It seems that everyone is concerned with what some call an impending Health Care Crisis in Canada these days. Hardly a newscast goes by without someone demanding that more money be spent on one area or another of the issue. The Federal Government announces an increase in equalization payments to the Maritime Provinces over the next few years, with the stipulation that this money be spent on health care. The total amount is huge, it would seem to most of us, but the provincial governments react by proclaiming that. although welcome, it is not nearly enough to address all of the demands that will be put on the system over that same period.

As I recall, when I started teaching back in 1968, health care in New Brunswick consumed around 21% of the total budget. It wasn't even the largest user; education took care of some 24%. In the years since then, health care costs have soared. Today, they consume more than 50% of the total budget, but the cries for more funding continue, from all corners, it would seem. It is almost as though Canadians have redefined this as the principal role of government at both the federal and the provincial level. Spending on social, education, environmental, and military programs has been curtailed as a consequence, and one is hard pressed to foresee any significant reversal of the pattern.

Where does it end? Can we continue to afford the kinds of expenditures into health care that have caused this huge drift toward financing it at the expense of everything else? I am getting on toward that time in my own life where I can foresee that the long run of low maintenance good health that I have enjoyed may be coming to an end. I find it easy to join in the chorus for more affordable senior citizen housing and care, for greater subsidies on pharmaceuticals, and for so many other things that may make my declining years a little more comfortable. Yet, there is this nagging question in the back of my mind that asks where all of the money is going to come from, and from whom else am I going to be taking it.

I don't have any easy solutions to what is looming as a critically important issue over the next few years. I do think, though, that we - all of us - have got to begin to ask some new questions. Where the money is going to come from after we have reached the point where there is no more to fight over is going to make the issue rather academic. Instead, we have to look at what is going to be available - realistically, dispassionately, and honestly - and begin to discuss how this money can be spent so as to benefit those who truly need it. It will not be an easy discussion, because it is going to force many of us to come to grips with a frightening reality - that of our own mortality - but, at some point, someone is going to have to make some fundamental decisions about who gets what. The longer we wait before we accept the inevitability that sooner or later the cash will run out, the harsher the decisions will be. In any case, the dialogue will not be easy. Unfortunately, it will be inevitable. Our choice is to begin now while we have some time to make compassionate,. humane decisions, or to wait until brutal facts demand brutal solutions.