Tag: healthcare

My Rant for Today: Immigration Overload?

January 13, 2024

Driving to have coffee with my friend at Timmies, I listened to the daily talk show with a panel on immigration. One said the Canadian public is sympathetic to (and has an enviable record), welcoming immigrants. Based on that attitude and arguing that the economy needs immigrants for its continued growth, the government doubled immigration targets to the 500,000 range. In addition, another million people arrive in Canada annually as foreign students and temporary workers, many of these becoming permanent residents over time.

The combination of immigration and temporary workers and foreign students have coalesced into a momentous problem in Canada, resulting in an acute shortage of housing and a precipitous decline in healthcare (lack of nurses, doctors, unacceptable emergency department waiting times). Without question, the huge number of recent immigrants, foreign students and temporary workers are a major contributing factor to these problems. 

Up until a few years ago, with half the number of arrivals into Canada compared to the recent year, assimilation into Canadian society had occurred seamlessly without impacting housing and healthcare. Services provided paralleled demand. (In fact, it has just been revealed that the Canadian cabinet minister responsible for immigration was warned two years ago that we were facing a housing crunch, even before immigration levels were increased this past year!  This warning was ignored for political purposes!)

Now, Canadians are becoming aware of what the massively increased number of newcomers has wrought, and anecdotal evidence points to a shrinking welcome mat.

One panelist on the talk show said that we need immigrants for our economy to grow. OK. How many do we need? I’m not too fond of loose talk. Provide some metrics. Arguments with no evidence to back them up are useless. The bottom line is: how many immigrants, foreign students and temporary workers do we need for the economy?

People with skills required in Canada would be a great addition to the economy, but how many immigrants are skilled in occupations we need?  We are told that we need them for house construction; however, we are also told that only about 5% of immigrants work in the housing industry….

I’d like to know how many of the half million immigrants we allow to enter Canada qualify for the needed skilled categories. Equally importantly, how many of these needed people would be allowed to practice their trade in Canada without certification (medical licensing, trade licensing)? And how long would it take to get their licenses to be productive in Canada?

Without data to back up the justifications for even more immigrants, we, the Canadian public, are left with only anecdotal information and our own experiences of worsening health care access, inability to find family doctors, long wait times for emergency care and rapidly increasing housing and rents which all will translate into reversing Canadians’ goodwill towards immigration.

A Taste of Canada: Getting Tick-ed

August 29, 2023

I contracted Lyme disease and take anti-biotics to get rid of it, doxycycline tablets for twenty-eight day. Not sure when a tick, those nasty tiny little bugs, gorged on my blood but suspect that when I cycled on a rail-to-trail over a month ago and stopped in the tall grass to relieve myself, a tick may have found me. That night my foot began to hurt, swelled up and was hot to touch, and the next day I could not put any weight on it.

The pain went away in a few days when I decided to see a nurse practitioner to find out what it could have been. She examined the foot but came up with no conclusions, so I ignored it. In retrospect, that was a mistake.

A month later, I had the worst shakes of my life, my teeth were chattering. The following days I had become extremely tired, moved like molasses, and lost my appetite to such an extent that I lost six pounds in a few days, symptoms of Lyme disease. On the positive side, if you can call it positive, I had no headache and fever. And then a rash appeared on my belly, another symptom of Lyme disease, that I was not aware of that time.

The symptoms convinced me to go back to my clinic and this time I saw another nurse practitioner who gave me a thorough examination and sent me for blood tests, including Lyme disease. But impatient to wait for the test results which would take numerous days in the labs, I admitted myself to emergency at the local hospital knowing that it could be a long wait, hours, to see an emergency doctor. But I would have the results immediately at the hospital emergency department.

Enterng the emergency room, a large sign welcomed me announcing that the waiting time to see a doctor is five hours, measuring at least four feet by four feet,. OK. Then I looked around and absorbed the cacophony generated by dozens of people in the room when a middle-aged and heavy person in a tennis outfit rolled around a wheelchair with, I think, his wife in it, who moaned loudly about the pain that she could not bear any more and wished to be dead. The scene reminded me of a lunatic asylum. Across from where I sat was a youngish fellow with a neck brace. Some people stood and shifted their feet back and forth; there were not enough chairs. The loudspeaker called my name and nurses triaged me asking about the reason for my presence here. I explained that I thought I had Lyme desease. The nurses took copious notes while measuring my blood pressure and pulse rate. And then I returned to the waiting room.

I observed the people around me and was struck by the diversity, i.e., including all shades of brown to black. Is this the composition of Ottawa today? Or are these the people who have no family doctors and forced to attend the hospital emergency room for health care? But then the loudspeaker called my name again for registration; I had to provide my address and other information, information that the hospital already possessed. During this time a little girl, perhaps three years old, held by her father, was crying constantly, adding to the loud buzz in the emergency room. This whole experience was emotionally taxing on me and imagined that there were people here who have had much more serious problems than I had. But Lyme disease can be very serious in the long run if not treated.

But after five hours, as announced on the large bulletin board entering the emergency room, my name was called again, and I entered a large room with a dozen or so examining rooms around a central area where the emergency doctors and nurses worked and consulted with each other. A nurse directed me to a small waiting room that I shared with a young teenager. He moaned about how hungry he was, having been here for eight hours with no food. I asked him if he would be picked up by his parents, when finished. Or were his parents waiting in the outer room and could get him some food at the food outlet next door? No, he said, his parents were not there, he will take the bus home after his stay at the emergency room experience. That surprised me and felt sorry for him.

It was close to midnight when an examining room had become available, and I was invited to enter it. I did not have to wait long, an emergency doctor came to see me and in ten minutes, prescribed an antibiotic for the blood test that showed a high count of white blood cells and another drug for the rash. And that was it; he said he did not know about Lyme disease.

Leaving after midnight after a seven hour stay tired me out. And I found it emotionally taxing observing all the people in the emergency room suffering from some ailment. But the simple recommendations of the emergency doc soothed me somewhat even though he did not confirm I had Lyme disease or even identify my illness. 

The bombshell came the next week when the the blood test the nurse practitioner ordered showed I had Lyme disease. I had been tick-ed. And I received the typical treatment: twenty-eight days of taking doxycycline.

I learned a few lessons from this experience. A conscientious nurse practitioner may provide excellent service. An emergency doctor treats obvious symptoms and may not search for root causes. And although I find emergency rooms interesting, I prefer to avoid them in the future.  When I go for a walk in the country now, I wear long pants and long-sleeve shirts and tuck my pant legs into my socks to make sure no nasty ticks can access my body for a blood-sucking treat.

The Good Life in Canada in Peril

April 9, 2023

I walked into the garage and stumbled in the dark towards the garage door handle to release it from the cable so that I could push up the garage door by hand; the power was out. We had an ice storm yesterday and the local hydro was still fixing the lines. It was getting cold in the house when we woke up in the morning without power.

When I pushed the garage door up, I saw our neighbor walking towards me up the driveway with a cup of coffee in his hand. And I heard a loud generator working in his driveway, explaining his coffee. He came to offer coffee or whatever we needed. That was nice of him. I told him we were just going to find an open restaurant to warm up and enjoy our coffee and breakfast.

Over our meal, I wondered what a nice lifestyle our neighbor has living in a five-bedroom house with one child. And he works at home allowing him to take a bicycle ride for a break and do chores around the house during working hours.

Canada offers a charmed life for many people, educated here and with a job. I socialize with them and enjoy their company most of the time. They are relaxed and enjoy the good life, although some are smug.

And their smug attitude in believing they deserve what they have bothers me. They truly believe that they worked and earned their status in life. And their good life makes this generation comfortable, less ambitious, and more complacent. Less achieving. I think that this is sad. This attitude, in my view, has pervaded the way Canadians and government look at issues.

I thought of the immigrants coming into this country and fully understand why they want to come here when they see what some people here have. But the immigrants have challenges. They do not speak the language fluently, if at all; they are not familiar with local culture; they have no local experience. And no local contacts.

And now the country allows half a million immigrants a year into the country for the next few years; bumping up the population when a recession threatens, there is a housing shortage and affordability gap, on top of a healthcare crisis. All these issues affect immigrants.

Although we identify these issues with some recalcitrance,we resolve them slowly, if at all. Often, we ignore them, thinking it doesn’t affect us, so no need to do any planning.

Potholes on the streets? No problem, it is the weather. This view is nonsense. The northern states in the US have similar climates with excellent roads.

Healthcare crisis? No problem, we’ll let in more foreign nurses and doctors, ignoring the fact that they have to be locally licensed, a time-consuming exercise that can take years.

Housing crisis? No problem, we’ll let in more construction and tradespeople, forgetting that they also need local licensing, and we also need land to build on.

No land to build on? No problem, we’ll just make our cities denser. We’ll let three units be built on single-family lots in Ontario, starting this summer, which will destroy some older, attractive neighborhoods.

Food price inflation? No problem, the government provides a subsidy; prints money, and just increases the national debt. Debt is for future generations to resolve.

It may be only me but methinks we do not solve problems but delay them, thereby creating fresh problems.

I think the country has become too complacent and downright lazy. We havelost our edge, our dynamism. We sloganeer about equity, diversity and inclusion, and LGBTQ…., matters, and forget that these ideals are impossible to materialize without creating jobs and opportunities and investing in technology and the future. You cannot have equity, diversity, and inclusion in the abstract, it exists in organizations employing people.

So, let’s get back our work ethic and get off our collective fat butts and build the economy by providing the opportunity for future generations.

The Nuclear Stress Test of the Heart

December 18, 2022

I drove over to the east end of Ottawa to the Cardiovascular Center in a strip mall. It was a bad move on my part to hit the road in rush hour, especially with all the construction going on. It was difficult sometimes to find the lanes toward my destination with all the traffic cones, although this was my second trip there. The first time they injected some dye into the blood flow to track the circulation. This time, they would track the circulation after stressing my heart out.

The Cardiovascular Center is in one of the most inauspicious strip malls. And within the mall, the center is between an optician and a pharmacy. The other small stores in the mall range from dog obedience school and physiotherapy to a Middle Eastern restaurant with Arabic writing on the storefront.

Driving to the Cardiovascular Center made me relax; I usually get nervous going to medical buildings. This place in the middle of a nondescript shopping mall is certainly not like going to a hospital and seeing uniformed nurses and doctors rushing around the hallways with official tags around their necks.

I checked in with the receptionist sitting behind a plastic window and sat down in the waiting room on a seat away from the sun that was shining through the floor-to-ceiling windows, making the room feel like a hot greenhouse.

The people in the room were all older, like me, some required canes for walking. One couple was talking loudly, otherwise, the room was quiet and I read my cell phone to pass the time.

It did not take long for a nurse to call me into a room furnished with a hospital bed, monitoring equipment, and a treadmill. Aha, I thought I will use the latter for the stress test.

Then the nurse asked me to take off my clothes from the waist up and lie down on the hospital bed. She put a blood pressure monitor on my arm while talking to me, then put electrodes on my chest. The last connection was an IV needle.

Finding a good vein to insert an IV is always a challenge for nurses. Although I drank a lot of water that morning to help show veins, and she said that she saw the veins, she could not find one large enough for the needle around my elbow. After poking me twice by my elbow, she put a smaller IV needle into the top of my hand.

In the meantime, we had a great chat about Ottawa that relaxed me and brought down my blood pressure, which is always high when I visit a medical facility, even if it is in a strip mall.

She started my IV drip with saline solution to help the veins; she explained it is used to deliver medications. After the saline solution, some nuclear material dripped into my veins to stimulate the heart. All this time she kept asking whether I felt nauseous, had a headache, was dizzy, or was just lousy. I did not have any of those symptoms but was getting anxious, as I started imagining that perhaps I should have those symptoms if the test were working. But she repeated the same questions in a few minutes, and I assured her again that I was fine and told her if she did not badger me, I could fall asleep on the comfortable bed. The lack of any sickness on my part was a good sign, she said, and that made me feel good.

The nurse also explained that if I felt sick because of the nuclear material, she would give me an “antidote” via the IV. Since I was not feeling bad, I am not sure if she gave me any antidote.

The bottom of my arm, which had the IV in it, was getting painful with pressure building up in it, and told her so. She explained that it is the rush of the liquids coming from the IV needle and because the veins are small in the lower arm, the flow of the liquid puts pressure on the walls of the veins.

The only other impact beyond the pressure in my arm was my pulse rate exploding from its normally low rate in the fifties. Perhaps it was the anxiety of doing the test. While the IV drip was going on, the nurse was in front of a monitor watching my performance.

After a while, she said that it is time to inject some dye into my veins for the “gamma” camera to track the movement of blood in my veins, especially around my heart. I said that was fine with me; she could have put any liquid, even alcohol, into my IV.

When we finished with all the cocktails entering my veins, she told me to go outside into a small waiting room and eat the snacks that they had directed me to bring. But I asked her, “When are we going to do the stressing”? and pointed to the treadmill. She replied that the stressing was already done and explained that the nuclear material injected into me made the heart race and mimic the action of the heart when one is exercising. Ah! So that was it. I did not feel like I exercised at all – I did not sweat – and felt gypped not having the chance to jog on the treadmill for a little exercise, but glad the first phase of the testing was over.

So, I went into a small waiting room and snacked. I was hungry by this time; as I had been told to fast for four hours before the test.

After a half hour in the waiting room, they took me into another room with a dentist-type chair. On the left side of the chair, there was the gamma camera, a huge L-shaped machine that covered my chest, and the left side. She moved the camera over my chest and told me to sit on the left side of the chair so that the other side of the L was next to my left side, where the heart is. The camera buzzed for four minutes and then after a break, we did it over again, for four minutes. Then I was done.

I felt quite relaxed coming out of the Cardiovascular Center. It was not only because the staff were pleasant but also because of the venue. We were in a strip mall, and I thought this visit was more like going for coffee at Starbucks than getting a medical exam. Maybe we should have all medical clinics in shopping centers instead of medical buildings. Now I just must wait for the results, which may come in a few weeks.

The Minister of Immigration’s Foggy Response to my Questions on Inreased Immigration to Canada

December 2, 2022

I wrote to the Minister asking if he considered the impact of his bumped-up immigration targets on the Canadian housing market (where there is a severe shortage) and on Canadian healthcare (which is bursting at the seams).

Although it is desirable to have more immigrants to grow our economy, can we provide housing and healthcare to them when Canadians are experiencing a housing shortage, and millions are without a family doctor?

I received an automatic acknowledgment, promising a response in six weeks if my questions are worthy of a response:

“Thank you for your email addressed to the Honourable Sean Fraser, Minister of Immigration, Refugees, and Citizenship. Please note that all comments and questions are taken seriously, and although Immigration, Refugees and Citizenship Canada (IRCC) cannot provide a personalized response to every message, we will review and consider all comments received.”

“…the service standard for a response to correspondence addressed to the Minister is six weeks if it is determined that a reply is warranted. “

A couple of weeks later, I received a form-letter providing officious government bumph but no response to my questions.

“The Government of Canada is committed to an immigration system that contributes to economic growth, supports diversity, and helps build vibrant, dynamic and inclusive communities. The 2023-2025 Immigration Levels Plan, tabled in Parliament on November 1, 2022, projects continued growth in permanent resident admissions with targets of 465,000 in 2023; 485,000 in 2024; and 500,000 in 2025.”

“The Levels Plan sets out a path for responsible increases in immigration targets to support economic growth and address labour market shortages. Over half of all planned admissions are dedicated to the economic class.”

“In 2022, Canada is on track to welcome 431,645 new permanent residents, and the 2023-2025 Levels Plan builds on this momentum. Increasing immigration will help cement Canada’s place among the world’s top destinations for talent, while reuniting family members with their loved ones and fulfilling Canada’s humanitarian commitments, including on Afghanistan resettlement”.

“For further information, I invite you to read the 2022 Annual Report to Parliament on Immigration.”

Ok. There is no mention of the availability of housing for immigrants, or the ability of our current healthcare system to provide healthcare to immigrants.

But wait, I thought there may be more information in the 2202 Annual Report to Parliament on Immigration. So I read the entire report and found the only remotely relevant text under “settlement and integration services”:

“IRCC supports the successful integration of immigrants to Canada through a suite of settlement and integration services. In 2021–22, IRCC funded more than 550 service provider organizations and provided settlement services to more than 428,000 clients. Services include pre-arrival and post-arrival orientation and information services, needs and assets assessment and referrals, language training, employment-related services including mentorship and apprenticeship programming, and services that help newcomers connect and contribute to their communities.” 

Again, nothing on housing and healthcare for immigrants.

Canada’s population of 38 million occupies 16 million housing units, with an average occupancy of 2.3 people per household. Applying this number to the 500,000 immigrants to be welcomed annually in a few years, we would need over 200,000 housing units annually, just for immigrants. But that is the number of units that Canada builds in a typical year. Even if we assume immigrant families double up, the housing shortage would get worse, resulting in even more unaffordable housing prices than we have today. Has the Minister not thought about the availability of housing for immigrants at affordable prices?

What about healthcare? Canada has 2.7 physicians per 1,000 population (in 2021) compared to the Organization for Economic Co-operation and Development (OECD) average of 3.5 (2017 or the nearest year). We do not compare well to OECD countries relative to the number of doctors per 1,000 population.

Applying the ratio of 2.7 physicians per 1,000 population, the half a million immigrants the Minister wants to bring to Canada each year would require 1,350 additional physicians. Would Canadian healthcare deteriorate further due to increased immigration? Would the 2.7 ratio be reduced?

Half a million immigrants annually would require thousands of housing units and doctors if they wanted to live the life that Canadians are used to. The Minister has not responded to my questions on how he would house the immigrants given the already shortage of, and high price of, housing in Canada. And he has not responded how our already overburdened healthcare system would grapple with an annual inflow of half a million of immigrants. Were these subjects an oversight by the Minister? Are we muddling ahead without an analysis of the consequences of our actions?