Episode 13

Andre Picard Part1: A Pragmatic Approach to Solving Healthcare


Guest: André Picard

Award winning health journalist at The Globe and Mail. Author of Matters of Life and Death


Key Takeaways

  • If André Picard could choose what to prioritize to improve Canadian healthcare, what would it be?

    • “There is no magic formula, first of all,” he says, but there are two things that stand out:

      • We have a sickness care system meant to help the ill. Shoveling more money into it might not be the solution. If he had the choice, he’d put more money into early childhood education and feeding kids at school – measures known to go miles in healthcare prevention.

      • How can we improve the system itself? We need to start with the basics, Mr. Picard says. Bolster primary care; we won’t get far without a good health foundation.

  • The social determinants of health are a concept Mr. Picard finds himself returning to again and again, especially when discussing vulnerable groups in healthcare.

    • We have to make an extra effort to reach out to them, he says. To make sure they’re heard; all the medicine in the world isn’t as important as a roof over their head.

      • Social services in Canada are grossly underfunded, making it all the harder for these groups to seek out help in the first place.

    • There’s no easy solution to the difficulties faced by indigenous populations.

      • At the very least, we need to start repairing the damage done by making sure these populations have access to basic necessities like sanitation and clean water.

  • The looming issue of mental illness is incredibly complex, involving discussions about medical history, economics and politics.

    • Like with other vulnerable populations, preventative measures are key; we need to prioritize initiatives like Housing First, realizing that these people need homes, social support and income stability just as much as they need treatment.

A Closer Look

Prioritizing transitions in healthcare

  • It isn’t easy to choose what to prioritize in our healthcare system. But Mr. Picard offers some insight into where to start.

    1. Shovelling money into our healthcare system isn’t always the answer. We need to focus on getting more value for our investment by focusing on specific areas, like prevention.

      • Early childhood education and making sure children can eat at school – these are the kinds of things that will give us the most bang for our buck.

    2. Canada has a sickness care system. We treat the ill. How can we improve the way we do this? The answer may lie in what Mr. Picard calls transitions.

      • Transitions are the points at which patients move from one institution to another: from the clinic to the hospital, or the hospital to homecare, for example.

      • It’s at these points, Mr. Picard posits, that we “lose people”. They slip through the cracks, are not followed up with, or not brought to where they need to be.

      • We need to bolster our primary care system, and make caregivers responsible for seeing patients through a system comprehensively; this disorganization is a fundamental issue in our healthcare system.


Humble Origins

  • What drove André Picard to healthcare journalism? “I stumbled into it,” he says.

    •  An important part of starting his career was covering the AIDS epidemic. Mr. Picard remembers the craziness of the time, during which medical journalism, the drug business and medicine profoundly changed.

    • An overarching theme in his journalism: don’t judge people. Don’t fall for stereotypes, and make sure to always give individuals the voice they need to tell their story.


Healthcare and vulnerable groups

  • Time and time again, the question of how to help vulnerable populations returns to the social determinants of health.  During their discussion, Mr. Picard highlights how all the medicine in the world isn’t as important as giving someone a roof over their head, a sustainable income and meaningful connections with friends.

    • Despite prevention being a proven way to address these issues, a major concern is that social services continue to be majorly underfunded in Canada; here, we spend about 13% of our GDP on these services, says Mr. Picard, while in Denmark it’s 27%. And you can see the results: better health outcomes, less spending on healthcare.

    • If we put more money in our communities, they will do better. This is what gives us the greatest healthcare value for our dollar. It’s as simple as that.

  • Indigenous populations face unique challenges that must first be addressed by acknowledging colonialism’s deep impact on their lives.

    • To make amends, we have to begin by following the recommendations of the Truth and Reconciliation commission.

    • At the very least, it is essential to provide these communities with proper sanitation and clean water, which many still lack.

  • About 20, 000 people sleep in the streets of Canada every night. Most likely, 90% of them have severe mental illness, Mr. Picard says.

    • The Housing First initiative is essential. It is impossible to begin treating individuals with complex mental problems without first providing them with a safe home.

    • Investing in this isn’t just an ethical win; preventing homelessness has been proved to save millions in medical dollars.

    • We need to fight stigma about mental illness and start treating it as a “brain disease” with a pathophysiological origin. We don’t allow people with cancer to walk the streets without treatment, so neither should these patients.

Further Reading

André Picard’s profile page at The Globe and Mail

Titles by André:

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