Health Conversation is Quiet

December 5, 2006 Health Conversation is Quiet Premier Campbell is attempting another grand experiment in the development of public policy; possibly inspired by the Citizens' Assembly on Electoral Reform, the Conversation on Health appears to have choked in its early days. The Campbell government's contribution to the Conversation seems to be little more than scare tactics from the Premier and his Minister of Finance that health costs are growing at an unsustainable rate, combined with a series of questions originally posed in the February 2006 Throne Speech, including: "Why are we so afraid to look at mixed health care delivery models, when other states in Europe and around the world have used them to produce better results for patients at lower costs to taxpayers?" That's question 4 on the website for the Conversation; question 3, also from the Throne Speech, is: "What does the principle of "universality" mean when some citizens have special access to services and surgical options that others do not have, for lack of extended or private insurance?" One could think that the government is playing devil's advocate if it weren't for the endless messaging, based on inaccurate information, about the cost of health relative to the ability of the public purse to pay. One might almost think that question 10 on the Conversation's website was designed with the False Creek Urgent Care Centre in mind: "The Canadian Institute for Health Information stated in a recent report that 57% of emergency room visits are for less urgent or non-urgent conditions. Most of these visits could be diverted to more appropriate levels of care and reduce pressure on our emergency rooms. What physical location and service alternatives should government look at to provide non-urgent care and treatment options for people who do not require emergency room level care?" It is hard to read stuff like that and not suspect that the fix was in for the False Creek Urgent Care Centre. Nevertheless, the government spin is that they are playing tough guy against those who don't want to obey the law of the province. Some political observers believe that folks at the Centre stumbled into their current situation because of bad advice and political naivety, not realizing that Bill 92 (2003) could be proclaimed. In the end it may make little difference whether they got to where they are through a wink and a nudge from a government bent on making BC's health system more European, or whether dumb luck has perhaps got them to the point of negotiating special fees for payment for their services solely by presentation of a CareCard. One way or the other BC is on the brink of a major turning point in the history of Medicare. It doesn't look like most British Columbians are going to learn about the Conversation on Health by participating in the opportunities offered by the government. The Conversation was kicked off with a news release and the launch of a website on September 28. Weekly reports are now available on participation in the conversation, and they show that as of November 26 the website gets an average of less than 350 visits per day. That's less than half of the traffic to StrategicThoughts.com, and a small fraction of the traffic to popular sites. The Conversation is operating with a budget of $10 million; StrategicThoughts.com operates with costs of about $10 per month - a difference of six zeros at the end. Interest in the Conversation was greatest in its first ten days, but since then it has received a daily average of 4 emails and 2 letters. The lowliest government backbencher gets more mail than that. There are two forms of electronic submissions to the Conversation; web submissions average 7 per day, while posts to web discussions average 10 per day. There will be face-to-face conversations around the province. As of November 26, almost 3,000 people have registered to participate in the forums. We don't know how many will be considered eligible after the government applies its rule of tossing out anyone who works in health care. No matter how you look at it, participation in the Conversation on Health is getting less participation than an average half hour on any popular radio talk show. Meanwhile the government is proceeding with its agenda of change. Whether it is part of a plan set down a year ago, or just a reaction to events of the last week, the government's handling of the False Creek Urgent Care Centre may have more influence on the future of Medicare in BC than anything that comes out of the Conversation that most British Columbians have thus far ignored.