Reflections on public health issues in Canada

Through his writing, André Picard shines a light into the dark corners of Canada’s health care system
By Katie O'Connor - Published on Aug 15, 2017
Nam Kiwanuka interviews health journalist André Picard on The Agenda in the Summer.

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In the late 1980s when André Picard first began reporting on health for the Globe and Mail, the AIDS crisis was in full swing. “I was interested in the politics [of health care], and nothing was more political than AIDS,” he tells Nam Kiwanuka on tonight’s episode of The Agenda in the Summer. It was while covering the crisis, he says, that he met a man whose story has stuck with him ever since.

“This was a young man who was in the hospital for something that was unrelated to AIDS, but he happened to be an openly gay man,” Picard says. Hospital staff refused to come into the patient’s hospital room to treat him. Doctors and nurses wouldn’t touch him. Meals were left outside his door. “They treated him as if he was infectious,” he says. When Picard arrived to report on the story, he shook the patient’s hand as he introduced himself. “He burst into tears. He said ‘nobody has touched me in three days.’”

Stories that combine patients and policy have fueled Picard's 30-year career. He recounts some of them in his book, Matters of Life and Death: Public Health Issues in Canada, a collection of his most powerful columns.

A man filming in The Agenda studio

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Here are some excerpts from his interview with Nam Kiwanuka:

On where health journalism fails:

I think the biggest failing of health journalism is we don’t contextualize stuff enough because a lot of things happen. There is a new study every day, and the public gets frustrated because they seem to contradict each other from one day to the next. But if you put it into some context people have to understand that’s how science is, it’s kind of self-correcting. If you don’t look at one study in isolation, you say 'look this is one of 20, and they all sort of have a trend telling us this.' If this one’s an outlier we should just not pay attention to it. So, little things like that make for better coverage.

On Canada’s health care system:

The problem with Canada’s health system is it’s frozen in time. We had an excellent system that was created in the late ‘50s, early ‘60s for the demographics of the time, a very young population having babies. With acute illnesses, the idea of chronic illness didn’t really exist back then. We’ve gotten much better at keeping people alive who are sick. So we have a lot of chronic illness today. Our system hasn’t adapted to that, whereas the European countries very much have.

On how Canada’s health care system needs to change:

I think the simple answer is modernizing it. Making an insurance program that reflects the needs of people. So, covering more – broadly. But I think one of the fundamental policy questions for me is we have to decide what’s covered publicly and what’s not. Because we can’t cover all things for all people at all times. That’s an open-ended insurance plan and it doesn’t work. So we have to put limits on it, but I think what happens is we set the limits very haphazardly with no rationale. No thinking it through. We just do it because it’s politically expedient.

On mental health:

We’ve beaten down stigma to a large degree, but to me when you do that there is this implied promise that there is going to be help and I think we’ve failed to follow through on that promise. We’ve spent a lot of time and energy saying, ‘hey it’s okay to come forward and talk about your story,’ and that’s great but there is no point talking about it if we are not going to help you out.      

On decriminalizing drugs:

We try to criminalize our way, jail our way out of these problems, and that’s not the way to do it. I think we should legalize drugs and try to give people help who need help and take the organized crime bit out of the equation as much as we can. People are always going to use drugs. They always have for time immemorial. So let’s ensure they get the safest drugs with the least harm. I think we owe that to ourselves as a society, economically, socially and morally to do that.

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