Dishing with DKG: The man who knows how to fix health care

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This is a new conversation series by Donna Kennedy-Glans, a writer and former Alberta cabinet minister, featuring newsmakers and intriguing personalities. this week: teacher health care Dr. Jon Meddings.

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I met Dr. Jon Meddings a decade ago; he’d just been appointed dean of the Cumming School of Medicine at the University of Calgary (a position he held until 2022), and I was a rookie MLA representing a constituency that included his university and a teaching hospital.

Governments and healthcare providers don’t always see eye-to-eye but when things get tense — I recall heated debates about primary care clinics, acrimonious disputes about doctors’ compensation, and diverging opinions on how to deliver cancer care to people in southern Alberta — Jon was a breath of fresh air.

Today, the COVID-19 pandemic has exposed all the cracks in a fractured healthcare system and people are overwhelmed, exhausted and distrustful of the politicians now scrambling to resuscitate the system. I’m eager to hear what this former dean thinks is possible.

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Warm chinook winds are sweeping through southern Alberta on the morning I drive to Jon’s home in a quiet cul-de-sac lodged between the U of C campus and the Alberta Children’s Hospital. I meet Jan, his wife, at the front entry; she’s heading out for a walk but has laid out slices of banana bread and cheese on the kitchen counter. Jon invites me to sit, in a deep winged-back chair in their sunlit coffee nook, and brews a pretty mean cappuccino for both of us and serves them steaming hot in tall white mugs.

Over the hissing of the Italian barista machine, we catch up on personal stuff but I find my attention drawn to the photographs showcased on this home’s walls. Jon and his wife are avid photographers and their art is magnificent — enormous blowups of dramatic starry skies and vast landscapes.

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Jon’s a 66-year-old gastroenterologist — a plumber, he jokes, who knows the ins and outs of things. He’s currently guiding British Columbia in the setup of a second medical school — at Simon Fraser University — to boost BC’s roster of primary care physicians. The province is also upending the way family docs are paid; rather than billing on a fee for service model, family physicians working full-time can opt for a $385,000 salary. Jon’s excited about BC’s shoring up of primary health and he’s watching what Ontario is doing with primary health networks.

British Columbia isn’t shy about raiding good ideas and people from Alberta; Dr. Deena Hinshaw, Alberta’s former chief medical officer, just got recruited to BC’s public health leadership team. With competition for frontline healthcare workers heating up, it’s easy to slip into an “Alberta First” mindset. If you want to advance the “Alberta Advantage,” Jon challenges me, take a look at some of the good ideas we discarded.

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Jon studied medicine at the University of Alberta, in Edmonton; his advanced training at a medical lab in Texas was funded by the Alberta Heritage Foundation for Medical Research (AHFMR), established in 1978 by Premier Peter Lougheed, embraced by Premier Ralph Klein, and then axed in 2011. “The reason Alberta is not Saskatchewan in healthcare and medicine is due to the AHFMR,” Jon asserts.

But will more money fix today’s problems? It’s not about more money, Jon agrees, what’s needed is an efficient and accountable system.

Our conversation came before this week’s federal-provincial health summit, but he knew exactly what to expect: “We’re now going to have this big flashy provincial-federal healthcare meeting and they are going to make another announcement like they have done every year for the last 30 years, pass a little more money around and say we’ve fixed the problem, you just have to wait to see the results. And nothing will change.”

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We agree that “privatization” is a bogeyman that shuts down much-needed dialogue. No one wants American-style healthcare, Jon quips, but we have a lot of private healthcare we’re not using efficiently: “In Canada, we spend 37 cents of every dollar in healthcare privately and that is greater than any other OECD country except the US” Prescription drugs, dental care, home care, seniors care, physiotherapy, lots of mental health care — all private.

In Canada, we define “private” narrowly, as meaning you can’t pay a physician privately, Jon laments, “and we lose the opportunity that private dollars and competition can give us because we restrict them. Look at senior care; there is almost a monopoly on seniors care and no public competition. Private dollars aren’t making our system better. They have an effective monopoly.”

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To be clear, Jon’s not suggesting more private healthcare as a panacea. What’s the big fix? It’s simple: Accountability. Provincial governments are actually being accountable to citizens for service delivery.

If you deployed a third party to run our healthcare system, you wouldn’t expect the government to say it to them: here are the benchmarks we expect you to hit and if you don’t, we’ll fire you. Why don’t we put the same benchmarks and consequences in place for a public system?

Is there a magic pill in all this? Perhaps. Jon wants governments to prescribe a patients’ bill of rights, with teeth. That means, if guaranteed wait times for gallbladder or hip surgery aren’t met, the government pays for you to have the surgery done elsewhere. That’s what we expect from Air Canada and West Jet when they renege on commitments.

Donna Kennedy-Glans is active in the energy business and a multi-generational family farm. Her most recent book is Teaching the Dinosaur to Dance: Moving Beyond Business as Usual (2022).