Michael Rachlis MD

Poverty is arguably the most important determinant of health.

Read a new five-part series on poverty and health by the Ontario Physicians Poverty Working Group (PDF).
And read the August 5th 2008 Toronto Star op-ed on poverty and health (MS Word), which summarizes the series.

Read about Tommy Douglas's Second Stage of Medicare in my paper from a new book published by the Canadian Centre for Policy Alternatives. Click here for details (Ms Word).

Complete PDF Version of “Prescription for Excellence:
How Innovation is Saving Canada’s Health Care System”
Click here for details.

As we approach the second century of the great Canadian Medicare debate, the Supreme Court Chaoulli decision has added charter rights spice to the mix. But, don’t make any mistakes; it’s the same old ideological and class conflict that has divided our country for a hundred years. The argument is mainly driven by those who would benefit from a more private system – commercial interests (including a small but growing minority of doctors) and the wealthy. The wealthy would benefit in two ways from a privatized system. First, they perceive that they could then have immediate access to high quality care. Second, if someone is wealthy and healthy enough, the bills for private care (user charges or private insurance) would be less than the increased taxes that the people perceive are necessary to fix the public system.

The newer voices in the debate include Canadians of all political persuasions who find the current system inadequate for their needs. One friend was recently denied public funding for a drug which was literally her only hope for life. She paid for the drug and is in remission months later. Another friend paid to get an immediate MRI for his swollen knee when the publicly funded one would take three months. Without being able to use my knees, I would be obese, diabetic, and cranky.

We spend a lot of money on our health system in Canada – over $5500 for every adult and child, $180 Billion in total, over one tenth of our entire economy. The US and a couple of other countries spend more but they aren’t healthier. For this massive investment, Canadians deserve seamless world-class care delivered by caregivers who feel that they have the world’s best jobs.

Canadians could have the world’s healthiest people and the world’s best health care system. In fact, if one looks across our great country, one will find that somewhere, someone has solved our apparently intractable problems, including undue waiting. HG Wells said that civilization is a race between education and disaster. Let’s speed up Medicare’s renewal by spreading these best practices rapidly and encouraging everyone to do even better. As Medicare’s problems wane, so will the demand that we change its underlying values. It’s not too late to save Medicare. It’s not too early to pitch in to help. Remember Tommy Douglas’s words—“Courage my friends. ’Tis not too late to make a better world.”