Healthcare Policy: A self-handicapping strategy?

We, members of a caring and democratically-geared system, are constantly vigilant of new ways of making healthcare services more economical and accessible to everyone. Yet, in spite of advanced techniques in research, treatment and increased funding, we are faced with higher morbidity and moratility rates, increased cost and reduced resources. In spite of our good intentions, each time we generate a new healthcare policy, it is accompanied by new ways of taking advantage of it. This occurs not only in our local community but indeed, in our efforts to improve international healthcare resources and services as well. The outcome invariably amounts to reduced healthcare goods and services to those who really need it. In addition, those who are able to provide the goods and services that are needed by the people are excluded by the healthcare system. There are essentially three general drawbacks at the policy and programming level that seem to be leading to this constant battle between those good intentions and our seemingly uncontrollable urges to take advantage of them: (1) lack of an effective follow-up and monitoring system that will report, enforce and implement policies and changes as required; (2) lack of knowledge about healthcare sciences and research that can help to formulate practical, realistic guidelines; (3) insufficient participation by healthcare scientists and practioners and too much participation by politicians (i.e., business, legal and labour personalities). Public debates and discussions held (and often televised as well) remind me of our grade nine science class trying to come to grips with nuclear physics. Why isn't the system allowing the "right" people to "do well" ? The answer is not a simple one! A good start would be to observe cases in point - to troubleshoot so-to-speak. There are far too many at all levels - government, frontline practice and end-user, who are taking advantage of healthcare regulations and too many to mention here. We can start by discussing a few here... (to be cont'd)

Gay Marriage: Does That Mean a Happy Marriage Anymore ?

A lot is being written about gay marriages in Canadian newspapers and countless other periodicals - both scholarly and otherwise ! The issue is currently being dealt with in the Canadian Parliament once again - i.e., a simple series of deep knee bends that MPs make to show their current position on the issue (and also to get the blood circulating again after those long hours of sitting in the same position). It is interesting that when it comes to healthcare and education policy and legal decision-making, concerned citizens and organizations are allowed to participate and are heard throughout the country. When it comes to the issue of gay marriages, they want a select few who are supposed to represent the whole country of 30 million people to vote on something that has the potential to destabilize the whole institution of marriage in the years to come. The system took "homosexuality" out of the DSM a few years ago and it is therefore, no longer viewed by clinicians as a mental disorder and is now considered "normal". The system has now seen it fit to bend religious and moral rules and indeed, in some scriptures our cosmology and the concept of the divine. Given our persistent culture of deference to authority (which is probably why we want to legitimize gay marriages in the first place), we are left to accept whatever law parliament passes without question or full debate. I wrote a few of these words in response to an article earlier this morning and the short mesage which comprised of barely thirty to forty words was not allowed to be published under their comments section. It seems that the whole network of those in authority have placed a wall between the public and those institutions that structure our everyday lives in this system.

The issue of economics however, still remains. Canada lives in a global community. It has dual citizenship agreements with several nations - most of whom do not legally accept gay marriages. How will this impact on issues of inheritence of estate or passing down of wealth when a last will and testament is unavailable? For example, if you have a gay marital partner here in Canada and have property in India, then: who should get the property after your death - your gay partner here or your next of kin living elsewhere, in India or perhaps the USA ?