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Reforms such as Ontario’s increased use of private clinics are long overdue
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Canadian health care is in crisis. The patient isn’t just sick; she is on life support, barely hanging on. Staffing shortages and treatment delays produced by the pandemic have proved the final straw, overwhelming a system in decline for decades. Starved of money, innovation and competition, it has effectively collapsed, and the results are nothing short of disastrous.
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Patients are dying in emergency rooms. It was reported last week that a Nova Scotia mother of three, Allison Holthoff, waited seven hours in ER before giving up and dying at home. A day before, another Nova Scotia woman had died after a similar ordeal. Overall, deaths in Nova Scotia emergency rooms were up 10 per cent in 2022: 558 people died last year, up from 505 in 2021.
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Patients are dying on wait lists for surgery. An analysis of Ontario Health records published by SecondStreet.org in August 2022 found that 1,417 Ontarians died waiting for some kind of surgery in 2021-22, a 43.7 per cent increase over pre-pandemic numbers and a 34.6 per cent increase over the average of the four pre-pandemic years.
Patients are dying waiting to see a specialist. As of September 2022, one million patients in British Columbia were on specialist wait lists, for everything from physiotherapy to cancer biopsies. Waits for some services were four times longer than at the start of the pandemic. Dozens of doctors sent a letter to the provincial health minister, saying, “it is soul-destroying to be unable to provide the specialty care that B.C. patients need and deserve.”
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This situation is completely unacceptable, particularly in a country that was forecast to spend $331 billion, or $8,563 per Canadian, on health care in 2022, according to the Canadian Institute for Health Information. As of 2020, Canada’s spending was $7,507 per capita, the fourth highest in the OECD, and well above the OECD average of $5,502. Yet we’re not getting value for money: Canada scores below average on patient safety, below average in many areas of access to care, and barely above average in quality of care, compared with its peers.
We’re not getting value for money
What are our politicians saying and doing about this? In response to Holthoff’s death, Federal Health Minister Jean-Yves Duclos’ office said that “no one should go through” what she and her family endured. In response to the specialists’ letter, the health ministry of B.C. said “we will always meet with doctors when they have concerns or suggestions on how to improve services.” And this week, Prime Minister Justin Trudeau pledged more federal dollars to provincial governments that have been clamouring for additional funding for years. “There’s a need for more money,” Trudeau said, stating the obvious. “There is a need for more to deliver results for families.”
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But there is also a need for reform. In Ontario, Premier Doug Ford has announced a series of changes to health-care delivery, including allowing pharmacists to renew prescriptions and prescribe medication for certain conditions, and having private clinics perform more cataract surgeries, MRIs and hip and knee replacements, paid for by the province. In Alberta, Premier Danielle Smith is looking at creating health spending accounts — not as a replacement for public health care, for which she had been previously criticized — but as an “add-on” to inject more money into the system. And during the past Quebec election campaign in September 2022, Premier François Legault promised to increase the number of private clinics and build a private “mini hospital”, built by the private sector but with services paid for by the state, in his province.
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These policies aren’t just common sense, they’re long overdue. They are also in step with public opinion. Polling done by Ipsos in 2022 for the Montreal Economic Institute found that 58 per cent of Canadians believe the government should allow increased access to private health care as long as it is paid for by government. Research done by the public affairs firm Navigator (where I am a principal) found that 62 per cent of Quebec residents want to increase private services to reduce pressure on the public system, and that 72 per cent of Canadian boomers say they support more private sector involvement if it means that every Canadian can access the care they need.
When it comes to health care, there is both need and appetite for change. People should not die for ideology. Governments need the freedom and the funds to bring all partners to the table, and make sure that Canadians get the health care we deserve.
Postmedia News
Tasha Kheiriddin is national politics columnist for Postmedia, a principal at Navigator Ltd. and author of The Right Path.