Canada

The patients’ dilemma

SUZANNE ZWARUN June 26 1978
Canada

The patients’ dilemma

SUZANNE ZWARUN June 26 1978

The patients’ dilemma

Canada

ALBERTA

Hillie Hedley is a Fort Macleod, Alberta housewife with a $l,000-a-month habit. A victim of Crohn’s disease, the 38-year-old woman has had nearly all of her bowel surgically removed. Since her body can no longer absorb normal food, she would die without a regular diet of an expensive high-protein fluid fed to her through a tube in her chest.

Alberta Health Care bears the $240-aday cost of her treatment in hospital, but not home treatment, although the protein would cost only $35 a day there. Blue Cross doesn’t cover it at all. So Hedley faced an unpalatable set of alternatives earlier this month when she went home. The protein would be supplied to her free if she returned to hospital, although she is feeling “healthy as a horse.” Otherwise, she and her retired rancher husband,Wes.would have to pay the $ 1,000 a month for her diet until their assets ran out. Then they could go on welfare, which would supply the protein free.

That Catch 22 situation was first brought to the attention of the provincial government last fall by the Canadian Foundation for Ileitis and Colitis. The government, says Hedley, did “absolutely nothing.” But

with her case to focus attention on the problem, the foundation launched a lobby that produced hundreds of letters, 1,500 from the tiny community of Fort Macleod alone. The provincial government hurriedly backpedalled and announced it would supply “total parenteral nutrition,” as the process is called, free to anyone needing it (about a dozen Albertans do).

The cost was a minuscule matter for a province that likes to boast it has the lowest

taxes in Canada, but the Hedley case brought home to Albertans what the province’s medical profession, backed by opposition politicians, has been complaining about for the past three years: health services are in an unhealthy state in the province of plenty. While the government was urging Hedley into hospital for her protein, thousands of other Albertans were waiting, some for as long as three months, for an empty hospital bed. Hospitals have been shutting down entire wings and cutting services because they say they can’t afford them. The Calgary General Hospital, for instance, faces possible court action as a fire hazard. Improvements were ordered six years ago and board chairman Les Roberts says the General “has done all the things we had money for.” But that still leaves the hospital $1.5 million short of safety standards—and a $ 100,000 fire there in April was an awesome reminder of the problem.

Hospitals Minister Gordon Miniely began his attack on spending in 1975, his final year as provincial treasurer, when he complained that hospital operating costs had tripled in four years. As soon as he changed portfolios, he told hospitals to hold spending increases to less than 11 percent. There was an outcry, beds closed, waiting lists grew. Miniely next moved to curtail new building,'after a study found that hospital construction in Alberta since 1970 had cost

18 per cent

more than comparative construction for hospitals elsewhere in Canada. He blamed “over elaborate design, excessive facilities, unnecessary frills and Cadillac standards.” Alberta’s health-care costs have topped $701 million, the biggest single item in the province’s $3.8-billion budget, and Miniely's supporters argue that pampered Albertans have become too accustomed to easy hospital admission: one study found that Albertans have the highest rate of elective surgery in the country, double Newfoundland’s rate. Health-care premiums remain low—$91.80 per single person per year compared to Ontario’s $228. But if Alberta can afford to abolish gas taxes, making gasoline 20 cents a gallon cheaper than any other province’s, the argument runs. Albertans shouldn’t have to line up for hospital beds. Trouble is, that logic contains a Catch 22 of its own: for Albertans to enjoy instant hospital privileges, the cost of gasoline would have to double to $1.40 a gallon. SUZANNE ZWARUN