HEALTH DOLLARS: DOWN THE DRAIN OR UP IN SMOKE?

Issue: Health-care status in Canada.

Problem: Insufficient funding (ain't it always the case).

Solution: Increased federal and provincial health-care funding (never
worked before, but hey, let's try it again, it's gotta work this time).

This debate has no shortage of politico/media buzz words: aging
population; exorbitant medication costs; excessive wait times;
high-tech (high-cost) medical testing; e-records; innovative (read
costly) surgical procedures; cancer care; coronary care; dementia
care; mental illness care (let's stop the list here, if I left out
any pressing special interest group, just count yourself included,
it's on the house, over here in Canada).

Provincial health ministries are in desperate fear of being crowned
(or dunce-capped?) the first to touch that magic number of 50 per
cent total provincial budget expenditure directed toward health care.
Ergo, new politico/media buzz words: primary care reform; health-care
user fees; higher deductibles; private health care; health-care
savings accounts.

Here in the world's most advanced, totally public-funded health-care
system (Canada), something must be wrong if the self-care and
alternative medical models continue to attract and reap huge
financial, out-of-pocket funding from more and more Canadians. Sure,
non-traditional approaches provide glowing testimonials, while
avoiding specific health claims. Sure, desperation occupies the minds
and wallets of families caring for the sick and dying when
limitations of traditional medical care hit the wall. And for sure,
severe sickness demands the rabbit-outa-the-hat production of
"instant" benefits.

Enter inhaled cannabis, a.k.a., medicinal marijuana (MM).

MM is the ultimate in homegrown, self-applied medicine. Totally
funded by the patient or family members. Essentially, totally safe
(especially when compared with the side-effects and adverse-events of
many traditional pharmaceuticals). No pulmonary issues when using
vaporizers and various edibles. With potential to modify (doc-talk
meaning 'improve') some medical conditions: cancer, Multiple
Sclerosis, osteoporosis and more. Never too old to use MM, especially
given that doctors can prescribe morphine and their derivatives to
seniors in intractable chronic pain. Addiction potential so low that
it's not even an issue for the self-medicating chronic pain
population. Finally, no need to fret about patients getting "high"
and possibly "happy." If sick people are a little "high" and "happy"
as a side-effect of their medical treatment - what's wrong with that?

An estimated half a million Canucks could benefit today from MM, but
is there a savings to the health-care system? Well, yes and no.
Health-care costs come from: hospitalization (including all related
services, there's 50 per cent); lab/X-rays/scans/ultrasounds (15 per
cent); medications (20 per cent and rising) and doctors' fees (15 per
cent). Looking at just one segment of health care - chronic pain,
that's 35 per cent of the population. Here alone, overutilization of
testing equipment, monthly visits to the doctor, along with drug
costs averaging $1,000 per month per patient - MM can save big time.

As we speak, at least 100,000 to 200,000 sick Canadians are using MM,
the majority for chronic pain disorders. Cannabis is usually obtained
from a "friend." Quietly and secretly. Only a paltry 5,000 carry the
Health Canada MM program access card.

Without the card, insufficient, unreliable product is consumed, at a
high direct cost to the patient. No savings to the health-care system
so far this way.

But start with an overhaul of Ottawa's MM program, allowing MDs to
sign up patients in the office, directly and immediately, plus
actively encourage MM authorization by doctors to help in the
alleviation of chronic pain and several other medical conditions.

Then, lift the unnecessary police scrutiny of MM Compassion Clubs,
perhaps having them serve as outlets for Health Canada, providing a
steady, superior supply of useful MM products - at a low cost and
directly born by the patient or family members. Then stand back and
watch the health savings roll in.

Oops, forgot to mention: Annual drug related, law-enforcement and
judicial costs in Canada are still over half a billion bucks - the
pot-related component consuming 65 per cent. Plus, to the cops: MM,
crack cocaine, crystal meth, heroin - they're all indistinguishable.
That's not fair. And not right for sick people self-medicating with MM.

Note to politicians: Put a health-care referendum to the people, yay
or nay for the active promotion of MM. Let the people decide.

Dr. David Saul is a general practitioner in Toronto with a practice
exclusive to fibromyalgia and MM.