Healthcare Quarterly

Healthcare Quarterly 2(2) December 1998 : 51-54.doi:10.12927/hcq..16559

Change, Reform, Positives, Negatives and Getting Ready - Elizabeth Davis on Healthcare Reform in Newfoundland and Labrador

Elizabeth M. Davis


We are experiencing societal change in this country and indeed in this world, coming with an intensity, a speed and a drama that is unprecedented in the history of humankind. Because we are in the people business, if that kind of social change is happening around us, the healthcare system has to change. There is no way we can be responsive to people if we do not recognize the intensity of social change which is facing people today.

We are also seeing incredible changes in how organizations are organized. We used to believe in the divine right of kings. Now, we look back at our ancestors and talk about how naive and unsophisticated they were. Yet, we still believe in the divine right of the pyramid - that all healthcare organizations, all public-sector organizations, all private-sector organizations, all governments should be created in the form of a pyramid with the wisest, most powerful person at the top and the wisdom and the power dissipating as you go down that pyramid.

A third reality of change around us is our understanding of health. When we understood health to be the absence of illness or injury, then we were able to build very large acute-care hospitals and put all our money into physician services. Today, we understand health very differently. It is a resource for everyday living, a sense of complete physical, emotional, social and spiritual well-being. With an understanding of health which relates not just to the person but to the family, to the community, to the population group, and indeed to the earth, we do not have a healthcare system that responds to today's definition.

And finally the financial realities. Healthcare has become increasingly more costly but with a less dramatic increase in benefits. We could not keep spending more money without any benefit, and therefore we had to do something. Every province in Canada has recognized that, every country in the Americas has recognized that. We need to change our healthcare systems.



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