When Push Comes to Shove in Healthcare

By W. Gifford-Jones MD and Diana Gifford Many factors determine who gets what care when fighting illness. It makes a difference where you live, what kind of insurance you have, and what health problem you face. But the bottom line is that there are only so many healthcare dollars to spend, and people are making decisions on our behalf about where the money goes. It’s time to ask if we have the balance right. Trade-offs are inevitable. Do we place a priority on reducing wait times for essential surgical treatments? Do we ensure everyone has access to a family doctor? Do we ramp up more support for drug use rehabilitation? These are tough questions with no easy answers. But when push comes to shove for limited resources, there should be urgency in putting an end to wasted money. We know good people are dying from drug problems, and they need care. But there are extremely nefarious people profiting from pushing illegal drugs, and it’s these criminals who have us spending tens of millions on safe-use and treatment centres. It’s another problem that otherwise good people make terrible, irresponsible decisions to misuse medications or buy drugs on the street. Let’s add in the doctors who readily prescribe powerful, addictive painkillers to patients without a thought for how to get them off the drugs or manage longer term use for chronic conditions. There has been enough experimentation in fighting illegal drug use and the evidence is piling up that current approaches are not working. There does come a time when millions of hard-working taxpayers have to say, “Enough is enough.” Law enforcement needs to continue to go after the criminals and put them away. And we must ask ourselves what’s the acceptable allocation to money to keep saving irresponsible people, often time and time again, from their follies. What are the trade-offs we are willing to make? In assessments of the “war on drugs”, it’s common to find calls to abandon punitive policies and adopt approaches grounded on harm reduction and human rights. But when efforts to uphold the highest standards of human decency are not working, we need to regroup. Particularly for those who have seen loved ones waiting for delayed cancer operations and other procedures, watching tens of millions spent on substance abuse centres is a bitter reality. It’s tragic for people who develop a cancer through no fault of their own and then need to wait for treatment. It’s a measure of society’s priorities when drug users can walk freely into treatment while cancer patients and their families have no option but to queue for surgical operations, chemotherapy, and other needed treatments. What do we do about the tragic overdoses of teenagers making bad decisions in using dangerous drugs? What about those falling into circumstances where addiction to illegal drugs leads to other crimes? We repeat, there are no easy answers. But we do need to observe where the costs of societal problems are spiralling out of control and make changes to how we spend our money. Putting the price of cancer care alongside that of illicit drug programs might be one way to sharpen the issues. What do you think about this matter? Should we be good Samaritans at all costs, or should we lean into tougher punishments. Should we pay for more drug treatment? Or should we advance funding for cancer care? In your opinion, what is the right way to frame a discussion on the choices we must make? We’d like to hear from you, and we’ll publish your views in a future column. Sign-up at www.docgiff.com to receive our weekly e-newsletter. For comments, contact-us@docgiff.com. Follow us Instagram @docgiff and @diana_gifford_jones