As we enter the final days of this provincial campaign, reforms to our health care system once again play a key role in each party’s platform. The Liberals, under a Neurosurgeon and a Radiologist, want to create mega clinics which will do ultrasounds and other tests and have them paid for out of the public purse. The PQ’s Health Minister, a former Dean of Medicine and Geriatrician, wants to expand the coverage provided by the present network of CLSC’s by having them open 24 hours a day. The other parties offer a mix of focusing on preventative medicine and cutting back on the bureaucracy. All of these proposals have their merits and their weakness but they all suffer from the same fundamental flaw: they let politicians control health care. The truth is that as long as we let politicians run our health care system, it will never work. Why? Not for lack of ideas. The present and past campaigns have had lots and lots of ideas. Are we any better off? No, because no matter what they say, no politician can shepherd the health care system through long term goals and planning. They’re tied to the election cycle. So before a plan can mature and bring results, mandates change, government finances and priorities change. We need to take back control of our health care system. Let the government commit to a specified amount of money per year for a decade or more. Lock that amount away and then let those of us who use the system decide where it should be spent. Let patients and health care workers, pharmacists and public health experts create a long term roadmap to improve healthcare for Quebeckers. Submit that plan to open and transparent debate. We can do that right now. I suspect strongly that once vested interests are exposed to the light of day, we will be able to agree to certain fundamental principles. For example: more emphasis on preventative care; easier access to front line care (nurse practitioners, family docs, social workers, etc.); and, the creation of community based resources based on local needs. The money would be tied to patients not to procedures or interest groups. Tough choices would still have to be made. We haven’t got enough money to do everything but evidence-based decisions can lead us in the right direction. The transition would not be without hiccups but it would certainly result in a more transparent, patient-focused system than the one we have now where paternalistic decisions are made behind closed doors about how to use our own money for our care. Wouldn’t you rather be in charge than let a faceless bureaucrat tell you what you’re allowed to do with your own money?