With a severe shortage of medical staff and long dangerous waits for hospital services—including life-saving operations and emergency care—our Canadian medical system is in turmoil.
We are told that there is a chronic shortage of doctors. That nurses are overworked and burned out. That ambulance response times are life-threateningly slow and emergency rooms are overflowing with wait times of 12 hours and more.
While all of this is going on, provincial government budgets are stretched beyond their limits, with the largest single budget item—over forty percent—being health care costs of one kind or another.
Part of the problem is that provinces are responsible for health care costs within their borders. However, the legislation governing health care is the Canada Health Act, a piece of federal legislation. The provinces are required to follow the provisions of the Canada Health Act and pay all costs associated with complying with the Act minus any grants given to the provinces by the federal government. In fact, the federal government uses the funding carrot to get the provinces to toe the line and provide health services it mandates as just one part of a vote-buying scheme.
The Federal Government, acting in concert with our Courts, have prohibited the provinces from establishing provincial health care plans that they believe will benefit their citizens. The provision of private health care clinics is but one example. Entrepreneurial medical practitioners have tried to open private health clinics and provide services for a fee. These purveyors of medical services are all very qualified in their chosen specialties. This alternate form of treatment can be obtained by patients much faster than via the public health care system. To survive economically, unlike their publicly funded colleagues, these medical professionals must keep an eye on costs, strive for efficiency, and charge a fee, sometimes a substantial one. However, if the fees charged are too high, or if the services provided are inadequate or not commensurate with the fees charged, no one will go to these clinics, and they will quickly go out of business.
The free enterprise economic system has been a roaring success and has singlehandedly contributed to the quality of life those of us living in the Western world enjoy.
However, for some strange reason the federal government, with the apparent support of the general public in Canada, has refused to allow private enterprise to save a troubled health care system. In reality, the reason is not complicated, albeit incomprehensible.
Medicare was born from the socialist ideology of one Tommy Douglas. Douglas was successful in turning doctors in Saskatchewan into bureaucrats; ultimately, left-wing federal governments embraced the idea nationally. Private, pay-for-service clinics were prohibited, and long lines of sick people gradually got worse over time to where we find ourselves today. The obvious question is: Why did socialist-leaning governments dislike private clinics operating side by side with publicly funded health care providers? The reason was that it was deemed unfair for a person with wealth to go to a private clinic for his/her health needs while another person with health issues but no money must wait in the queue. What the advocates of universal health care really wanted is for everyone to stand in line waiting for medical services and do so regardless of the length of the line or one’s socio/economic standing. It appears that these folks have had their wishes satisfied as our health care system is, by any definition, in crisis.
The argument advanced by the private providers of health care was and is that those who could afford to pay for private health care would shorten the line, thereby allowing those with little or no money earlier access to care for their health needs.
That argument fell on deaf ears because advance access to health care was alleged to be unfair. Why should a rich guy get early access to health care when his neighbour wallows in line with the rest of the plebeians? Socialism wasn’t supposed to work that way! Health care was but one obvious area where the evil members of society who made money, allegedly on the backs of the poor, would be treated equally to the poor, and that philosophy was enshrined in the provisions of the Canada Health Act.
It seems pretty clear that health care in Canada has morphed into an unaffordable, money absorbing, idealistic system that simply no longer works efficiently, causing all consumers of health care to suffer equally.
I have a question: Why is there a shortage of doctors in Canada? Statistics are more readily available in the United States, but I have found some Canadian statistics which I refer to below. However, I strongly suspect that what is happening in the US would be mirrored in Canada.
According to an article that appeared in the Association of American Medical Colleges dated October 2019, research shows that almost 40% of women physicians go part-time or leave medicine altogether within six years of completing their residencies. That fact, combined with an article published by the Canadian Medical Association in January of 2019 which stated under the heading Physician Mix: Out of 86,092 physicians, 39% (33,913) are aged 55 or older, 43% are female; 57% are male. In that same article under the heading Physicians in training 56% of first-year medical students in years 2017/18 were female.
If we look at those statistics together, it seems pretty clear to me that more women are being trained as doctors, and that more women are then leaving the profession after but a relatively short period of time and most do not return.
Those of you who do not have, or cannot find, a family doctor understand what I am talking about. You probably live in constant fear of not having a family doctor to call when you need help. So, when you or a family member gets sick, off you go to the emergency department at the closest hospital—which has now, in effect, become your family’s doctor. The people who emergency wards in hospitals are designed to serve–that is, people with “emergency” medical needs—are left waiting with serious issues while someone else is prescribed aspirin for a sore throat and sent home, not before exacerbating the emergency room line-ups and overwhelming emergency room staff.
Getting back to my question: Why is there a shortage of doctors in Canada? The answer, in my view, is not a politically correct one. Women are admitted to medical school in numbers that exceed male students, and this has been going on for many years. As noted above, the females graduating with a medical degree and who have completed their residencies leave the profession at a substantially higher rate than their male colleagues. Statistics do not lie. Accordingly, why is it surprising that we have a shortage of “practicing” doctors in Canada? It ain’t rocket surgery as Don Cherry used to say! And it sure isn’t politically correct to point this out either, but we all, in our hearts, know it to be true.
To solve the problem, would it be unreasonable to require all medical students to sign an undertaking to practice medicine in Alberta (or their province of education) for a specified number of years? After all, educating medical doctors is a very expensive exercise with the cost subsidized by taxpayers. As a result, we simply cannot afford, in more ways than one, to spend scarce resources on people who do not intend to become full-time contributing, long-term members of the medical profession.
I know there will be howls from the left. After all, one is not allowed to ruffle the feathers of the status quo especially when perceived rights of women are concerned, even if what is being suggested kills every reader with logic.
As a result of this politically correct mess, our health care system has not kept up with Canada’s population increase. Canada’s population exploded over the past 50 years, and the reason for the dramatic rise falls at the feet of our immigration policies, governed once again by a federal statute. The idea of “chain migration” was embraced by those politicians courting the ethnic vote. A young immigrant I will call Sonny, who has a university degree from some foreign university, is admitted to Canada, and then in quick succession thereafter, Sonny’s brother, father, mother, grandmother, grandfather, cousin, uncle, aunt, and any other relative are then welcomed to Canada under our immigration laws called “chain migration.” These older, many times under-educated, immigrants put an awful burden on our health care system as those of us who have paid a king’s ransom in taxes over the years stand in a long line with our new Canadian friends, unable to access the medical care we need and for which we have paid over our working lives.
With the funds we have accumulated over the years, we can afford to go to a private clinic in the United States or elsewhere. However, the real, present, practical worry people my age have is what happens if you truly require emergency medical help in the middle of the night, and you attend the closest hospital but cannot be seen by a medical professional because of the volume of patients and the shortage of medical personnel. That very real possibility scares the hell out of me, my family, and my friends.
In Alberta, we are issued Health Care cards, free of charge so every qualified person living in our province gets “free” medical services. But anyone with a brain knows full well that the medical services are far from free! As above noted, these “free” services consume more than forty percent of Alberta’s annual budget.
At one time, not that long ago, Albertans had to pay an annual yet very nominal Medical Card fee. That was abolished as a vote-buying scheme by the government of the day. I suggest that such a fee be reinstated and increased to at least $100 per person per year. I would also advocate charging a fee to everyone who attends an emergency ward of a hospital. I think that would go a long way to cut down on visitors to emergency wards who, as I noted above, have turned these wards into their private doctor offices, many times for insignificant medical issues.
When I had my own company, we had a very comprehensive medical/dental plan for our employees. Our plan paid one hundred percent of dental costs. However, I noticed our premiums were increasing rapidly, and I also noticed that many of our employees were getting all their dental work done on our plan and then quitting their jobs As a result, we decided to reduce the dental coverage to eighty percent of the cost and, believe it or not, that solved the problem. Employees would rather have bad teeth than pay twenty percent of the cost to fix them. However, they were more than happy to pay nothing and let others pick up one hundred percent of their tab.
I believe the exact same result would occur if those attending emergency wards in a hospital were called upon to pay a fee of say $50 per attendance. Everyone has a credit card these days, and the fee per emergency room visit could be charged to the patient’s card or to the card of someone accompanying the patient. If no one in the family has a credit card, then service would still be provided but the outstanding fee would be ultimately paid as a precondition to having a, for example, driver’s licence renewed or some other governmental service provided. I strongly believe that the implementation of such a fee would go a long way to solving the emergency room chaos and getting that service back to where it was intended, and that is to provide emergency medical assistance to seriously ill patients.
I think that if my suggestions, noted above, were followed, the medical crisis we are now enduring would, over a relatively short period of time, be well on the way to being solved and Canadian citizens would, once again, be receiving the medical treatment they can rely on and deserve.
Finally, I would lobby the federal government to amend the Canada Health Act to allow private but regulated medical offices to open their doors to competing with our public health care system. In fact, we do have private health providers at the present time, but governments are very selective as to who can provide these privately owned medical services. There are clinics available to private citizens who pay an annual fee to receive “front-of-the-line” medical services. In addition, there are private companies that provide laboratory services and bill the government, and there are diagnostic clinics that provide x-rays and pain-reducing services at no cost to the patient and are paid for by the government. And by the way, the owners of these private health care providers do extraordinarily well financially, with some having cozy relationships with our provincial government.
Stop disparaging wealth, and allow people to access the care they are looking for privately and pay the fees charged. That will, indeed, have the effect of shortening the line for those seeking medical help through the public system. Ideology and political correctness have no place in something as important as maintaining the health of a jurisdiction’s population.
It seems to be universally acknowledged that our present health care system is in crisis and is not working as intended. Are we to just sit back, wring our hands together and voice our complaints about how our health care system has deteriorated, or are we to acknowledge the problems with our universal health care system and at least try solutions that could very well help save a system that is slowly dying.
In summary, my solutions are as follows:
- Amend the Canada Health Act to give provinces more autonomy and allow pay-for-service private health care providers, not just for the politically well-connected but for everyone.
- Re-examine the criteria for admission to medical schools, and require graduates to agree to a minimum period of time to remain actively, full-time, involved in the profession.
- At least for the time being, re-examine Canada’s immigration policy and do away with chain migration until our medical system has had a chance to catch up with the present demands on medical services. Consider charging a fee for medical services, and especially a fee for attendance at our over-worked and under-staffed hospital emergency rooms.
You may not agree with any of my suggestions aimed at saving our medical system, but one thing seems evident: we simply cannot afford to sit back, do nothing, and allow our health care system to implode.