September 6, 2022
Canadians pride themselves on having the best healthcare system in the world. Politicians tell Canadians they have the best system. And people believe it is good because it is publicly funded and is universal. Yet, studies consistently show that the Canadian system ranks often at the bottom in terms of access, etc. among OECD countries.
Private healthcare is anathema to the Canadian public; they have been led to believe it would draw doctors away from the public system and create double-tier healthcare benefiting the privileged classes, which includes politicians, people of influence, and physicians). who can pay.
Yet, eye care, dental care, physio treatments, and other healthcare services have always been provided outside the government’s healthcare system.
The government pays doctors’ fees for their services. Doctors are small business owners, but their practice is controlled by the government paying agreed-upon fees for patient visits, procedures, and other consultations. The fees are negotiated between the doctors’ association and the government periodically, just like union/employer negotiations.
Not everybody has a family doctor. Due to the shortage of doctors, people are encouraged to use emergency rooms in such situations. That is one reason why ER rooms have become crowded, but what other options do people have if they do not have a family doctor? Compounding this problem is the fact that family doctor clinics more and more choose not to provide holiday and weekend coverage – sending people to the ER as well.
Now Ontario faces the terrible challenge of crowded ER rooms where people die awaiting service.
In a recent article on Canada’s worsening health care crisis, the National Post’s Sharon Kirkey quoted medical insiders who said that emergency rooms are now so backlogged that Canadians risk seeing rising numbers of patients killed or permanently disabled by otherwise preventable conditions.
“I never thought I would say that. But those of us working in emergency medicine have seen people with serious problems … not be able to access the actual department,” said Saint John emergency doctor Paul Atkinson.
Reading this article, an American friend commented (and most Americans think Canada has a great healthcare system):
“Sounds as if the ER situation is seriously dire! Never imagined ERs would ever temporarily close or that triage would fail so miserably. Why aren’t student nurses or even orderlies pressed into service in waiting areas checking at frequent intervals on people as they wait to be seen by doctors, by doing even basic things like talking to people to see if they are still breathing, worsening, or still stable?? Very stressful time for patients, family, and staff. Burnout and attrition among stressed medical staff bound to worsen, just as it has among teachers, school bus drivers, police, etc.—no easy solutions, but the policy makers better try to find more sustainable procedures asap before the systems crash entirely.”
My wife, who has spent many years volunteering in the healthcare field responded to her:
“I know a few years ago at the hospital I am familiar with we wanted to use volunteers in one of the cancer clinics to simply review routine things with patients to prepare them before coming in for some treatments…something we had been doing for several years until the unions decided that should be union jobs, so we had to stop using very capable volunteers. Volunteers have subsequently been limited to, for the most part, helping patients and visitors with wayfinding. When a patient is discharged the family often must find the wheelchair and help the patient into it… nurses are not permitted to do that job or wheel patients to their cars and orderlies are not available.”
“Until a few years ago the hospital could perform MRIs for only 7 hours a day because the province only provided funding for the technicians for that number of hours, despite long waiting lists. Of course, the province had no problem opening the MRI area for members of the hockey team because they were “special” and were allowed to negotiate a contract…but only they could use it. Despite very long lineups for all diagnostics, there is no charge to the patient if they do not show up..often leaving holes in the schedule for a valuable resource. The system is in utter shambles.”
“My family doctor recently sent us a note that the clinic will no longer be doing anything by telephone…all requests, even routine prescription renewals, requisition for massage therapy, physical therapy..both of which you need to activate your insurance, Routine monitoring that they used to do by phone will require an in-person visit. We are no longer able to send an email with a question. Never used it too much, thank goodness, but apparently during COVID the province created a fee schedule that allowed the doctor to get the same fee for telephone and zoom consultations as for an office visit but recently apparently lowered this fee, prompting our clinic’s response. Also, most, if not all, physician’s office and clinics in Ottawa do not have 24/7 coverage. Some have Saturday morning coverage via their urgent care status, but you must have an appointment…if they are booked you are directed to the emergency dept of the hospital. Our family health clinic, which has 16 doctors, is in this category; with 16 doctors, they do not see it as their responsibility to do after-hours or weekend coverage…referring you to the emergency dept. It is ridiculous and such a waste of resources….and, of course, is a factor in overwhelming the emergency department, and burnout of triage nurses. Just a total mess, last weekend a local Hospital closed its emergency department, as did one of the hospitals in the Ottawa Valley. Hospitals are divided east and west and have worked out some rotation system for closure, I think, because of lack of doctors…”
No question the delivery of healthcare is complex. But many services could be improved right now. Why do we not do it? For example, highly expensive MRI machines sit idly in some hospitals because of a lack of money to pay for staff for twenty-four-hour, seven-day service. And with no financial penalty for people who have an appointment for an MRI, but fail to show, while others are waiting months. So, we have the equipment and high demand for MRIs, and we let the machines sit idle. Let’s solve this problem immediately!
As well, we should take a close look at the “myth” of private healthcare as undesirable. We should study countries with private/public healthcare systems and develop one suited to Canadians. We would be joining most of the rest of the western world if we did this, including Europe. And yes, we should train more doctors to alleviate the shortage (or perhaps also look at better/easier ways to accredit the large number of foreign-trained doctors who are allowed to immigrate to Canada because of their medical education but wait years to be able to practice.
andrasthehun.ca 