TRUE NORTH COLUMN: Need health care in Canada? Get a public relations team!

What’s the first thing that pops into your head when you think of the Canadian health care system?

If you’ve been paying attention, it’s probably tens of thousands of waitlist deaths, sky-high average wait times and millions of patients without a family doctor.

But if you haven’t checked the news since the 1970s or so, you might still have the idea that Canada’s health care is all about equitable access: no matter who you are, you can and will get the care you need. 

That’s the point of a universal system, right?

Unfortunately, this vision of Canadian health care simply doesn’t line up with reality. With the government’s bans on private care, most Canadians simply don’t have much of a choice. It’s either wait for the government to get around to fixing your chronic health problem, or travel somewhere else.

However, there is another way to finally get that knee replacement you’ve been waiting years for: tell your story to the media.

Governments don’t want to look bad. Sure, all the stats about the failures of the health care system aren’t great for government popularity, but it’s another thing to put a face to the numbers. When the headlines show a real person suffering due to the government’s incompetence in its health care monopoly, things can start to become really difficult for politicians who want to get re-elected. 

With that in mind, should it be shocking that many patients share their story with the media, and then, shortly afterwards, are surprised to get a phone call with a scheduled date for their surgery?

Here are just a few examples of this. 

Bill Bagyan from Kingston, Ont., waited for surgery for over a year and a half with an agonizingly painful urological condition. That entire time, he had to have a catheter in. Any man who’s had to use a catheter for even a day or two during a hospital stay knows how painful it is. Imagine coping with that for 18 months. Bill eventually got fed up and told his story to CBC. A mere five days later, he finally received his surgery. 

Devin Gallant, a teenager from Fort St. John, B.C., suffers from spinal muscular dystrophy, a disease that causes his muscles to waste away. Corrective surgery was cancelled four times before his family had enough and spoke to Global News. Just over a week later, Global reported that Devin had suddenly received surgery.

Dean Baker from Welland, Ont. wasn’t sure he would make it through the year. He had been diagnosed with a brain tumour and desperately needed surgery. The hospital couldn’t tell him when he’d be able to get it removed. So, he spoke to the St. Catharines Standard, the local paper. One day later, he got a call with good news: he’d be in for surgery within the month

These are just a few examples. It’s important to stress that these patients did nothing wrong. When you’re suffering from chronic pain and unable to walk, or there’s a serious chance that you might die, it’s perfectly understandable that you would do everything you can to get health care.

But should patients really need to have to share their story with the media in order to receive timely care? Of course not. Canada should be allowing patients more choice – use the public system or private options – to reduce wait times. We should be copying other reforms that have been used in better-performing universal health care systems around the world. 

But in the meantime, you may want to think about your media strategy in the event of a major health problem. It might just help you get the care you need.  

Dom Lucyk is the Communications Director for SecondStreet.org, a Canadian think tank. 

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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.