September 30, 2022
Americans disenchanted with their country’s inaccessible health care system often point to the Canadian system as a model, but any Canadian can tell you that our reality is far from ideal.
Even before COVID-19, we had grown accustomed to standards that would puzzle many American policyholders. A trip to the ER could result in an all-night wait if your life didn’t appear to be in immediate danger. You might call all the family doctors in your town and find that none of them have accepted new patients. As the National Post notes, five million Canadians, nearly one-eighth of the population, currently do not have a family doctor. Having recently left my pediatrician, I count myself in this group. Add to that our significantly long wait times for surgeries and it’s easy to see why many Canadian patients are unhappy.
While it is undeniable that the COVID-19 pandemic has taken these conditions to the worst extremes, their root causes have long been in place. Forbes reported that in 2013the average waiting time for a medically necessary intervention after referral from a GP was four and a half months, twice as much as in 1993. In 2006, Nadeem Esmail, Fraser Institute Scholar pointed out that Canada’s doctor-to-population ratio already sits at a dismal 26th out of 28 countries with universal health care, with those numbers set to worsen in the coming years. This was mainly due to government restrictions on the training of doctors and the fact that a significant part of the workforce was at retirement age. Meanwhile, high overhead, unattractive pay, and stressful hours are factors that deter new graduates from pursuing studies in family medicine instead of more stable jobs in clinics or specialist practices.
Flash forward to the current decade, and wait times and staffing issues have become dire. In 2022, emergency rooms across the country experienced a rampant number of closures, which particularly burdened Canadians living in rural areas. According the toronto star, at least 86 closures occurred in Ontario alone between July and September of this year. As The New York Times writes, it stems from a nationwide shortage of nurses, many of whom have been pushed to their limits by unsafe working conditions, low pay and pandemic-induced burnout.
As the fallout from this backwardness in health care becomes increasingly apparent, more and more critics are expressing a desire for more privatization within the Canadian system. Among the provinces most eager to comply is Quebec, where according to Radio Canada, major political parties are actively proposing to expand the province’s private health care network. Costs for patients at the planned centers will be covered by public health insurance while being privately owned and operated. While there may be naysayers who think it shatters our national identity of totally “free” care, Canada’s refusal to embrace private options sets it apart from other nations in ways that aren’t necessarily good. .
In a National Post editorial, Tristin Hopper points to the two-tier system in countries like the UK, Germany, Australia and Norway, where free public and paid private care are the two options. In Canada, there is rarely a private alternative for patients waiting for publicly funded care. As Bacchus Barua of the Fraser Institute noted in 2017a Commonwealth Fund health policy survey of adults in Australia, Canada, France, Germany, Netherlands, New Zealand, Norway, Sweden, Switzerland, United Kingdom and United States saw Canada rank last in many metrics essential. These included the ability to get a same-day or next-day appointment when sick and waiting for emergency room treatment, specialists and elective surgeries. Conversely, the leading countries have all succeeded in integrating the private sector into their universal healthcare system.
It is imperative that we abandon polarized misconceptions about health care in Canada versus that in the United States and accept that “private” is not always a cruel word. There is no point in Canada maintaining an entirely public system if it inflicts so much hardship on its people. Ultimately, policymakers in both countries should prioritize access and quality of care, while placing less emphasis on arbitrary labels. While Canada’s proximity to the United States makes it an easy scapegoat, the real models exist on the other side of the globe, and our nations on both sides of the border have an immeasurable amount of work to do.
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