- Hardcover: 304 pages
- Publisher: Allen Lane; 1 edition (Jan. 10 2017)
- Language: English
- ISBN-10: 0735232598
- ISBN-13: 978-0735232594
- Product Dimensions: 15.8 x 2.8 x 23.5 cm
- Shipping Weight: 481 g
- Average Customer Review: 18 customer reviews
- Amazon Bestsellers Rank: #21,114 in Books (See Top 100 in Books)
Better Now: Six Big Ideas to Improve Health Care for All Canadians Hardcover – Jan 10 2017
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A Toronto Star Canadian Non-Fiction Bestseller
A Toronto Star Original Non-Fiction Bestseller
A Globe and Mail Canadian Non-Fiction Bestseller
A Globe and Mail Hardcover Non-Fiction Bestseller
Longlisted for British Columbia's National Award for Canadian Non-Fiction 2018
“It's a prescription to improve health care across Canada” —Healthscape
“Dr. Martin offers a timely and insightful perspective on Canada’s commitment to providing health care as a right to all people. The U.S. health care system has a great deal to learn from Canada and from Better Now.” —U.S. Senator Bernie Sanders
“Universal healthcare is at the very heart of a caring and equitable Canada. Danielle Martin provides us with a practical, accessible and deeply inspiring roadmap for how we can live up to that sacred promise. —Naomi Klein, author of This Changes Everything
"Dr. Danielle Martin has written an outstandingly useful book, for all Canadians, as the nation once again faces the challenges of ensuring effective health care for all. In doing so, Dr. Martin avoids the easy formulae of blanket solutions and properly roots health care’s future success in making hard choices on delivery, scope, and structure, based on Canadian values." —Roy Romanow, former Royal Commissioner on the Future of Health Care in Canada and Senior Fellow, Political Studies, University of Saskatchewan
"A clear-eyed, fearless and detailed manifesto, written with empathy and analytical rigor. For doctors, patients and all Canadians, Better Now is an inspiring prescription for the right balance in our shared health care framework." —Hon. Hugh Segal, Master of Massey College, University of Toronto and former director of the Institute for Public Policy
About the Author
DR. DANIELLE MARTIN, MD, CCFP, FCFP, MPP, is a family physician in Toronto and Vice President of Medical Affairs and Health System Solutions at Women's College Hospital. She teaches family medicine and health care policy at the University of Toronto and is a leader in the debate about the future of health care in Canada. In her first year of practice, she helped launch Canadian Doctors for Medicare to promote a high quality, equitable, and sustainable health system. She was named Canada's 8th most powerful doctor by The Medical Post in 2015 and is a regular contributor to CBC-TV's The National. She writes a monthly column for Chatelaine.
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The early chapters provide a solid foundation for understanding how Medicare works today, and if there was ever a law that you need to know what you're talking about before arguing about something, should be required reading by every Canadian. Coupled with a pre-emptive strike against the recurring simplistic "quick fix" ideas, they set the stage for the necessary but unlikely "adult discussion" we should be having but aren't.
The first five big ideas — relationship-centred primary care, national pharmacare, strong evidence-based treatment practices, better organization of resources, and guaranteed basic income — are presented in an accessible manner, tied to patient stories, with solid explanations of how they would improve the health system. Given the audience and limited space, the tone is necessarily inspirational rather than prescriptive.
The last big idea focuses on what is needed to change the system, to actually have these or any of the other ideas that have been suggested over the years actually happen in Canada. It is again high-level and general, not so much an actual blueprint for a way forward, but an explanation for the public about the extremely difficult obstacles that are encountered when there is any attempt made to change healthcare in Canada.
So much more could be said here, and I'm sure earlier drafts contained a lot more about feckless administrators and bureaucrats, promoted beyond their skill level and doing everything they can to not be noticed, to particular groups of physicians and allied health professionals who have been screwed over so many times they've given up caring about the system as a whole and just want to hold onto what they have got, to the morale problems, the perverse non-accountability exercises. Yes, perhaps just a taste of these is best.
This book provides a path for the public to go beyond the sound-bites that are all most Canadians see from Dr. Martin and others. From that point of view, the book accomplishes this. Her point of view, which touches on clinical and administrative, far enough along in her career to have had some worthwhile and credible experiences and yet early enough so as not yet to be completely jaded, comes across well in the optimistic but not idealistic tone.
At times, the limitations of her perspective do shine through. Though there are a few token examples drawn from other provinces, her perspective is solidly Ontario-based. As an obviously gifted and emotive family physician, who's undoubtedly encountered a range of poor-to-excellent specialists, a reliance on primary care looks ideal. As a counter-point, my wife is a specialist (psychiatry), who's encountered her share of poor-to-excellent family docs, and the thought of relying on many of them to be the center of anyone's care is a disaster waiting to happen. Similar other thoughts crossed my mind given she's practiced in more provinces (Ontario, Alberta and BC) and different settings (non-profit and for-profit hospitals, both community and tertiary, community clinics, and private practice). There's a lot of variability out there, which is of course what makes the whole change process so challenging.
She wryly quotes one health policy consultant who says "there have been lots of sensible books with self-declared big ideas about how to fix the system, and none of them has any influence." Despite the significant writing on the difficulty of health care change, if this book were meant as a standalone, I think the quote would still apply. But when seen as a backgrounder, only a part of a broader campaign of awareness and advocacy, and a means to engage the public in a positive, national conversation by Dr. Martin and many other health professionals in Canada, I think this book works. There's so much inertia preventing change, so those who hope to make progress will need all the help they can get.
repetitive even in the local hospital network. Her case studies are very informative. I intend
to read this book a second time.
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