Development Biology and Genetic Endowment Health Services Gender Culture And on their website PHAC (The Public Health Agency of Canada) continues; The challenge we face is how to use what we know about the determinants of health to: focus our research agenda so we can increase our understanding of how the basic determinants of health influence collective and personal well-being adopt strategies that improve health for Canadians That’s where a population health approach comes in. In a population health approach, taking action on the complex interactions between factors that contribute to health requires: a focus on the root causes of a problem, with evidence to support the strategy to address the problem and efforts to prevent the problem improving aggregate health status of the whole society, while considering the special needs and vulnerabilities of sub-populations a focus on partnerships and intersectoral cooperation finding flexible and multidimensional solutions for complex problems public involvement and community participation A population health approach recognizes that any analysis of the health of the population must extend beyond an assessment of traditional health status indicators like death, disease and disability. A population health approach establishes indicators related to mental and social well-being, quality of life, life satisfaction, income, employment and working conditions, education and other factors known to influence health. I like this! I fell in love with this before and I am in love with it still. This is a good time for an emoticon. How about we explore what is good and what is right because to me that sounds good and sounds right and sounds like something we should stick to. Creating solutions to those challenges is a good place to start. That’s what innovation looks like to me.
A Patient Voice 
All I can tell you is that the system is chewing me up and spitting me out I’ve had such a hard time with Dr they only want you if they can fix you,I had such a fight with the pain mgmt Dr over me being late and I called saying I was running behind,my health has fallen into disrepair I was in a bad car accident going on 3 yrs I am not the same person and it sucks being a patient and proactive
Sheldon
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Thank you Sheldon for your candour, I can relate, and being able to share and relate is a very powerful tool in healing. Your pal, Harlon
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Harlon, I agree we need a population health approach. Our culture of health care (in the US at least) seems to focus mainly on individual responsibility for health and disease, e.g. if you got sick, it must have been because of bad “lifestyle” choices. But so much of what makes us healthy or not is beyond our control as individuals. Thanks for a very informative post.
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Thank you Lisa for taking the time to invest in this post, and I am particularly grateful that yo keyed in on what was my primary theme – that of population health. As you mentioned people often get “blamed” for their condition, where, in fact, there were a lot of variables (genetic, gender, income status, coping skills) that play a huge factor in setting the stage.
I am so glad I have you on my side. 🙂 Harlon
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Well said Harlon. Its sad to see a system set up with the best intentions begin to fall apart due to profit and greed. Treatments are much more profitable than prevention. There’s a shift that needs to happen – back to community, and the good of all. 💛
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Sound thoughts, Harlon. Our problems over here are generally the result of the decline in the concept of service and caring in favour of finance and profit
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I feel that we facing the similar problem here; profit over care and improved patient outcomes. Sigh!
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Yes – the way of the modern world
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Reblogged this on A Call to Witness and commented:
Timely and important post
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I often envy Canadians and their systems. Not so much the cold, though. Glad to see you writing about this topic. Carry on and stay warm!
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According to the World Health Organization, Canada ranks #12 of 191 countries. Pray to Dhanvantari (hindu, physician of the gods and god of Ayurvedic medicine) seeking his blessings that you were not born a citizen of Sierra Leone… gurl. 🙂
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Agreed. Canada’s weakness is what we pay per capital for healthcare. Of all the countries with Universal Health Care we actually rank near the bottom of cost per outcome, so it’s a matter of efficiency.
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You can still pray anyway, just because… I think I need more wine.
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I agree, and I think you are right, it’s always good to be grateful. I need some more Beyonce sized vodka now that you mention it.
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Corporate greed is corrupting healthcare for many worldwide. Many doctors, being puppets of the pharmaceutical companies, won’t even consider many herbs and natural remedies that work wonderfully for certain things.
Here, in the U.S., what Trump is doing to healthcare is insidious.
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Agreed, and in Canada, where we allegedly have Universal Health Care, I believe the pharmaceutical companies and other profit seeking stakeholders are taking up the lion’s share of the budget, so that we do not have the resources for effective health care delivery. It’s a mess!
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Thanks to God, you’re not under the Trump’s new budget about Health and Care. : a real nightmare for Obama… and so many people in USA, I suppose !
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Thanks to God, I am not an American 🙂
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