Neonatal ICU Crisis: Unusual or Inevitable?

Hurricane Katrina demolished New Orleans on August 29, 2005. Katrina killed almost 1,500 people and cost $70 billion to clean up.

People knew it was coming. They were told to evacuate. City planners had warned of something like Katrina for years.

Katrina was the surprise everyone expected but no one wanted to believe.

Canadian healthcare is not well. Sick babies cannot fit into overstuffed NICUs. Young people die for lack of beds. These stories aren’t news anymore.

A journalist from a National paper told me, “I need something new to say. My editor won’t publish without a new angle. People are tired of hearing the same thing about hospital overcrowding.”

Last week, I asked an MP, “What do you think about the new tax changes?” He gave a long defence of Morneau’s tax grab on small businesses. He sliced up all the arguments that he expected I would raise.

Then, he let me ask some questions:

What about pregnant docs who use their corporations as the only option available to fund maternity leave?

What about retired docs who live off savings in their corporation and cannot go back to work?

How can you just change the rules after people have built their whole careers on them?

He seemed touched but unmoved, until I asked the next question.

“What about the impact on physician resources? You remember the 1990s… Ontario ended that decade with 1.2 million patients without a family doc. Communities fought to attract doctors to their town.”

He softened. “Oh I know,” he said. He had spent years recruiting doctors, when he worked in municipal politics. The smaller towns could not compete.

By the end of the conversation he was nodding agreement.

Then he shrugged. “But where is the money going to come from?”

We can be certain of 3 things:

  1. Medical technology will invent new treatments.
  2. Regardless of what we spend on care today, people will want more care tomorrow.
  3. We could spend our whole provincial budget on healthcare.

Medical care presents a challenge worldwide. Other countries seem open to trying different ways to structure and fund care. Canada just keeps doing the same thing:

ration high cost treatment,

restrict or replace doctors,

and keep patients standing in line.

Taxes have outpaced every other cost of living in Canada. It cannot be otherwise. If we keep offering all the same social benefits in the same way that we do now, we need more money. If we expand the social ‘safety net’, we need more money.

This cannot go on forever. Small businesses and professionals happen to be the cow the government wants to milk today. Tomorrow it will be someone else.

But people want to hear something new. They do not want to hear that we cannot afford everything we want or that Medicare is struggling.

Journalists find chronic overcapacity boring. They want to hear about outbreaks and unusual events.

Media does not want to hear that the neonatal ICU crisis, last week, was exactly what we should expect.

If we insist on running our hospitals at near capacity all the time, we must have days when we do not have enough beds for all the patients who need them.

We should stop acting surprised when we hear that there are no beds for babies in NICU.

Hospital administrators and provincial bureaucrats will never admit to a healthcare crisis. They fill hospital auditoriums and gymnasiums [“auditoria and gymnasia”?] with old, sick patients, but no one lets the media take pictures.

Most doctors and nurses know better than to talk about challenges with access and wait times. Their jobs depend on keeping quiet.

Hurricane Katrina might have been the most anticipated catastrophe ever. It had to happen. You cannot build houses below sea level and expect that they will escape flooding forever.

Canadian healthcare sits, like New Orleans, below sea level. No one in the world copies our system. No one wants to be like us.

Let’s hope people stop celebrating our uniqueness and start experimenting with new ways to provide care before the real storm hits.

Photo credit: modified from USAtoaday.com

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6 Replies to “Neonatal ICU Crisis: Unusual or Inevitable?”

    1. Agree. We can do better, but it starts with agreeing that there’s something that needs to improve.

  1. Its hard to expect the system to change when there are so many within that are fighting to maintain the status quo. Look at the doctors for Medicare group that has intervener status in the dr day case in BC. Unfortunately we are being prevented to even discuss change from not only the government but our own colleagues. Not until these groups realize that healthcare is not infinite or without increasing costs will we ever have a real discussion on how to improve it.
    Brad

    1. We are almost ready for the discussion, Brad. The situation is not only bad but the public and media is finally starting to become more aware of it.

  2. How topical! My heartfelt prayers go out to those affected and those “first responders” (isn’t that something like “primary care physicians”, or docs in northern rural emergs.) sacrificing there own comfort and safety to help, BUT “Houston, we have a problem”.

  3. I was an NICU nurse in the early 90’s. We had overcrowding back then with babies being shipped to Buffalo and yet I still could not get a full time job. The people power was there but the government underfunded so we sat on the sidelines while our most vulnerable were flown away from family and friends, even their mothers who had to find their own way to the USA to be with their babies. That was the reality 20yrs ago, I had to move to the Middle East to get a job, you will see highly educated and superbly trained people leave this country, nothing has changed, the flood is coming, my toes are wet…

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