March 1, 2002

 Alan Dolman, Chairman

Interior Health Authority

2180 Ethel Street, Kelowna

BC V1T 3A1 

Dear Mr. Dolman:

 RE: Reorganizing Healthcare     

Our new Premier and government are asking for solutions to the issues facing the healthcare system - issues that are vital to BC’s economy and the government’s success.   

A group of people concerned about these issues contributed to the formation of the Okanagan Institute for Strategic Development. These people and others continue to be deeply concerned about, not only the current conditions of healthcare, but also of the broader affect on socio-economic conditions in the community. They also want solutions. 

Attached you will find a copy of a P&A discussion paper that I participated in, entitled “Regional Health Care”. This was submitted to OSHR and to the BC and Federal Ministries of Health in 1994.  P&A has continued, from outside the system, to analyze issues facing health care and to offer approaches to solution to the government and locally to OSHR.   The message was given, and eight years later little has changed - the post-war approach to healthcare continues.  

The paper took a strategic look at healthcare issues - including the relationship between healthcare and the economy - and possible approaches to solution. The paper also discussed spin-offs from the healthcare system that had the potential to stimulate innovation and economic development, fueling economic production, the tax base, and quality of life in the region.   

One area where there is still significant spin-off potential is in the development of more advanced Information Systems, within the HL7 standard.  Better IS, combined with administrative changes and outsourcing options, will be crucial to reducing costs and meeting decided operational standards.  At the same time, the cost of the system development and the system administration will have to be better controlled. 

As a recap of the discussion paper, it was P&A’s analysis that the growth in consumption of healthcare relatively to GDP was not sustainable.  Resources and tax spent and consumed in healthcare obviously is not available for other purposes.  

Consequently, inefficiencies, excess spending and consumption of healthcare are at the expense of investment in economic production, education, research, socio-economic and ecological needs. Ironically, these competing factors are also key elements in creating and maintaining good public somatic and mental health.  

It is important to emphasize that the issue is not whether healthcare is excluded from the pricing mechanism and provided by government, or whether it is provided by the private sector for a price direct to the consumer.  The issue is that excess consumption inevitably hampers Canada’s and BC’s comparable advantages and competitiveness in the global marketplace. It erodes economic production and those factors that create social satisfaction and good health.  

In 1993 and 1994 it was P&A’s analysis that excess spending had reached that acute point, and was eroding our quality of life and health. Decades of old problems had been left unsolved and allowed to escalate into adversity. It was the conclusion that only a radical overhaul of the system could save the patient from a ‘heart attack’.  

At that time, senior government showed little interest in trying to understand the cause of the increased consumption of health care and the negative impact the excessive consumption has on the allocation mechanism and ultimately on the socioeconomic conditions.  

Therefore, it was decided to attempt a bottom-up local approach, and to submit the discussion paper to OSHR. The purpose was to inspire OSHR to recognize the issues and press the BC government, and eventually the federal government, to pay attention to the issues and support the need for change.   

The purpose of the paper’s proposed pilot project was to create a platform that would involve all levels of government and stakeholders in the issues and testing of solutions.  

In short, the initiative failed to create interest within OSHR, the government showed no interest, and the issues continued to escalate to the current situation.  

As Franz Kafka wrote: “The message were given. Nothing changed.”  

Society needs the healthcare system to modernize and to shift from the present passive to a proactive approach – including: modern analysis, information and monitoring systems and proactive early intervention. 

In order to reduce excess consumption, we must identify that point on a standard supply and demand curve where the health care system is promoting good public health and preventing diseases. That will allow us to recognize what is truly excess and allow us to take steps to reduce excess consumption and deadweight in the system. 

The importance of course is to integrate health care in the economy, and establish the point on the supply and demand curve where the health care system is promoting good public health and preventing diseases, and determine how to reduce excess consumption (C+ Q + Q1).   

As a footnote, this ties into the general need for the government to develop better analysis, monitoring of the allocation mechanism, and intervention methods in the economy. That is the governments, not the private sector’s role.  Society cannot afford to continue to allow decades of old problems, such as in the forest and health sector, to escalate until they cause irreparable harm.  

Ultimately, we continue to follow the situation and management of the healthcare system with keen interest.  We were concerned in 1994. We are no less concerned today. The healthcare system has a significant impact on BC’s comparables advantages; the liquidity and investment flow into economic production and the factors that create good health. 

Consequently, this also ties in to issues related to the Community Charter and the Premiers Technology Council, realizing the connection, the two sides of the same coin, between IT and the investment and liquidity flow, in BC’s local economies.

I have taken the liberty to send a copy of this letter to our Premier and to Hon. Ted Nebbeling. We are always open to meet and discuss solutions.

Yours truly, 

Okanagan Institute for Strategic Development 

Kell Petersen

 

 

 

 

 

cc: Honourable Gordon Campbell

      Honourable Ted Nebbeling