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SUN NEWS COLUMN: Canada can’t afford social distancing apathy

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Twenty-two doctors from Saskatchewan recently went to Edmonton for a curling event. Soon afterwards 11 of them were diagnosed with having the coronavirus.

Aside from pondering why doctors of all people would travel to a curling event during a pandemic, ask yourself this question – when was the last time you went with a large group of people to an event and heard a few days later that half the people from your group were sick from it?

ABC News reported the average person with the coronavirus spreads it to twice as many people as they would the common flu. The National Post recently reported on new research that suggests nine out of 10 infections in China were transmitted by people who didn’t show any symptoms.

To be clear, I’m not a doctor. But it doesn’t take a brain surgeon to see this virus is quite contagious. Our economy can’t sit on the sidelines for long, but in the short term, Canadians should listen to social distancing directives, especially around at-risk people.

In fact, our health care system is ill-prepared for a serious outbreak.

Reflect on what’s been happening in Italy. The small European country has over 86,000 cases and the death count regularly rises by hundreds each day. Although this virus originated in China, Italy now leads the world with over 9,000 deaths.

Their health care system is bursting at the seams. If the coronavirus hits Canada with the same intensity it would be a nightmare. Heading into such a scenario, our system is arguably less prepared than Italy’s was.
This past January there were media stories about hospitals in Ontario being so overcrowded that patients were being treated on stretchers in the hallways. Other provinces have struggled with this problem as well.

In British Columbia, the province’s Anesthesiologists’ Society released a report in 2019 noting that there were 85,468 patients waiting for surgery at the end of 2017-18. The report notes, “The most common government benchmark is a wait of 26 weeks (or about six months).”

As British Columbia just put all elective surgeries on hold, many waiting lists will balloon even further. And behind those waiting list stats are often people like Jenny Mckenzie, who had to live with immense pain before her hip surgery.

Stats from the Organization for Cooperation and Economic Development (OECD) show that for every one thousand people, Canada has fewer hospital beds and doctors than Italy. Canada could have more beds and doctors, but our governments ration what they provide the public while blocking most forms of private health care.

The Fraser Institute examined the OECD’s data and calculated that Canada’s government-run health care system ranked near the bottom of 28 developed nations, when it came to both acute care beds and doctors for every one thousand people. Thankfully, we were middle of the pack when it came to nurses per capita.

As Sun columnist Lorrie Goldstein recently pointed out, health care is the policy problem Canadian politicians should have been focused on fixing over the past couple decades.

When Canada gets through this, and we will, our elected officials need to put meaningful reform on the agenda. Governments cannot continue to block private health care options while rationing health care to Canadians – doing so could leave us in a vulnerable position again in the future.

But for now, everyone needs to do their part. Our health care system can’t afford otherwise.

Colin Craig is the President of SecondStreet.org, a new Canadian think tank.

This article was published in the March 27, 2020 edition of the Toronto Sun, Ottawa Sun, Edmonton Sun and Calgary Sun.

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Prevention – reduce demand in the first place

If Canadians lived healthier lives, we could reduce demand for emergency services, orthopaedic surgeries, primary care and more. 

For instance, if you visit the Canadian Cancer Society’s website, you’ll read that “about four in ten” cancer cases are preventable. The Heart and Stroke Foundation notes that “almost 80 percent of premature heart disease and stroke can be prevented through healthy behaviours.” A similar number of Diabetes cases are also preventable. 

Many joint replacements and visits to ERs and walk-in clinics could also be avoided through healthy living. 

To be sure, not all health problems can be avoided through healthy living – everyday the system treats Canadians with genetic conditions, helps those injured in unavoidable accidents and more.  

But there is an opportunity to reduce pressure on the health care system through Canadians shifting to healthier lifestyles – better diets, more exercise, etc. 

To learn more, watch our Health Reform Now documentary (scroll up) or see this column. 

Partner with non-profits and for-profit clinics

European countries will partner with anyone who can help patients. 

It doesn’t matter if it’s a non-profit, a government entity or a private clinic. What matters is that patients receive quality treatment, in a timely manner and for a competitive price.  

In Canada, governments often delivery services using government-run hospitals instead of seeing if non-profit or private clinics could deliver the services more effectively. 

When governments have partnered with non-profit and private clinics, the results have often been quite good – Saskatchewan, Ontario and British Columbia are just a few examples of where partnerships have worked well. 

Canada should pursue more of these partnerships to reduce wait times and increase the volume of services provided to patients.  

To learn more, watch our Health Reform Now documentary (scroll up) or see the links above. 

Make cross border care more accessible

In Canada, citizens pay high taxes each year and we’re promised universal health care services in return. The problem is, wait times are often extremely long in our health system – sometimes patients have to wait years to see a specialist or receive surgery. 

If patients don’t want to wait long periods, they often have to reach into their own pocket and pay for treatment outside the province or country. 

Throughout the European Union, we also find universal health care systems. But a key difference is that EU patients have the right to go to other EU countries, pay for surgery and then be reimbursed by their home government. Reimbursements cover up to what the patient’s home government would have spent to provide the treatment locally. 

If Canada copied this approach, a patient waiting a year to get their hip operation could instead receive treatment next week in one of thousands of surgical clinics throughout the developed world. 

Governments benefit too as the patient is now back on their feet and avoiding complications that sometimes come with long wait times – meaning the government doesn’t have to treat those complications on top of the initial health problem. 

To learn more, watch our Health Reform Now documentary (scroll up) or this shorter video. 

Legalize access to non-government providers

Canada is the only country in the world that puts up barriers, or outright bans patients from paying for health services locally. 

For instance, a patient in Toronto cannot pay for a hip operation at a private clinic in Toronto. Their only option is to wait for the government to eventually provide treatment or leave the province and pay elsewhere. 

Countries with better-performing universal health care systems do not have such bans. They allow patients a choice – use the public system or pay privately for treatment. Sweden, France, Australia and more – they all allow choice. 

Why? One reason is that allowing choice means some patients will decide to pay privately. This takes pressure off the public system. For instance, in Sweden, 87% of patients use the public system, but 13% purchase private health insurance. 

Ultimately, more choice improves access for patients. 

To learn more, watch our Health Reform Now documentary (scroll up) or watch this short clip on this topic. 

Shift to funding services for patients, not bureaucracies

In Canada, most hospitals receive a cheque from the government each year and are then asked to do their best to help patients. This approach is known as “block funding”. 

Under this model, a patient walking in the door represents a drain on the hospital’s budget. Over the course of a year, hospital administrators have to make sure the budget stretches out so services are rationed. This is why you might have to wait until next year or the year after for a hip operation, knee operation, etc. 

In better-performing universal health systems, they take the opposite approach – hospitals receive money from the government each time they help a patient. If a hospital completes a knee operation, it might receive, say, $10,000. If it completes a knee operation on another patient, it receives another $10,000. 

This model incentivizes hospitals to help more patients – to help more patients with knee operations, cataract surgery, etc. This approach also incentivizes hospitals to spend money on expenses that help patients (e.g. more doctors, nurses, equipment, etc.) rather than using the money on expenses that don’t help patients (e.g. more admin staff). 

To learn more about this policy option, please watch our Health Reform Now documentary (scroll up) or see this post by MEI.