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Health-care focus should switch to prevention: André Picard

André Picard photo by Peter Ford / Pinpoint National

André Picard photo by Peter Ford / Pinpoint National

André Picard’s romance with journalism began as an extracurricular affair.

While studying administration in the mid-1980s at the University of Ottawa, he developed a passion for writing as a music reviewer for the student newspaper, The Fulcrum.

Instead of becoming an accountant or business executive, Picard earned a second degree in journalism. As a top graduating student at Carleton University, he was snapped up by The Globe and Mail, where he has worked for more than a quarter-century.

Posted to the Montreal bureau, he shifted from political to health reporting with a national focus and in the process acquired an international reputation for excellence.

Picard is not satisfied with merely factual and in-depth reporting and analysis.

Those who worked alongside him got to know a colleague/competitor who would not make do with “he-said-she-said” journalism, a slice of colour and some background.

His work as one of North America’s top health journalists reflects his personality: Behind the placid exterior lies an inquisitive, perceptive and industrious scribe for whom the work only begins with the official story.

Philippe Couillard, the health policy adviser-turned-Quebec Liberal Party leader, said of Picard at a symposium last year: “André, in my view, is the most thoughtful and certainly often courageous public writer we have on the health care sector in our country.”

Passion and commitment are what drove Picard to write the first of several books, such as The Gift of Death: Confronting Canada’s Tainted Blood Tragedy (Harper & Collins, 1995), where he pieced together the story behind the 1980s scandal. More than 1,200 people had contracted AIDS from tainted blood in what is said to have been the worst health-care disaster in Canadian history, much of it centred in Montreal.

“That was a sprawling story. I wrote about it for many years, so I thought it needed to be brought together in one coherent story,” Picard said in an interview.

Juggling his day job, a busy public speaking schedule, and family life—he is married to Gazette reporter Michelle Lalonde and they have two teenage daughters—Picard followed up with a 118-page study of The New Face of Charity in Canada for the Atkinson Foundation and Critical Care: Canadian Nurses Speak for Change (HarperCollins, 2000).

Picard’s latest is a comprehensive review of the history, strength and weaknesses of health care in Canada, written for the Conference Board of Canada.

Picard’s guiding thread is “to embrace social justice without abandoning fiscal prudence.”

“I tend to be a pragmatist. Social justice has to be important, but we can’t be spendthrift. We have to think about the money part. Maybe that’s the accountant in me.”

Picard writes that Canadians are getting “more care, faster and better” and that the $200 billion Canadians spend annually on health care ($140 billion is from the public treasury) is “good medicine for the country’s economy, especially when the economy is ailing. … It’s a redistributive social program as well as a health-insurance plan.”

On the weakness side, he asserts that the focus on acute medical care rather than enhancing social welfare programs and preventing health problems has been “politically expedient, but a costly mistake and missed opportunity.”

We can be “a little smarter and get more bang for the buck” by spending more on prevention, he observes.

Improvements in education, child care and housing have a major impact on human health and he agrees Quebec has been “a little smarter” with such programs as pharma-care, free dental care for children up to age 10, and $7-a-day child care.

“Quebec is really good on the social, but spends a little less on health care, and has a very bureaucratic medical system.”

With the increasing cost of publicly funded health care and a steadily aging society, Picard expects private and insurance-funded care will have a greater role.

“The objections we have toward private care are way too dogmatic. Every country that has universal health care has a mixture of private and public care.

“The discussion we should have is what’s the right mix, where is it most appropriate?

About 23.2 million Canadians have private health insurance, covering drugs, various diagnostic services, and supplementary health care such as private rooms.

Picard’s leitmotif for private care: “We should turn to the private sector if the services provided are of equal quality (private and public institutions need the same rules and regulations), if they are the same price or cheaper, if they are faster, and if the public option has been exhausted.

“We need to avoid so-called cream-skimming, where all the profitable procedures are left to the private sector and all the complex, expensive care is left to the public system.”

Public awareness and pressure can be effective, as it was in 2004 when Ottawa pumped in an additional $5.5 billion to reduce wait times for cancer and heart surgeries, hip and knee replacement, and cataract operations.

“Our system was created when our population was young. Now we have this older population that needs chronic care. We have to rejig the system with a different philosophy.”

Picard says that on any given day, 7,500 patients are in Canadian hospitals, at a total cost in one year of $4 billion. Half of them could be at home if proper home care were available, at one-third the cost.

“Imagine $4 billion being put into home care instead of having people live somewhere they don’t want to live. We could get a lot of home care out of that money.”

Picard is critical of the Harper government for “withdrawing completely from the health-care leadership game, concentrating instead on writing cheques.”

“I don’t think their interpretation of the constitution—responsibility for health care is shared with the provinces—is correct. It’s convenient for their beliefs, but I think Canadians expect more than that.

“The federal government’s role is not to take over the provinces, but it is to level the playing field.”

The Path to Health Care Reform: Policy and Politics may be downloaded from elibrary.ca, or ordered by mail for $20 from the Conference Board, 255 Smyth Rd., Ottawa, Ont., K1H 8M7. 1-866-711-2262.

irblock@hotmail.com

Photo: Peter Ford / Pinpoint National 

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One Comment

  1. IN THE USA NOW, IT SEEMS THAT HEALTH CARE AND PREVENTIVE CARE, HAS TURNED INTO DEATH CARE. THEY WANT TO GET RID OF AS MANY OF US AS THEY CAN, SO THEY CAN BRAIN WASH THE REST OF THE POPULATION. YOU FOLKS IN CANADA HAVE NOT SEEN NOTHING YET!!!

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