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The Way It Is - Bob Michels (9/01)

Who is to blame for province's health-care woes? What has replaced "the weather" as our favourite topic of discussion? "health care.

Who is to blame for province's health-care woes?

What has replaced "the weather" as our favourite topic of discussion? "health care." Ask almost anyone in Northern Ontario for his or her opinion about health care and you will get one!

We were not always concerned about health care. I can remember house calls, evening office hours for doctors and open hospital beds. OK, so I am over 50. Nonetheless, like many of you, I believe that more can, and must be done, to restore reasonable access to primary health care within a reasonable time frame.

What is the situation now? In Thunder Bay, for example, many people are unable to even find a family doctor. As a result, some have started to travel to Nipigon, a 90-mile trip, because they can actually get an appointment to see a doctor within a reasonable time frame!

So who is to blame for this situation? We all are - government, physician governing bodies, health-care administrators, patients, you, and me.

For a start, let us look at how well we have looked after our own health. Using northwestern Ontario figures, here is how we stack up against the rest of the province:

* The overall mortality rate is 11 per cent higher compared to the rest of the province

* Diseases of the heart and circulatory system are 28 per cent higher than the Ontario average

* Cancer rates are higher than the Ontario average

* Accidents, poisoning and suicide rank higher than the rest of Ontario by 26 per cent

* Residents of northwestern Ontario are hospitalized 33 per cent more frequently than the province overall

* Musculoskeletal and connective tissue disease is 60 per cent higher

* Nervous system and sense disorders are 46 per cent higher

* Respiratory disorders are 44 per cent higher

* Injuries and poisonings are 43 per cent higher

* Circulatory system disorders are 29 per cent higher

* Alcohol consumption is 22 per cent higher

So, through our choice of lifestyles, we are partly the authors of our own misfortune. In addition, like other Ontario residents, we have been seduced by the very costly new medical technology - CATScans, MRIs, and the like.

Medical morality also contributes to our dilemma as we generate most of our health-care costs in the twilight years of our life, sometimes attempting to extend lives far beyond their natural limits despite the personal indignities and outrageous costs involved in doing so.

More doctors, particularly in Northern Ontario, might open the door to more timely, preventive health care, and perhaps even increase our focus on health promotion, all of which will serve to reduce the need for and the cost of health care.

So, how to explain the doctor shortage?

The apparent "closed shop and closed minds" mentality of the Ontario Medical Association and the College of Physicians and Surgeons might be one barrier, not only to the increases required in training places, but also to the experimentation needed to find more cost-effective ways to deliver health care.

Our niggardly approach to increasing our supply of doctors is another factor.

What do you know about Denmark? Here is information that might interest you. The population of Denmark at 5.4 million is just about exactly half the population of Ontario. Ontario is almost four times larger than Denmark (Greenland excluded). Ontario is blessed with abundant, marketable natural resources that greatly enhance Ontario's economy and government coffers, while little Denmark has to rely on its wits and intellect.

Ontario's response to its shortage of doctors involved increasing its medical school places from 112 to 160, and increasing the number of foreign-trained doctors allowed to enter our system after further training and testing from 36 to 90 per year.

Little Denmark, faced with a similar situation, increased its medical training places to 4,800 and now exports trained physicians to other countries such as Norway.

Yes, it is simplistic to ask, "If Denmark can do it, can't we?" True, their system of salaried doctors differs from ours, at least for the time being while government attempts to convert our system. On the other hand, people across Ontario are looking to the federal and provincial governments for bold action.

As you know, Ontario has announced that it will soon establish a new medical school in Northern Ontario.That is a bold step for which the Ontario government should be congratulated. Maybe, with federal government help, we can take a slightly bolder step and establish two new northern medical schools, one in Sudbury and one in Thunder Bay.

Bob Michels is an author and consultant living in Atikokan.