Canadian health care at a crossroads

Palliative care
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Susan MartinukIt has been a revealing week for Canadian health care and what we have witnessed is not good.

In Fredericton, NB, a senior passed away while waiting for care at a hospital emergency department. A witness noted that the man was “clearly in discomfort,” yet it wasn’t enough to gain the attention of health-care workers. He eventually slumped over and died from a heart attack. Premier Blaine Higgs responded to the resultant public outcry by firing both his Health Minister and the CEO of the health authority that oversees the hospital.

Things were no better in Ontario, where a 76-year-old cyclist with a broken leg was left languishing on a stretcher in the hallway of a small, local hospital for four days. The problem? He needed surgery at the London Health Sciences Centre, and it did not have any available beds.

Meanwhile, in Victoria, B.C., our country’s 13 premiers were meeting to discuss health care, but talks never went beyond the usual squabble over money.

The Premiers wanted the federal health transfer payments increased from 22 per cent of health care costs to 35 per cent. The federal government responded with a blatant “no” and said the province’s monetary calculations failed to consider the additional $2.85 billion to cover surgical backlogs and the roughly $70 billion allotted to health care over the past two years to battle the pandemic.

Finally, the legal system in B.C. weighed in on health-care innovation by turning down a legal appeal to allow individuals the right to use their own money to buy insurance that would cover medical care outside of the government system. (Canada is the only country in the world to rely exclusively on a public health-care system.)

Both the B.C. Supreme Court and the B.C. Court of Appeal have now ruled against Dr. Brian Day and his attempts to modernize health-care delivery in Canada.

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The legal decision allowed that the rights of some patients may be violated by waitlists that deny their access to timely health care, but it is more important that the government monopoly on health care be sustained so it can ensure the equitable provision of health care and prevent the creation of a two-tier system.

The families of patients daily denied care (as in the situations above) are likely unimpressed by the Court’s ideological attachment to the notion of equal access and its insistence that the system remain unchanged.

Based on all of the above, the logical question becomes – “What’s the plan?“

What are we going to do? Fire a Health Minister every time someone dies?

After all, research shows at least 11,581 patients across Canada died in 2020-2021 while waiting for surgeries, diagnostic scans and specialist care. Another five million Canadians do not have a family doctor. There are over one million Canadians on waitlists for treatment.

After two years of pandemic spending, federal and provincial coffers are empty. Research from the Frontier Centre for Public Policy shows that eight out of 10 provinces spend at least 40 per cent of all revenues on health care; for New Brunswick and Prince Edward Island, the two outliers, the numbers are greater than 30 per cent. One analyst believes health care could take as much as 80 per cent of provincial budgets by 2030.

Every extra dollar assigned to health care has serious implications for every other social expenditure, including education. How much more are we willing to allot to health care?

It’s difficult to expect the court system to consider the financial ramifications of its decisions since it functions within a strictly legal context. However, we do expect the courts to examine the evidence and rule with consistency when upholding (or claiming to uphold) charter principles. Yet, the B.C. Court of Appeal has failed to do so.

Canadian courts ruled in favour of the few over the many when they agreed to an individual’s right to what is now called Medical Assistance in Dying. In a legal system so obsessed with rights and equality, and with laws that have been changed to allow individuals to choose death over pain, one would think that the courts would rule that an individual has the right to timely treatment that relieves pain.

Canadians are at a crossroads; it’s time to stop talking about money for health care and start talking about changing health care.

Susan Martinuk is a Senior Fellow at the Frontier Centre for Public Policy and the author of Patients at Risk: Exposing Canada’s Health-Care Crisis.

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By Susan Martinuk

Susan Martinuk is a Vancouver-based research consultant, and former researcher in reproductive technologies and infertility. In 1990, she and her colleagues achieved a world-first medical breakthrough—the first to visualize and record the process of human ovulation. From 2010 to 2012, Susan carried out the first-ever study on access to, and utilization of, PET (positron emission tomography) imaging in cancer care in Canada.

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