TORONTO SUN COLUMN: Canadians fed up with critically ill health care system

When the Bolsheviks ruled the Soviet Union, everyday Russians would line up for hours a day just to get some bread. Others, understandably, would skip the lines altogether; realizing the shelves might be empty by the time they got into the store, they would seek another way to fill their belly.

Sadly, Canada’s health care system shares some shocking parallels with bread lines under one of history’s worst regimes.

A new SecondStreet.org poll sheds yet more light on the decaying state of Canada’s government monopoly in health care.

The poll, conducted by Leger, shows many Canadians are opting out of getting the health care they deserve. Almost half the respondents said they’ve avoided going to the doctor or a hospital because they don’t think they’ll get care promptly.

That’s right. In a wealthy country, rich with natural resources and intelligent, industrious people, half of the population simply doesn’t want to deal with the excessive wait times in a hospital.

That’s bad enough if all you have is a broken arm (it’ll fix itself… right?), but what if it’s a strange pain in your chest or stomach that later turns out to be cancer or a serious heart problem?

Well, discouraged from seeking immediate care in hospital, you’re now treated to the pleasure of waiting months or years for potentially life-saving treatment.

Wait, wait, wait… and hope you get care before it’s too late. Just like the poor citizens under Lenin, Stalin and Kruschev! While those sick of the bread lines could sometimes find food on the black market, or get away with growing their own vegetables, the options for modern Canadians to receive important health care are even more limited.

Except for Quebec, waiting is the primary option; travel is one of the only others.
The Leger poll also sheds light on this second option. Roughly one in 10 Canadians said they have travelled out of province for private health care. This isn’t just an escape route for the ultra-wealthy — about 9% of respondents with an income under $60,000 still said they have left their province for care.

Of course, it’s more difficult for low- or medium-income Canadians to afford travelling for care — but when your mobility, an escape from chronic pain or even your life are on the line, people make it work.

Canadian governments could, of course, make travelling for care more accessible.

That’s another one of the points covered in this poll. In the European Union, patients have the right to travel to another EU country, pay for surgery and then be reimbursed by their home country up to what it would have cost to perform the surgery locally.

This isn’t a perfect solution, but it immediately gives patients access to faster options. And Canadians are on board — the poll shows more than 70% like this policy.

Finally, Canada could, in the spirit of those final Soviet leaders who tore down the wall, realize that a stifling government monopoly simply doesn’t work. Down with bread lines and down with banning patient choice. Canada could keep its universal health-care system, but allow patients to pay for care — an option supported by 61% of Canadians.

It’s clear. Canadians are fed up with living under a backwards health-care system that forces them to wait with no options within their own province. They want health reform now. Sticking with a broken system will only lead to more pain, suffering and death.

Dominick Lucyk is the communications director with SecondStreet.org, a Canadian think tank

This column was originally published in the Sun newspapers on December 7, 2024.

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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.