communities and being
forced to live with strangers in institutions, having to deal with
unfamiliar faces,
unfamiliar food, unfamiliar routines, and often tragically, abuse and
neglect. Then imagine
this happening to you in your twilight years when, more than
any other time in your
life, you deserve care and compassion because you are so
vulnerable.
Why does Ontario have
one of the highest rates of institutionalization in the world ?
Why do we violate the
human rights of vulnerable people by forcing them to live in
institutions against
their will ?
I’ll tell you
why.
Because until very
recently older adults and people with disabilities have not been
considered to be a
powerful interest group, but private nursing home corporations and
their supporters have
been.
Older adults and
people with disabilities tend not to spend a lot of time banging on the
doors of powerful
politicians, donating to their campaigns, and threatening them with
litigation if they do
not do what they want them to do.
That’s because they
are having enough trouble trying to manage day-to-day as victims
of bad health
policies. And many don’t think they have a chance against powerful
vested health
interests.
Maybe it is time to
change that.
Power, and how it is
wielded by the medical-industrial complex is one of the greatest
threats to Medicare in
this country today. Tommy Douglas knew it and we know
it.
The demons of
self-interest are also a major threat to our health care system -- the turf
wars that go on in
health care at the expense of us all.
4
Instead of providing
attendant care to older adults to help them with cooking, laundry,
bathing, dressing and
other activities of daily living, we insist that older adults must have
biomedical services.
In fact, almost all of our responses to aging have a biomedical
flavor. Policy makers
are not getting it. Age is not a disease !
What does all this
mean for each of us in the event that we become disabled as we age
? Well, it means our
condition is likely to be seen as medical and requiring medical
interventions rather
than as a natural process that requires things like everyday
assistance.
Which costs more ?
Which makes more sense for us as we age ?
Turf wars, fueled by
self-interest, are another of the biggest threats to Medicare
today.
Instead of working
cooperatively to ensure the best possible care, many health and
human services
professionals are at war with each other over turf. Their patients and
clients are the
casualties of that war.
Finally, greed is a
major threat to Medicare. Can we honestly say that every person
who has a six figure
salary in our health care system today deserves to have a six
figure salary
?
Many people complete 6
to 10 years of post-secondary education, but not every
professional demands a
six figure salary to provide a service to
society.
The question is why
are those working in health care so prone to demanding huge
salaries rather than
demanding reasonable salaries and feeling some degree of
satisfaction in easing
the suffering of others ?
Why is money so often
the first concern and patient care the last concern ? Why will
some doctors get a 35%
pay hike over the next few years as an incentive to simply do
the right thing ?
Why is it that those
who administer our hospitals are allowed to earn so much more
than the nurses who
work the front lines every day ?
How are these things
calculated, and by whom ? How much profit is enough ? Should
there even be profit
made in health care ?
If all of us do not
soon begin to ask some incisive questions of our politicians and health
care providers about
these things, then we will continue to have the health care system
we deserve. In a
democracy, the responsibility falls upon each one of us to ensure that
our democracy works,
and that government is providing appropriately for the people
who have paid taxes
into it for a lifetime.
Make no mistake, greed
at the expense of the public, is also one of the greatest threats
to Medicare in this
country today.
5
The last biggest enemy
of Medicare is the apathy of the citizens who simply feel that
others will take care
of things for them. They outsource responsibility for their own
health to their
politicians, their health care providers, and the advocates who are trying
to make things better.
It takes all of us to make a change, not just a
few.
It is the apathy of
all of us that allows politicians to ignore pleas for help from the
families of older
adults abused and neglected in institutions, those abandoned without
appropriate support in
their communities, or people deprived of their regular caregivers
because of unfair
request for proposal processes and lost home care
contracts.
It is our silence that
leads health bureaucrats in this province to believe that they have
the right to dictate
to citizens what they will and will not get, as opposed to
understanding that
true public service demands that they listen to the public and
respond accordingly
with policies that protect the public rather than the interests of the
powerful
few.
The arrogance of
politicians and bureaucrats in decision-making positions, and their
belief that the will
of the people does not matter, is another threat to Medicare in this
province and in this
country. Tommy Douglas also called that in the 1950’s, and it is
equally true
today.
So -- what will you do
should you become ill or infirm ?
Don’t wait until you
become ill or infirm. Sit down now with your family members and
friends and write out
a power of attorney for personal care. Go and visit your MPP and
find out now how to
make the health care system work for you. And if it is not working
to your benefit --
then speak up, and encourage others to do as well. Join an
organization like the
Alliance of Seniors. Don’t wait until you are too vulnerable to do
so.
Where will you live
and who will look after you ? Unless you specify otherwise, you
could end up living in
an institution because there isn’t much else to help you at
home.
If you don’t like that
thought -- get to your elected officials, and challenge them to
represent you in
calling for a fully funded, non-profit home care system where every
penny the government
pays out goes into providing care for you.
Tell the Government
you want a moratorium on creating any more institutions until
home care and
non-profit community
services -- in-home and residential -- are at a par in funding with
the institutional
sector.
Tell them you want
rent geared to income housing with attendant care support. And tell
them that you won’t go
away until you get it.
6
Right now, you can’t
properly plan for your future health and assisted living needs
without facing the
grim possibility of nursing home placement. We simply do not have
much between home care
and a nursing home.
We need small
residences in the community with 24 hour staffing, and hospices to help
people who need
palliative care.
We need to tell our
government officials that it is not their call about whether or not they
want for-profit
provision of health care. It is our call. There is not a single longitudinal
study that shows that
for-profit is better, or even cheaper. There is no excuse for out
politicians to choose
an option that allows providers to remove 10% to 20% of precious
health care dollars in
profit.
This is a public
policy issue, not an ideological issue. We are paying for it, and we have
a right to demand
better for our tax money.
Tommy Douglas urged us
to remain steadfast and to keep pressuring for the health
care system we want.
He also said that he did not want to become a monument on
Parliament Hill
because he saw what the pigeons did to those.
Perhaps though, he can
remain for us, a symbol of all that is good about this country,
and a beacon that
lights our way and helps us raise our voices in unison to build a
better society as a
new generation embraces his remarkable vision.
Thank
you.
Dr. Patricia
Spindel:
Doctor of Education -
University of Toronto (Sociology)
Master of Education -
University of Toronto. (Applied Psychology)
Co-founder - Advocacy
Centre for the Elderly
Past President -
Concerned Friends of Ontario Citizens in Care
Facilities
Former committee
member - O'Sullivan Review of Advocacy for Vulnerable
Adults
Currently Coordinator
of Social Services Program, and formerly Associate
Dean,
School of Health
Sciences at Humber College.
Currently Chair of the
Ontario Coalition for Long Term Care Reform
Recipient of
Government of Canada medal for service to the
community.