This book by the U.W.O. graduate general medical practitioner, and former federal health minister is part autobiography, part political campaign rhetoric and part suggestions to make access to health care available to all Canadians. I found the suggestions for the latter to be a bit nebulous but certainly worth considering.
Back when Bob Rae was premier of Ontario, I wrote that we should consider amending the B.N.A. Act to make health care a federal rather than a provincial responsibility. That would eliminate 11 Colleges of Physicians and Surgeons, with their significant bureaucracies, with licensing and disciplinary authority, and replace them with one albeit larger federal one. The author never seems to have considered this, but it would at least eliminate the interminable squabbling between provincial authorities.
The author also never mentions the tragedy of hundreds of foreign-trained doctors driving cabs or flipping hamburgers, because the provincial Colleges delay or deny them licensing to practice in Canada. Most of them are probably as competent as domestic graduates.
There is no mention of the overuse of imaging techniques and overprescribing, in place of old fashioned physical examinations,and discussions largely driven by patient expectations and fear of being sued.
The chapter on Hope as an essential ingredient of mental health incorporates a wishy-washy amalgam of the author’s Presbyterianism and First Nations vague and flexible beliefs that I found to be unhelpful, but at least she acknowledges that other belief systems can also provide hope.
The short chapter on Belonging is mostly common sense to address the epidemic of loneliness. But by putting it into the context of health care, the author expands the reach of medicine that already is stretched thinly dealing with more and more diseases. Some purists would consider this to be to be a societal rather than purely medical problem.
The chapter on Meaning is full of extreme pathos as she describes her two year old daughter’s sudden death from meningococcemia, on the way to the hospital in Niger, where she and her husband lived while working for Doctors Without Borders for nine years. But Meaning from this??
The author bemoans the lack of training in social determinants of health in Western’s medical school curriculum without any consideration of whether or not that is the best or most appropriate place for it to be addressed. The curriculum is ever more crowded as it is with ever expanding medical knowledge; would it not be more appropriate to include it into, say, political science, or law teaching for those who could actually do something about those determinants- future politicians? The chapter on the shameful care provided to indigenous children and the author’s role in trying to change that bears little direct relationship to “health for all.”
There is no doubt about the author’s diligence dedication, intelligence, idealism, altruism, and hard work. In spite of my negative comments about this book, were she ever to run for political office again, I would probably vote for her, if she were in my riding and maybe even campaign on her behalf.
2.5/5
2.5/5
The Passionate Reader 