Patients continue to suffer with health care in a crisis

It’s a familiar story in almost every corner of the country. Health care is in crisis.

The latest cry came from a group of 11 rural communities in Nova Scotia. They have banded together to battle the serious health care problems being encountered by people in their region.

”Rural Nova Scotia is suffering greatly from lack of access to services, lack of family doctors,” Shelburne Mayor Karen Mattatall told CBC News last week. ”It seemed impossible to get the attention of the province, so we thought if we work together we could formulate some plans and maybe get them to listen to the concerns.”

Mattatall also chairs the Rural Nova Scotia Health Care Crisis Working Group. That group comprises people representing 11 municipalities from Mahone Bay to Digby. Members of the public have also taken part and the Nova Scotia Health Coalition is working with them.

Many Shelburne residents have no family doctors. The local Roseway Hospital emergency room was closed for three nights over the Easter long weekend. That forced people to travel to Yarmouth, Liverpool or Bridgewater, which puts more burden on those hospitals.

“You’re putting ill people on the highway,” Mattatall said. “When those things are happening in the wintertime, it certainly increases the opportunity of accidents.”

But Nova Scotia isn’t the only area suffering from a lack of health-care services. An opinion piece in The Globe and Mail back in January highlighted a similar problem in Ontario.

“There is an unfolding health-care crisis in Ontario that requires serious action,” wrote Jon Dwyer, managing director of Aereus Technologies & Interspec Systems, and a member of the City of Toronto’s innovation economy advisory council, in a guest editorial back on Jan. 3. “The problem is felt acutely during cold and flu season.”

“We have each seen the signs in recent years, and heard the stories: surgeries cancelled at the last minute due to a patient backlog; elderly loved ones kept on gurneys in hallways for hours or even days; ER wards choked with patients waiting for care,” he added. “Even Ottawa’s Children’s Hospital of Eastern Ontario recently warned families about waiting times to treat children in the emergency department.”

Dwyer said the Ontario government did make some moves. He indicated the government announced two decommissioned hospitals in the Greater Toronto Area were put back into partial use last fall. The facilities, deemed surplus years ago but not yet sold off, were not operating as full hospitals, but had added hundreds of beds to the local network, specifically for patients waiting for a bed in a long-term-care home or rehab facility.

But the crisis is much bigger than just one hospital or one city. Perhaps a headline in The Edmonton Journal last July said it best: Health care in ‘crisis’ — Canadian Medical Association pushes for national standards.”

“With the premiers set to meet in Edmonton this week, the Canadian Medical Association is pushing for national health guidelines,” Emma Graney of The Edmonton Journal wrote.

That national vision is necessary to stave off further degradation in the quality of Canada’s health care, said CMA president Dr. Granger Avery.

“Canadian health care has been steadily going downhill for the past 30 years,” he said. “It’s currently ranked 10th out of 11 similar public systems around the developed world, yet spends the sixth-highest amount of money. In short, said Avery, it is “an expensive system that doesn’t actually give people what they need.”

In Avery’s view, Canadian health care is now at a crossroads — either it can continue along the path it’s on and keep going downhill, or governments can come together to institute a national set of guidelines, and turn a corner.

“Not only is this really important, but it is actually an opportunity for Canada to stand out in the world and say, ‘Hey, we can figure this out, and if you want, you can copy what we’re doing here’,” he said.

But can Canada figure out a solution to its health-care crisis and the rising costs right across the country? The Fraser Institute doesn’t believe current approaches are the right ones.

“Government health spending is growing at unsustainable rates, while patients are facing shortages of medical resources and declining access to necessary medical care. The president of the Canadian Medical Association recently called on the federal government to become more involved in the management of provincial health systems in order to solve the serious problems plaguing Medicare. Unfortunately, the CMA president seriously misdiagnosed the cause of the health system’s ills,” The Fraser Institute report said.

“The current health system does not have a “management” problem; it has an “economics” problem,” the report said. “The looming crisis in our system has three identifiable causes: the government’’s monopoly over funding for medical care, the politically planned allocation of medical goods and services, and the lack of consumer exposure to the cost of using health care.“

Just last November, the Institute warned:

  • The dominant role played by government financing in Canada’s single-payer health care system has led to an oversight related to demographics: senior migration.
  • Health care spending is skewed towards the first year of life and after retirement. The average amount spent on health care by governments in a person’s first year of life is $10,800. For those between the ages of 65 to 69, that amount is $6,424, but it rises to $13,797 for those over 70.
  • Taxes, on the other hand, start out quite low and then climb steadily to one’s prime earning years (56-63), before beginning to decline as one nears and then enters retirement.
  • When a senior migrates from one province to another, they are likely to have paid the bulk of their lifetime taxes in one province but will consume the majority of their health care in another.
  • Six provinces experienced a net inflow of seniors between 1980 and 2016: British Columbia, Alberta, Ontario, New Brunswick, Nova Scotia, and Prince Edward Island. The remaining four provinces (Saskatchewan, Manitoba, Quebec, and Newfoundland/Labrador) experienced a net outflow of seniors. British Columbia recorded the greatest inflow (40,512), while Quebec experienced the greatest outflow (37,305).
  • Based on average annual health care costs by age, British Columbia had the largest cost at $7.2 billion (in 2017 dollars) while Quebec had the largest savings at $6.0 billion.
  • A partial analysis of potential tax revenues provided by migrating seniors suggests that BC’s costs could have been mitigated by as much as 36.3 percent while Quebec’s savings could have been reduced by as much as 19.2 percent.

So what’s the solution to this crisis? There seems to be no problem identifying the many problems and lots of ideas on how to fix them. Maybe it’s time governments – provincially and federally – worked on putting some of those ideas to good use.

Jeff Wilkinson

Jeff Wilkinson  is a Senior Politics Reporter at Debate Report covering provincial and national politics, . Before joining  Debate Report, Jeff worked on several provincial campaigns including Jack Layton. Jeff has worked as a freelance journalist in Toronto, having been published by over 20 outlets including CBC, the Center for Media and VICE.com.

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