Who Pays–Us Or Them? I Think It Should Be . . .

Wine, Liquor Bottles

As I grow older and time moves more quickly by I recognize I am becoming less tolerant and understanding of some of the choices people make that have nothing to do with me directly but could influence my pending quality of life. I am speaking specifically about available health care and the cost that lifestyle choices may have on that care.

After a career of substance use and an even longer period of time (clean/sober) working as a residential counsellor in a local rehab/treatment program I feel I can offer, with some degree of honesty and accuracy, the following observations and thoughts about using alcohol, tobacco and drugs to extreme or at least to excess. I do understand that we have choices about what we put into our bodies, how much and how often. There is an abundance of quality information out there to clarify the long term effects of substance abuse with a strong degree of accuracy.

As of 1992 (I hope that we’ve conducted more recent studies) the estimated total cost of substance use to the Canadian Government exceeded 20 Billion dollars. It is likely closer to twice that by now and even that figure may be conservative. When I think about that number I think about how that fact has affected the quality of living not just for seniors but for most of us when it concerns health care and home care. I was watching the news recently and a story came on about a little girl. She was 6 years old and diagnosed with cancer. At approximately $29K a month her family is unable to cover the cost of the medication that could change the course of her life. Unfortunately there is no public coverage.

The public does pay, however, for people who access the medical health system over and over and over again for illnesses and necessary medical treatments (broken bones, car accidents, domestics involving the police) that are connected to their lifestyle choices. I’m not talking about diseases or illnesses associated with past work conditions etc. or having been exposed to contaminants in their neighbourhoods. I’m talking about developing cancer because someone will not stop smoking or the person who continues to drink excessively after being told repeatedly to stop or face the health related consequences. Then he/she goes on to develop liver problems, kidney problems, heart disease, a variety of cancers not to mention how often they access other services such as home care, mental health services, social services, public services like the fire department. Much of this because they felt it is/was their right to do whatever they please and screw anyone who thinks otherwise. Remember I am only talking about those repeated visits to medical and mental health care facilities or public services that could have been avoided had the client heeded advice from professionals who explained specifically the likely outcomes of their continued abuse of alcohol and drugs. Then consider all the misery and deaths attributed to impaired driving. Still the public picks up the tab for decisions that could have been different. I know better than to believe that alcoholism and drug addiction are diseases and the poor soul who ‘has it or them’ is doomed for life. Please. The only thing that person is plagued by is poor decision making and a soft backbone. Otherwise how would you explain all those folks who manage to clean up and live completely drug free and substance free lives with little or no help whatsoever. They do it because it needs to be done. This doesn’t include those who get clean and sober by using some of the usual approaches–A/A, N/A, C/A, S/A, O/A, S/A and there’s some others. The point is there are a variety of ways and means to manage these lifestyle issues that many folks just refuse to use.

I think that the paying public needs to be helpful to and supportive of anyone who needs help to turn their lives around and to get back to where they can be happy, healthy and productive human beings in their homes and their communities. I also agree that everyone should have the right to live their lives according to what they want as long as those choices don’t interfere with someone else’s right to do the same. It’s their life to do with as they see fit and if they want to drink themselves to death or smoke themselves into oblivion or do drugs so be it. I (we) have no right to tell them otherwise. However, when these same folks keep coming back again and again with their hands out looking for the public system to assist them having made little or no effort to consider other lifestyle choices we need to re-think just how much help we need offer them. Perhaps they need to pay for their own health care. We, meaning the public, provide the expertise–they provide the money to pay for that expertise. I guess it’s a like a users fee.

I think of that unfortunate little girl whose life is just starting but because of a lack of dollars and shrinking budgets, this little girl may not have a chance at any kind of life. Perhaps a few of those 40 billion dollars that go to those with lifestyle disorders of their own choosing could find their way into the coffers so that people who have had no say in their troubles can have a chance to live their lives with dignity and promise.

That’s how I see it anyways, Jim

Comments are always welcome.

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