Health Care

CultureLaw

If you are living in Quebec and have ever needed to see a doctor you know that it’s impossible to speak objectively about health care. Despite the promises of government after government, the Quebec health care system is a mess. Emergency room wait times in Montreal can be up to ten hours or more. In their haste to treat patients, doctors and nurses often jump to dangerous and unfounded conclusions that put patients at risk.

Take the case of Carol*

At forty seven years old, Carol is active, eats well, and is a devoted mother. She also suffers from ovarian cysts and is allergic to morphine. She arrived at the Glen’s emergency room a month ago with excruciating abdominal pain. Despite her screams of agony the doctors refused to consider that her pain was caused by anything serious. They tried to pump her full of morphine and send her home but Carol refused.

One doctor finally listened and ordered emergency surgery. It was only when she was on the operating table that the nature of her illness was revealed. The cyst had ruptured and destroyed her fallopian tube, requiring its immediate removal.

Then there’s the case of Daisy.

At 33, she’s a non-smoker and active. She suffers from depression and was hospitalized almost ten years ago for it. Her mental health diagnosis has tainted every attempt she’s made to receive care for physical health problems from the Jewish General Hospital (JGH) and its affiliates. Four years ago she went to her GP with crippling back pain. He diagnosed a disc problem and prescribed physiotherapy and anti-inflammatories. In spite of this, the pain kept getting worse, and she returned to her GP who ordered the least conclusive testing. When the results were negative, she said:

“I’m still in pain,”

Her GP shrugged his shoulders and told her it was anxiety before shooing her out of his office without any referrals. Since then she’s made multiple visits to the JGH’s ER and walk-in clinics in excruciating pain that numbed her right foot and robbed her of the ability to use the toilet unassisted. Every time, she’s been pumped full of morphine, lectured about morphine addiction, and sent home. It was only through family connections that she found a specialist who discovered nerve damage and operated on her.

Jewish General Hospital (photo: WikiMedia Commons)
Jewish General Hospital (photo: WikiMedia Commons)

The health care system’s refusal to take her seriously caused delays in treatment that ultimately cost her her job. She’s been surviving on a pittance from welfare ever since. Travelling from ER to ER trying to find a doctor who will properly investigate her physical health problems has become her full time job.

Quebec governments have been hiding behind financial concerns to justify their abhorrent treatment of patients.

The problem is that the quality of care in this province isn’t just awful. It’s illegal.

The Quebec health care system is governed by many laws including the Canada Health Act and the Quebec Code of Ethics of Physicians.

The Canada Health Act is the law that creates a mechanism allowing Parliament some control over the health care system in each province.

It’s called Transfer Payments.

Transfer Payments allow the federal government to transfer money to each province for health care provided they meet certain criteria. The criteria are public administration, comprehensiveness, universality, portability, and accessibility.

Government health insurance plans have to be publicly administered and operated. The plans have to insure all insured health services provided by hospitals and medical practitioners. In order to be universal the plans have to insure all insured persons in the province.

In order to be portable, the provinces can’t impose a minimum period of residence for health care higher than three months, and they have to provide some reimbursement for emergency health services obtained out of province. Last but not least, the provincial health plans have to

“provide for insured health services on uniform terms and conditions and on a basis that does not impede or preclude, either directly or indirectly whether by charges made to insured persons or otherwise, reasonable access to those services by insured persons.” (emphasis added)

Violation of these criteria by the provinces can result in a reduction of this money. If necessary, the federal government can even withhold it in its entirety.

Then there’s the Quebec Code of Ethics of Physicians which lists the obligations of Quebec doctors. Physicians in Quebec can’t refuse to examine or treat a patient for reasons related to the nature of their illness or the context in which it appeared. They can’t refuse to treat someone due to sex, race, colour, religion, civil status, age, pregnancy, ethnic or national origin, social condition, sexual orientation, morality, political convictions, or language.

If a doctor’s beliefs interfere with her ability to treat someone, the doctor has to help the patient find someone else. The physical, mental and emotional behavior of doctors toward patients has to be beyond reproach. Willful or negligent violations of these rules can make doctors fully liable at all times and subject to civil suits for professional negligence.

Despite Quebec’s flagrant violations of Canada’s medical accessibility laws and doctors all but flaunting their prejudices in walk-in clinics, private offices, and emergency rooms, people don’t seem to complain enough.

The reason is fear. We’re all afraid that filing complaints and seeking second opinions will somehow jeopardize our chances of getting lifesaving care when we need it.

But it shouldn’t, because that’s illegal too.

You want proper care? You have to fight for it. If a doctor treats you like trash, file a complaint. If a hospital screws up and you or a loved one gets worse, go to the ombudsman, and then to a lawyer if necessary. If you think you’re being dismissed because of your age, gender, or mental health diagnosis, don’t be afraid to go to another hospital and demand a second opinion.

It’s not only your health at risk. It’s your life. And in this healthcare system, you’re the only one you’ve got.

*Names have been changed for security and anonymity reasons

Maple SpringNewsPolitics

What is austerity? Very simply put, it is when governments decide to ‘tighten the belt’ in order to resolve ‘debt crises.’ A government starts running a deficit, and thus has to review its budget. While that sounds like a very basic accounting job, it is inherently extremely political. Why? Because you have to decide on which expenditures to cut, or which sources of income to raise.

Two large scale anti-austerity protests have taken place in the past couple of months. All around Montreal, you can still see ambulances, firetrucks, and police cars covered with “On n’a rien volé” stickers. Clearly, that’s just the tip of the iceberg. Parti Libéral du Quebec’s (PLQ) cuts are real, but they are in no way new, or unexpected.

The Maple Spring of 2012 brought hundreds of thousands of students to the streets. Why did the students take to the streets? Back in 2012, PLQ announced that it was planning on raising tuition fees by $1625 over five years. That was an unacceptable policy, mainly because education is supposed to be a basic right, and not a privilege.

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From the November 29 Anti-Austerity March

Of course, the PLQ’s decision to raise tuition fees was not out of the blue. Quebec was (and curiously, still is) facing a rising debt crisis. What happens when you find out that your balance is in the negative? You try to break even. This sounds all logical and rational. Yet, breaking even can turn out to be problematic, if you have your priorities set wrong.

In 2012, PLQ assumed incorrectly that students could be made to bear the burden of the provincial government’s debt crisis. The Maple Spring was the students’ response to this misjudgment, and it was without a doubt very polarizing. While there were hundreds of thousands of students taking to the street almost every week, there were others who wanted none of this.

The problem with the pacifist mind frame is that not everyone can afford to be apathetic. To some, an increase of a thousand dollars over the course of five years might not be too much; but for others it effectively means that higher education is barred to them.

At any rate, after the Maple Spring, the PLQ was replaced by the Parti Québecois (PQ), which declared that the tuition hikes would not take place. However, the PQ decided to cut university budgets by $123 million. So instead of directly barring education to some students, the provincial government succeeded in reducing the quality of education for everyone.

Montreal May 22 protest
From the May 22 student protests in 2012.

Similar to Bill 10 which would overhaul Quebec’s health bureaucracy, and Bill 3 that will overhaul municipal pensions, the cuts to university budgets are part of the same austerity regime based on all the wrong priorities. The provincial government finds itself in a debt of about $3.9 billion and figures that the solution is cutting social services.

The Maple Spring showed that students were more than willing to fight a government that encroached on its basic rights. And more recently, the past two months have shown that mobilization against austerity is not just a possibility, but a reality. It is a little disappointing that people start caring about the consequences of austerity only after they themselves are affected, but that does not matter anymore.

Enter the Spring 2015 Committee. Take a look at what they say on their website:

“While they reach for the last pennies in our pockets, federal and provincial governments increase military spending, invest in prisons, police, and security measures, and roll out the red carpet for the extraction industries. People with friends in high places, the rich, large companies, multinationals, banks and lobbying firms are running the show. A small minority is strangling the community. If the interests of the majority do not orient the actions and priorities of the government, it is illusory to continue to speak of this as a democracy. In a just and equitable society, wealth should not be accumulated at the expense of our environment and should be fairly redistributed among all.”

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“Like wolves, humans act collectively and form groups in order to survive and defend our common interests.”

There is nothing innocent about austerity. It is not simply an apolitical economic decision to break even; mainly because there can be no such thing as an apolitical economic decision. Governments have priorities, and this government has shown us that their priorities are not social justice, social equality, or even simply social services.

It seems, however, that there is enough money in the provincial coffers to fund the $1.2 billion required for the infrastructure projects for the infamous Plan Nord.

It is clear that the governments of this province, both PLQ and PQ, have got their priorities wrong. It then falls on us to collectively fight against austerity and stand in solidarity with one another.

Of course, none of the political choices available might be pleasing. In fact, you might be completely against the system to begin with. But the realistic choice is fighting one battle at a time; while keeping the dream of social justice and social equality alive. It is realistic, because at least we know we can fight the good fight.

This is not just the students’ fight anymore; although I daresay students have led the charge, and are still leading the charge. But it is time to realize that austerity affects us all. As such, it is our collective responsibility to stand in solidarity, and say no to austerity.

 

NewsPolitics

It certainly isn’t an understatement to say that in the past weeks the political debate in Quebec has revolved around the charter. It is my personal belief that it is a very important debate to be had, not because the charter itself has any premise but rather because the purpose of the charter is wrongful and would be extremely harmful for Quebec society at large. But I also don’t believe that it’s an understatement to say that the charter is but a smokescreen made to emphasize ‘differences’ that have never existed in the first place.

Yes, it is my belief as I have said in one of my past articles that the charter was a sort of electoral shortcut, a magical illusion serving the purpose of creating a debate that couldn’t hold it’s ground in the real world, the place outside the realm of political spin. All the evidence shows that there is no ‘integration’ problem in Quebec, the number of reasonable accommodations has never been flagrant and comparatively to other immigration situations throughout the world, especially in Europe, there hasn’t been any ‘flare-ups’ such as 2005 in France or London 2013.

Why the charter debate then? There are many explanations, especially political ones, but the truth is that it’s a debate that suits the ‘neo-liberal’ forces in the Quebec National Assembly because with such a smoke screen they can make their true intentions disappear.

On Tuesday the announcement was made, in very vague terms, that hypothetically in the near future public hospitals would have the possibility to charge patients for their beds. In clearer terms it means the death of public health care as we know it.

Unlike the debate on the charter this is a debate in which all three main political parties, the PQ, the PLQ and the CAQ, in Quebec City are on the same wavelength.

In this dire situation, should the charter still be at the center of our political debate? Should the charter still be on everybody’s mind?

Well that’s were it gets problematic, doesn’t it? The fact is that discrimination is unacceptable in any condition, but while the charter continues to monopolize all the space within the public arena, economic discrimination is at its point of culmination.

The fight against the charter must go hand in hand with the fight against economic discrimination, because in the end, discrimination, whether its origin is xenophobia or economic inequality, is still discrimination. The fight for a more just society encompasses the fight for public universal health-care, the fight universal public education and the fight for minority rights, the rights of refugees, the fight for civil rights.

The false dichotomy that divides civil rights from economic and social rights must be abolished. Until then, our struggles are but disjoint pieces of a huge jigsaw.

The theoretical right to be a free entity able to express one’s singularity is a fundamental human right. The debate revolving around the charter is an important one because we must defend that fundamental human right, but what is theoretical freedom worth if, in practice, outside the world of theory, the balance of your bank account is the soul decider of if you live a decent life or a miserable one, if you enjoy all the freedoms at your disposal or not, if you succumb to sickness or survive.

Over my dead body will any government privatize public health care.

* Top image: Rémi Prévost, marxist.com

News

While I have on several occasions woken up in a strange bed, there have been few that compare to waking up in a hospital. The hangover offered by designer poisons – or chemo brain as the doctors I know have taken to calling it – is one which tends to last not only for hours, but for days. On a good day you might wake up and momentarily forget where you are, and if you’re really lucky, why you’re there. It is a short lived bliss of course; often the  illusion doesn’t last more than a couple of seconds before it is interrupted by the cold insistence of steel bars on your bedside. From here the routine varies a little, although the basics are usually the same: the same thin mattress with it’s mirthless off white sheets, the same small television set at the head of the room, the same tangle of plastic tubing running between your body and a set of machines just off to your right. What varies – if only in a very consistent manner- is the pain. If you’re especially unlucky it’s the first thing that wakes you up, sometimes with shaking, almost always with enough force to make you cry out. Regardless of whether or not you’re ready for it, the malignancy that makes its home inside your body is ready to start its day, and it expects you to do the same.

Perhaps one of the clearest memories of treatment I have is a boy several years older than me sitting alone in one of the many waiting rooms of the Montreal Children’s Hospital. Brightly coloured and filled with a variety of toys, it was clearly designed to avoid the somewhat bland, heavy feeling of adult hospitals. The boy, however, did not notice the decorations. Instead he shook. For forty five minutes, and then an hour and a half, and then two hours. He would stand, he would sit but more than anything else I remember the screaming. He screamed for morphine. For a nurse. When the nurses came they told him they couldn’t give him any more morphine as to do so would risk killing him. So the boy sat. He sat and he screamed.

It is no secret that a common and effective treatment for these illnesses is the use of medicinal cannabis. In fact, few other drugs offer such a wide range of medicinal benefits to both symptoms of cancer itself, and the side effects of chemotherapy. Anyone who knows the overwhelming feeling of chemo-induced nausea will  tell you the same. To understand what it actually means to have one of these malignancies living inside of you – not for days, or weeks, but years – is to understand the necessity of medicinal marijuana.

Instead,  what we have seen this week is nothing short of the most repulsive demagoguery on the part of Health Canada as it attempts to further restrict access to seeds with which cancer patients and others can grow cannabis plants within the privacy of their own home. Prohibition itself is nothing short of an embarrassing assault on civil liberties and the rights of the individual: extending this practice to those who actually need and stand to benefit from these  drugs should be viewed as inexcusable, even for those who do not favour the legalization of marijuana.   Medicinal marijuana could have helped the boy above, and countless others like him. Instead, it has been decided for us that it is preferable to hinder these people’s access to the medication they need.

It is a national embarrassment that instead of standing up for individual rights and the well-being of its citizens, Health Canada would choose instead to serve as the enforcement arm for a groundless, decades-old prejudice. It is shameful, and anyone who supports it ought to have a part of that  shame. To promote an unjustifiable and contemptible extension of the government into individuals private lives is one thing, to knowingly deny the ill  the best available treatment is another. What has been decided is that it is not only enough to persecute a truly victimless practice, but that such a persecution is of greater importance than those that fill our cancer wards.

Cannabis will never be as dangerous as chemotherapy, but for those who truly understand what it means to be terminally ill it will be just as necessary. It’s time that Health Canada  stopped enforcing morality, especially principles this ridiculous and unfounded. Maybe it’s something our current Health Minister, Leona Aglukkaq will never understand. Maybe it’s the type of thing you can only understand when you wake up one morning in a  hospital bed.