A modest proposal

Issue: BCMJ, vol. 53 , No. 4 , May 2011 , Pages 156 Editorials

Due to the structural integrity of our Cheez Whiz-reinforced DNA, the baby boomer generation is going to last for a while, creating a problem. As this huge demographic wave hits retirement, our med­ical system is going to become more stressed than ever. 

The boomers are going to consume more health care services as they age and demand ever-increasing investigations, treatments, and more. The difficult question is, how is our socialized medical system going to keep up? It is pro­bably somewhat unrealistic to expect the following generations to fund this gluttonous blip. 

I don’t know how we can financially sustain the status quo. I think it is time to carefully start weighing our options. One solution is to increase taxes, but I’m not sure this would be a popular choice. How about delisting some services? However, this avenue appears to be political suicide as every time our socialized medical plan is challenged, parallels are made to other Canadian horrors such as increasing gas taxes, outlawing fighting in hockey, and raising the price of beer.

We already pay provincial medical insurance premiums (many pro­vinces do not), so we can’t argue that our medical care is free. So perhaps if you have money you pay more, but is this just another penalty on the rich? Is the answer to expand the private health care sector to relieve the strain on the public system? Might as well talk about raising beer prices again.

How about a means test? The amount you pay depends on your in­come and savings. This could be link­ed to your income tax return. Life and disability insurance premiums are already based on a number of health risk factors, so perhaps we could use some of these. How about if you smoke, or if your BMI is greater than 30, you pay more? Perhaps if you abuse drugs and alcohol there should be some financial penalty. 

All of us know at least one miserable person who spends their time spreading negative energy and just generally making the world a less beautiful place. Perhaps we could start personality petitions and if you receive more than 20 signatures on your “Am I a jerk?” form you pay a financial health penalty.

Why not take direction from the Boy Scouts and if you don’t do a good deed every day, then the rest of us won’t pay for your coronary stent, or maybe you get a used soft drink straw inserted instead? We could organize neighborhood watch health patrols and if your neighbors don’t like you, your grass isn’t cut, or you have an oil stain on your driveway, you get dinged. 

We could run popularity contests, and if you garner enough votes you and your family are covered but if you are an unappealing mean ogre then you’re out of the plan. Or maybe we just shoot you, thereby saving even more health care costs. Finally a reasonable answer—if you get sick and no one likes you, we enact euthanasia. We could have a vote and then snuff out your torch, so to speak. Just think of the reality television revenues generated that could then be used to help fund the system. 

I am at the tail end of the baby boomers and I really need some smart people to start thinking about this very real and inevitable problem, because quite frankly many people find me irritating and I don’t like my chances. 
—DRR

David R. Richardson, MD. A modest proposal. BCMJ, Vol. 53, No. 4, May, 2011, Page(s) 156 - Editorials.



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