Dear Editor,

Kirk Brown is correct that an open, honest, and intelligent discussion of our health care system is called for in the lead-up to the expiry of the Canada Health Act in 2014 [Unbiased system review is critical, May 10, TIMES].

He suggests that our “public figures” should be in this debate.

I would go further – encouraging all citizens who are users or future users of the health care system to join in.

Extensive public consultation will be needed to design the type of health care system we can continue to be proud of.

The radically different U.S.-style system I was referring to in my original letter was one in which there are different hospitals for the rich and the poor.

It is the universality of our system that Canadians are rightfully proud of and willing to protect.

I won’t pretend I’m an expert at ranking national health care systems.

As someone with a background in science, I’m not about to regurgitate meaningless statistics.

Ongoing reviews of our health care system are important since we don’t want to be wasting the hard-earned dollars of our taxpayers – be it to public servants or private companies.

As someone with more than 30 years of experience in both the private and the public health care sector, I’m fully aware that there are problems in both systems.

The inability to retain quality workers in the low-paid private system adversely affects quality and efficiency there, whereas the public system is challenged with top-heavy management teams who feel a need to “fix” things that aren’t broken.

Bankers and business think tanks (such as the CD Howe Institute) have been warning us that our public health system is unsustainable for reasons of their own.

I take what they have to say with a grain of salt.

The recent changes in legislation that have brought down the price of pharmaceuticals by allowing more generics is an example of an overdue change that will vastly increase the sustainability of the system.

As a pharmacist, I found it fascinating how quickly some brand name medications lowered their prices to ward off the new competition. (Their shareholders had been major beneficiaries of our taxpayer funded health care system for a very long time.)

Ending subsidies to corporations and using the savings to invest in health care is another way we can ensure sustainability.

Although I understand that the private-public debate is a focus for some, I prefer to think in terms of what actual services should or should not be included in the health care system.

If someone is so frail or demented that they can no longer clean, cook, shop or do laundry, for instance, does the “housekeeping” they require fall into the health care budget as it would if they were hospitalized?

If they can no longer bathe themselves at home or remember to take their medications, what do we do?

Families in our community are being called upon to do more and more of this work for their elderly, but some elderly have no family to depend on and very few resources. What then?

These are the important questions we need to see addressed.

I agree with Mr. Brown that ideologues – whether from the left or the right – are not going to be an asset in the transparent discussions that are urgently needed.

Respectful dialogue between open-minded, knowledgable people across the political spectrum is more likely to move us forward into an improved health care system that will be there for everyone if and when they need it.

Elizabeth Rosenau, Maple Ridge