Do Not Get Sick In Canada – OpEd

Most perplexing is the positive image that some foreigners have about the Canadian health system. That is until you get sick here and require medical support and advice.

The positive image is soon dispelled thanks to excessive wait times in clinics, closed emergency wards, unresponsive queries and overcrowded hospitals ad mare usque ad mare.

Often ‘progressive-thinking’ foreigners enjoy raising the concept of universality of the Canadian healthcare system paid for by taxpayers and offered free of charge. This point is taken up by the Romanow report (the name of a former Governor General of Canada) which observed that, “Canadians embrace medicare as a public good, a national symbol and a defining aspect of their citizenship.” 

One of the many illusions about healthcare in Canada is indeed that we have a ‘universal’ healthcare. The concept of a universal health care system was introduced in the Canadian prairie province of Saskatchewan on July 1, 1962 by a socialist politician and preacher named Tommy Douglas. Since then, political parties, medical lobbies and acolytes of free enterprise to make money have gradually displaced proponents of a universal free of charge system open to everyone who requires medical attention.

The obvious drawback to such a system is its cost. Over time, governments shell out more and more of their budget to cover expenses incurred by the medical system. Health costs have skyrocketed since the 1960s prompting some to question the viability of the principal of free medical care. According to the Canadian Medical Association (CMA), between 30-40% of provincial (state) budgets go to health costs while the government of Canada and its provinces spend a total of more than 300 billion per year.

Universality can be cost-effective when one considers the economic cost of privatized health care. The working poor become poorer under a privatized system while absentee rates at work skyrocket. Add to that sick children who require a parental presence and suddenly a universal system makes sense. Free daycare is an excellent example of how to mitigate the cost to workers and their families. This includes the newer virtual jobs made essential by the COVID 19 pandemic. Universality of care has economic benefits both immediate and longer term.

The jurisdictional question is pertinent since it has sparked ongoing controversies about who gets the tax money to pay for health costs. Unfortunately, it has become a political football making the ill even sicker. Federal-provincial wrangling over who pays what and how much relates directly to the lack of clarity of the British North America Act (BNA) that created Canada in 1867. On the federal government side, funds are linked to federal priorities and withheld from provinces who refuse to spend the money according to the priorities of the governing party.

Poor provinces bend first and accept the funds given that the need is so great. In the provinces, blame is directed at Ottawa for the lack of or insufficient monetary transfers. Meanwhile patients suffer from an inefficient management of funds and human resources. The blame game continues as patients are held ransom to federal-provincial quarrels. The patients’ welfare is of secondary concern. Patients are sacrificed at the altar of politics and the need for political parties to find convenient bouc-emissaires to explain their own actions, or lack thereof, on the health file.

Medical personnel are not to blame for this political lethargy. Having broken my back in May 2023, I was able to observe up close the work of medical personnel in the emergency ward of a Montréal-area hospital. I was overwhelmed by the courage and diligence of the personnel – nurses, doctors, janitors, social workers. All were devoted to their patients.

This observation also leads me to conclude that the problem with Canada’s broken health system is political in nature. Political parties, especially the two traditional ones (Conservatives and Liberals) have used health as a Trojan horse to get themselves re-elected using muckraking and blame-game techniques. It is suggested that the current anarchy in Canadian health care is the fault of previous governments, or it is the fault of doctors or nurses who refuse to work long hours.

The CMA underlines that ‘Bold choices will be needed to solve the crisis in funding’. So far, neither the federal government or any provincial governments have demonstrated any boldness or innovation capable of having an impact on health care spending.

So, the jurisdictional and administrative mess continues unabated. The blame game, an indispensable element in political parties’ strategy here, also continues since health care is an intensely political issue with the government’s re-election in the balance. Political power asserts itself over the common good. Politics is more important than serving the public.

The public also has a responsibility in this regard. Showing up at the emergency ward of a hospital inebriated is ludicrous. It takes more than one or two professionals to deal with the individual and weekends at hospitals have become horror stories in which the local police are invariably involved. Medical personnel are not trained in police work and understandably reject having to deal with uninformed and belligerent arrivals. The public needs to be informed by politically neutral information about the necessity of prevention and not more self-serving political propaganda by the ruling party of the day.

In the Province of Québec, the situation is complicated since medical services have to be provided in both French and English. Québec’s Coalition Avenir Party (CAQ), despite it having a massive majority of deputies at the National Assembly, is yet to make any cogent effort at increasing efficiency and services for its citizens. Most of its efforts are directed at creating private clinics and other political initiatives.

Meanwhile the principle of universality wanes as taxpayers pay more for less medical care. Prevention, instead of being a priority, has become an afterthought. Mental health is sorely neglected and the ill are turned out of the hospital in droves. Other provinces are in a similar situation – no funds, no services to linguistic minorities, unhappy and overworked medical professionals and little thought given to training better, faster and more strategically.

Of course, the COVID pandemic only increased the strain on health care but it was already in crisis before the pandemic. COVID 19 simply accelerated the downfall and produced incredible distortions in the provision of essential services. Governments often seek to attribute the absence of services and or their privatization to the pandemic. Another blame game has begun. However, we now know the source of this ‘confusion’. It is Canadian politics. It is an insult to the public’s intelligence to ascribe so much of the mismanagement of health care to the COVID pandemic.

The only education of the public of interest to the political class is to define the limits of any pre-emptive criticism of their policies. This effort explains to citizens what not to do in clinics and public places. Other categorical imperatives such as ‘Do not raise your voices’ ensures that idle minds remain focused on obeying government desires and decrees rather than stimulating any free thought and analysis of the predicament we are in thanks to the malevolence of the political class. It is not education for prevention rather it is political propaganda for political purposes being passed off as something it is not.

Most of those who oppose universality of health care believe that private health care is more cost-effective and efficient. For example, many believe that the waiting times for operations could magically evaporate if everyone started paying for services. Isn’t that why we pay taxes? Many cannot afford to pay for expensive but necessary operations and medical acts. In effect, Canadians pay twice for this stunted version of health care, once at tax deadlines and once again at the clinic. Not focusing on public health care and directing funds to the private sector has weakened the public system to a point of no return. Much the same can be observed in rising educational costs in Québec where taxpayers sponsor both the public and private school systems.

What could reverse the trend, or at least render it less onerous and noxious on the public and assist the ill in addressing their health care concerns?

Reversing the trend will not be easy and requires bold political moves as the CMA suggests. Many, including those health care professionals working today, still believe in the universality of health care but they are not encouraged to provide their input. Governments have grown used to ignoring any advice or criticism from the people in this country.
The health care crisis in Canada is really a societal crisis, one in which political expediency trumps any human cost.