Lessons of grassroots health care

Frank Hendricks (a false name for a real person) weighed 560 pounds. He suffered from congestive heart failure and uncontrolled diabetes. He was a smoker, drinker and cocaine user.     

He needed hands-on help, but in the poor rust-belt city of Camden, New Jersey (where factories are shuttered and industry has flown away to Asia) Hendricks received only hit-or-miss care, until he or someone else discovered that he was in serious trouble. Then ambulance crews rushed him to the hospital emergency ward. 

This happened several times. The American health system offers erratic Medicaid to poor people such as Hendricks. Medicaid alternately rescued Hendricks and turned him loose and neglected him.

Canada — where millions of people have no family doctor or friendly, knowledgeable helper to co-ordinate their care — could learn something from this American distress story and its halfway happy ending.

Dr. Atul Gawande, surgeon, health care analyst and Harvard professor of medicine, told the story in an article entitled “The Hot Spotters,” in the Jan. 24, 2011 issue of the New Yorker magazine.

Dr. Jeffrey Brenner, a creative number-crunching physician, learned that one per cent of patients in Camden racked up 30 per cent of the costs. Hendricks was part of the one per cent.

Brenner set out to help the troubled people. By joining into a team that comprised physician, nurse-practitioners, nurses and  social workers, and offering individually designed preventive and healing care to each targeted patient, Brenner and colleagues (on a lean budget financed by health foundations) brightened 300 lives and reduced health costs by millions of dollars.

Through enquiry, advice and care, they stirred Hendricks’ willpower and expanded his network of helping sources. He lost 220 pounds and now has disability insurance and a steady place of residence rather than welfare motels. He keeps his diabetes and heart ailment under control with reliable medical supervision and abstains from alcohol, tobacco and cocaine.

His visits to the emergency ward are shorter than they were.

Can Canadians apply the targeted care principle more widely? Can we train a sufficient number of health professionals — some of them working in salaried teams in new public clinics — to improve the superior public health care system, that we are so smug about, and thereby restrain its costs?

Can we reinvent health care and the failed strategies of war-on-drugs, skimpy, grudging welfare payments and lock-‘em-all-up justice? 

People whose inner slogan is “I’m all right, Jack, pull up the gangplank, I’m aboard” say we are already doing too much “nanny-state” care.

Pessimists say we can’t do widespread targeted care because we’re too lazy, busy trying to make money, too deeply submerged in hockey, football, movies, video games, tourist cruises, electronic interchange with pals and partners, or lulled to sleep by lobby-group blarney.

But it ain’t necessarily so. I am among the optimists.

We are learning to conserve people, in a way that roughly parallels the recycling of glass, metal and paper in blue boxes.     

The rise of deal-making workers like Brenner suggests that artful, calculated, hard-nosed human-conservation enterprises — rather than pretences of conservation — are becoming the accepted standard of social or technical behaviour.  

Victoria used to dump all the city’s garbage at sea. Unbelievable but true. We still trash and dump human beings.

My hunch is that increasing numbers of us — including simple neighbourly helpers and such power-for-me politicians as Prime Minister Stephen Harper — are getting a clear view of the change in the texture of human relations and the payoff from conservation — in cash, in happy-value and in votes.

Harper won’t repudiate the corporations that sponsor him, but he may recognize that good health brings financial blessings.

I believe teachers and curriculum designers can and will launch preventive-health courses from kindergarten to university. They know poverty and ignorance are major factors in illness and shorter lifespan.


—G.E. Mortimore is a Langford-based writer. Think About It runs every second week in the Gazette.

Just Posted

Number of SD62 kindergarten registrations about same as last year

Approximately 850 kindergarten registrations for 2019/2020 school year

28 years later: Dunahee disappearance remains largest investigation in Victoria police history

The four-year old Victoria boy went missing without a trace on March 24, 1991

City of Langford mails out information on sewer connection requirement

Plan lays out obligations, exemptions and financial assistance information for the costly hookup

Update: BC Transit driver taken to hospital with serious injuries after assault

Driver attempted to stop an altercation between two people on the bus

Protective human chain forms around Victoria mosque for Friday prayer

Islanders stand arm-in-arm to show support in aftermath of New Zealand shootings

‘Families torn apart:’ Truck driver in fatal Broncos crash gets 8-year sentence

Judge Inez Cardinal told court in Melfort, Sask., that Sidhu’s remorse and guilty plea were mitigating factors

POLL: When do you think the next major earthquake will hit Vancouver Island?

According to seismologists, Vancouver Island is overdue for a magnitude 7 earthquake.… Continue reading

Greater Victoria Wanted List for the week of March 19

Greater Victoria Crime Stoppers is seeking the public’s help in locating the… Continue reading

WestJet sticking with Boeing 737 Max once planes certified to fly

WestJet had expected to add two more of the planes this year to increase its fleet to 13

B.C. driver caught going 207 km/h on motorcycle along Okanagan Highway

A motorcyclist was caught by Kelowna RCMP going 207 km/h on Highway 97C

Motorcyclist dies after three-vehicle crash on old Island Highway

Accident happened at 12:15 p.m. Friday near Country Club Centre in Nanaimo

B.C. fire department offers tips to keep your home safe during wildfire season

With wildfire season getting closer, the Penticton Fire Dept. offer tips to keep your home safe

Most Read