Time for a B.C. health consumers' association

By Paul Willcocks
VICTORIA - I'm tired of being the forgotten person in the health care system.
We health care consumers are the only ones without a real say in the way services are delivered.
Nurses and other workers have their unions; the doctors have the BCMA; and drug companies their lobbyists. All push to advance their interests.
But you and I, the people who rely on the system, have no voice. The power people make the decisions, and trade off their goals. We have no say.
It's not fair to say that government should represent us. Any government balances a huge range of interests and pressures, and we the health care consumers are just one interest group.
Health Minister Colin Hansen thought about us, when he got in that noisy battle with Nanaimo emergency room doctors. But he also thought about the government's freeze on compensation for doctors, the businesses that want lower taxes, the people pushing other spending and his government's commitment to a balanced budget.
That's his job, and it does not involve focusing on the needs of people who use the system.
People get touchy when you talk about health care consumers, seeing some sort of political judgment in it. But that's what we are. We pay money - an average $2,700 per person for health care - and we get something in return.
We're particularly powerless consumers, because government - for sound reasons - has created an effective monopoly on health care. If I decide my local grocery store is doing a bad job, I can shop somewhere else. That can't happen with the health care system.
It's not just that we're voiceless. Because we're silenced, all sorts of special interest groups claim to advocate for consumers when they're really pushing their own interests.
The Cancer Advocacy Coalition, for example, does an annual report that this year linked higher spending on cancer care with lower death rates. B.C. spends the most per-capita spending on cancer, the report found, and has the lowest mortality rates. More money equals lives saved.
But perhaps we have a lower cancer death rate because of anti-smoking efforts, or because people are generally healthier here, or because we have a large Asian population less predisposed to cancer.
A consumer organization would look at all those factors, and weigh the effectiveness of using the same money for other health priorities.
But while the cancer coalition is doing important work, it doesn't speak for consumers. It's mission is to make cancer the top health care priority, not to promote better overall health care.
It's only one of many such groups. And like almost all the other illness organizations, it depends on funding from big pharmaceutical companies which have their own goals.
Drug policy expert Alan Cassels of the University of Victoria says drug company funding creates obvious conflicts for organizations dependent on millions in contributions. "You can almost see the influence of the money."
But when Health Canada holds big consultations, these are the groups it calls to the table. Each advances its special interest; no one speaks for us. When the decisions are made, we're not even there.
Gordon Campbell and the other premiers talked about reinventing health care when they met in Vancouver. But the consumers need a real role in that process if it is going to work.
Australia has found a way to make it work. Its Consumers' Health Forum is almost 20 years old, formed with government support after consumers demanded a voice. The association is a coalition of health and community groups - no providers or care workers or corporations.
It publishes articles and reports, handles complaints and speaks to the government on behalf of the consumer.
All for about $750,000 a year from government and a bit more from members, and with a lean paid staff of eight.
It's time for the Consumers' Health Forum of BC, with government support and a recognized place at the table.
Footnote: The idea makes lots of people nervous. What if the forum is somehow captured by a small group, politicians worry. But the fact is that efforts to improve health care are not going to work if the end user is left out of the process.