The Family Clinic in Marathon, Ont., on Nov. 11, 2022.David Jackson/The Globe and Mail
What can be said about Canada’s health care system that hasn’t been said countless times over, as we watch more and more people suffer and die as they wait for baseline standards of care?
Despite our delusions, we don’t have “world-class” health care, as our Prime Minister has said; we don’t even have universal health care. What we have is health care if you’re lucky, or well connected, or if you happen to have a heart attack on a day when your closest ER is merely overcapacity as usual, and not stuffed to the point of incapacitation.
The health care is “free,” sort of, depending on your needs – but you also won’t necessarily get primary, specialist, or even acute emergency care in a reasonable amount of time either.
Perhaps, to some, the price tag justifies waiting a median of 286 days in Prince Edward Island for a knee replacement, or being sent across the border for radiation treatment if you have cancer in B.C. You might have to endure unconscionable suffering, but hey, the price is right… right?
In our stupor, we accept this tradeoff because the alternative – admitting that we need to totally overhaul the way that health care is organized, funded and delivered in this country – is too scary to consider, and too fraught politically to propose.
But it’s even scarier that in January, a quadriplegic man was stuck on a stretcher in a Quebec emergency room for four days, and he developed a pressure sore so severe that it exposed muscle and bone. He chose medical assistance in dying (MAID) to alleviate his suffering.
It’s scarier that this month, an Ontario man who developed Guillain-Barré syndrome on vacation in Costa Rica was told he couldn’t be flown home, because there were no beds available there.
It’s scarier that a man who lost vision and the use of the right side of his body while driving in Tsawwassen, B.C., was left to wait an hour and a half by the highway for an ambulance. When he was eventually driven by his family to the hospital, he had to wait another seven hours to see a doctor. It wasn’t until the next day that he was told he’d had a stroke.
These stories were all reported just in the last couple of weeks, and there are plenty more that illustrate the dysfunction – and indeed, the cruelty – of a system that has completely fallen apart. Soon, everyone will have their own story about the inhumanity they endured while trying to access care, and maybe then there will be consensus on the need for an entirely new framework. But we really can’t wait. Our system is the envy of no one, and our fierce loyalty to the mirage of a functioning health care system is literally killing people.
No doubt some people will take umbrage with this assertion. They will cite their own experience of prompt care or diagnosis or the excellent treatment they’ve received for one or more chronic or emergent conditions. That’s wonderful for them.
But you don’t get to claim a purportedly universal system is working when more than one in five Canadians don’t have a family doctor, which renders Canada dead last among wealthy nations in terms of access to primary care. You can’t claim a system is working when we spend more per capita than our peers and receive less (so let’s drop the lazy refrain that our system is struggling because we don’t fund it enough). And you can’t claim a system is working when an infant having a bad allergic reaction has to wait 11 hours to be seen, or a teen has to wait 19 hours for an emergency appendectomy.
If your “universal” system is routinely subjecting vulnerable people to extreme forms of suffering, then the system itself is a failure. Indeed, it’s more than that: it’s a disgrace that is having deadly consequences.
For years, experts have proposed various ways to overhaul the system. Former health minister Jane Philpott just released a book proposing we treat primary care as we do education: as a legal right, where access is assigned by postal code. Susan Martinuk from the Frontier Centre for Public Policy suggests a hybrid private/public system modelled after those in other developed nations. Experts with the C.D. Howe Institute released a 13-point plan for health care reform last year. But instead, our government is announcing plans for free birth control pills and a new dental care scheme that dentists don’t seem to want to partake in.
We can’t even get the basics right, and we’re adding new programs on top. This is insane.
We need to wake up, and get real. The health care system Canadians tend to fiercely protect is little more than a concept. The reality is pressure sores down to the bone.