Questions for the Health Conversation

March 24, 2007 Questions for the Health Conversation Participants in the regional public forums for the Conversation on Health are asked to consider 52 questions contained in 11 "conversation starters" that are part of the participant registration package. You can see those documents on the Conversation's website. It would be easy to spend a month or two discussing the questions posed in the conversation starters, while being distracted from what's missing. The questions in the conversation starters start with "What's most important to you about your health and the health of your community?" and end with "What are your views on how to best help people struggling with problematic substance use?" In between are such useful mind-benders as "What do the Canada Health Act principles of comprehensiveness, publicly administered, universality, portability, and accessibility mean to you?" and "How can we design end-of-life care services and facilities in smaller and rural communities that meet community needs while respecting the challenges of both health human resource staffing issues and the financial ability of smaller service providers and facilities to operate in these small and rural communities?" If it weren't for the fact that participants in the regional public forums are self-selected, the exercise could be described as the largest focus group ever conducted. Missing from the conversation starters are questions like: Should the public sit as a jury and offer their opinions with respect to the arguments of well informed but opposing views, or should they pretend they are the experts and offer technical advice to government? Why can't doctors and nurses be trained to wash their hands? Why won't health authorities release business plans and other internal reports so an informed public can better participate in policy decisions? Shouldn't the public be able to see the detailed accounting for various departments and cost centres? Why does most of Europe, other than France and Germany, pay physicians differently than we do in BC? Why haven't we experimented with more alternative payments systems? It doesn't help the conversation to have the Campbell government pushing its agenda that the current system is unsustainable. It is difficult to obtain independent verification of many of the assertions made by government in its conversation starters, but the data are clear that health costs are not consistently increasing at 5% more per year than the increase in government revenues (as assumed by the Minister of Finance in her infamous projection that health costs would reach 71% of the budget by 2017. In a few months Premier Campbell will announce what he has heard out of his Conversation on Health. Anyone who has attended a conference with breakout groups and many flip charts has probably wondered how anyone can accurately reflect a consensus opinion in a conference summary. The same applies to the Conversation on Health, which is why many believe the conclusions have already been written.