86 Comments

I think health care is going to be a serious liability to all governments in power - even the Federal Liberals who aren't directly responsible for it. I know a specialist physician who couldn't find a GP for her family. I get very tired of physicians defending our system - since they don't actually experience it - however apparently the system doesn't even work for them any more. I spoke today with a colleague whose husband had four blockages in his heart and yet had to wait over two months for bypass surgery. I know for a fact that this surgery in the past this would usually happen the same day or the next day. He was put on a six week waiting list and then they delayed it further. During this time they told him not to strain himself - because a heart attack could come at any time and kill him. Not stressful at all. What this really highlights that while our progressive politicians wax poetic about fighting 'disinformation' and 'climate change' the basic functionality of society is degrading in a way that impacts normal citizens negatively. I think all incumbent governments are going to pay for this.

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As many others have pointed out the way this pandemic was handled could only guarantee a loss of faith in public health, so I don't blame people for not trusting them. Add in that todays disinformation is tomorrow’s science and you have a recipe for disaster.

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I disagree. We had a completely unknown virus dumped on is...the first one I can think of where you're contagious before you have symptoms. We're incredibly lucky it wasn't more lethal on younger people, but it took a while to learn that....and then it changed...and changed again. So science is trying to keep up with a moving target, while numerous agencies are profiting off misinformation about it, and the US president is pretending it will "magically go away". If politicians had taken the advice of public health and acted on it immediately, I suspect none of the lockdowns or other interruptions would have been as serious, although I'm not sure Canada's healthcare system would have survived any better.

I think beating COVID was a team game. There were far too many "I"'s doing their own thing that mad a bad situation worse, and that was compounded significantly by politicians waffling about not shutting down every business that didn't involve food, or medicine.

I realize that would have created even more economic challenges, but those would have been offset by shutdowns of much shorter duration.....but that's just my "research" on the subject :)

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On health care -- I truly wish we could move the conversation away from systems/delivery and towards principles. What do we want from our healthcare system? Let's start with that and then keep an open mind on how to best deliver that rather than stubornly sticking to the system we know because "America!"

For me -- I'd love to see a system that continues to excel at addressing life threatening issues without bankrupting people. It's what our system -- up until recently -- has done ok and is really set up to do. Unless I'm mistaken, thought, that's as much about having an effective public health insurance program as it is about delivering healthcare.

For 'quality of life' healthcare -- including chronic issues -- my observation is we don't do as well. That's where people complain about having to wait for, say knee surgery. Living a long time in pain or with issues *sucks* -- how can we make that part of the system work better? Provide more timely care and more care options affordably? My own sense is this probably cannot effectively be done with universal 'free' access. But, can we explore how to do this really well, and provide a lot affordable options for people? I think that would make a real change in people's sense of the quality of Canadian healthcare -- after all, most of us only have one or two life threatening healthcare issues, but almost all of us will have an issue that impacts our quality of life.

Another bit I don't think we do well (at least in my experience in Ontario) is coordination of care. If you have a complicated health issue, you may be dealing with your own family doctor, specialists plus other providers. My observation -- the coordination of these experts is kind of on you. They are all busy and provide a piece of the 'getting you better' puzzle, but they don't necessarily communicate with each other and don't have time to ask a lot of questions. The quality of your care to some degree depends on your ability to advocate for yourself and navigate the system -- you become a bit like a construction contractor, coordinating the various skilled trades on a project. Not everyone can do that -- and struggling with that means we don't really have the kind of equity of access we pride ourselves on.

One last thing we really, really need to do better on is end-of-life care. We have a system that is focused on keeping people alive and eventually that's not possible (or desireable). Given an aging popluation, we need to invest -- heavily, right now -- in options like hospice care that can allow people to reach the end of their lives as comfortably as possible. We're way behind here.

In short -- we have a system designed to address life threatening disease that we also use for everything else. Maybe we need different approaches optimized for different kinds of healthcare?

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I can't speak to other provinces or even other areas of BC but in the Lower Mainland there does exist at St Paul's Hospital a couple of programs I am familiar with and they are wonderful. The Heart Clinic and the Kidney Care Clinic.

The HC does the follow up on heart surgeries. Every few weeks or months as required you go in and everything is reviewed usually by one or two doctors. The kidney clinic is usually a longer term commitment. Every three months you meet with a nurse, a dietitian, a pharmacist, a social worker, and a doctor, one after another, the doctor is last and quickly reviews what's been covered. Blood tests are usually done before the visit but can also happen right there if necessary. The entire visit usually takes an hour and a half and you are either told to keep doing what you are doing or a new rx is made or suggestions for a variety of things. While the doctor and the nurse were often new (especially the nurse), most of the staff were there every visit which was always reassuring. Everyone was kind and encouraging and never rushed. For 5 years they were wonderful and I'll be forever grateful. (Then they f*cked up but that's another story.)

I've not heard of other similar programs for other illnesses or issues, although I'm sure they exist in one form or another. I know that St Paul's is the gold standard, for BC at least.

We always hear about awful wait-times and queue jumping and bad outcomes and we should, but we seldom hear about the success stories, the happy endings, or great outcomes. Maybe, when they are separating conjoined twins joined at the head and they both survive, are we pleased. I will bet there are those who consider that a waste of resources. Especially if the family is poor and from another country.

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My daughter is a surgeon in Ontario. I have many friends in Niagara region who cannot get health care services at all. The health care system in Ontario is not failing. It has failed already. Much of the blame should be laid on Ford who continues to think it wise to offer nurses a 1% raise year after year. Nurses are leaving in droves. No nurses, no surgeries, no nothing. We are watching stupidity in action.

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Correct me if I'm wrong the the vax mandate drove a ton of good people out of the system, especially nurses

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No, it was the strain of holding up iPhones to people so they could say goodbye to their families before they were intubated. It was having shifts extended and vacations cancelled. It was having to be in full gowning for the entire shift, and having to deal with people coming to the hospital unable to breathe asking for the vaccine. The system and the administration simply burned them out, while Doug capped their raises at 1% while calling them heroes. The sheer hypocrisy of his commentary versus his actions was infuriating, and I'm not in that profession.

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There could be more money for nurses, but Canadians are cheap and don't want to pay out of pocket while government has no more money to give.

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No, we're at the Catch 22. Taxpayers don't want to pay any more, but don't want to give anything up. Governments can't get elected by telling the truth about the situation......and so the ship keeps sinking.

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We get what we deserve, always

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Good nurses like good nurse Kristen Nagle?

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You are wrong.

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founding

As regards a mixed public=private care system, I think we should experiment. Heck, we already have the Shouldice Clinic in Toronto for hernias, and it seems to fit in very well.

In theory, private care may just draw resources from the public sector and so not imprtove the quantity of health care. In practice, a private sector would have incentives that the public sector lacks -- building more facilities with investor money and so loosening the straitjacket of provincial budgets, finding ways to qualify foreign-trained medical personnel without worrying about the extra strains such extra personnel would place on budgets, streamlining purely aministrative functions and leaving medical personnel more time to care for patients, and so on.

As we have learned, most recently with passports, airports and visas, governments are not partivularly good at delivering services to the public. Some private sector participation, and the competition it brings, might do wonders.

As you so rightly say, let us look at European models. We might learn something.

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Not to mention the money that Canadians now spend in the US and elsewhere to get faster access to services. This is the true 2 tier of our system. Those with the means will spend their money on healthcare wherever they can get the service.

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It will always be that way. Our choices are to capture the Tier 1 money to improve Tier 2 service or let it leave the country.

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I mean that the wealthy always can get immediate healthcare services (whether in Canada -- such as athletes or in other countries) because they are willing to pay handsomely. We can let them go outside and pay or we can take their money and use it here to buy more MRI machines, clinics, nurses and doctors.

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RemovedSep 7, 2022·edited Sep 7, 2022
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One of the concerns you hear is that private health care will siphon off the easy cases and dump the hard ones on the public system. Of course, an all-public system gets all the hard cases already...

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" The world is not behaving in ways that we were told we could count on, and that leaves people angry and afraid."

Best sentence in the dispatch. I think it explains a great deal about how people are feeling ... and coping.

'looking forward to more of The Line. 😊

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I cannot wait for the day Trudeau et al go up in a sheet of flames with one outrage too many and get punted with vigor to oblivion. His day will come, even John Gotti stopped being Teflon covered one day and karma caught up with him.

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You will be waiting for a long time, Ted.

If the Liberal caucus had an ounce of self-respect Junior would have been cashiered long ago.

But, of course, that ounce of self-respect is entirely lacking and therefore His Exalted Self's dystopian reign is not ending anytime soon.

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Unfortunately, l don't see an end to his reign in the immediate future either. But it will arrive one day as it does for all of them, and I'll savor that day when it comes. I just hope it comes with a Trudeau sized scandal attached so he leaves the stage a pariah ever after.

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That's good advice and l think you should do just that. Fascist laws....lol

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If l agreed with you and your points in this thread, we'd both be wrong.

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Sep 7, 2022·edited Sep 7, 2022

Of course he will. He's a narcissistic, himbo with all the money a man could ever use. Plus the pension. He's set for life, no matter what.

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I've missed you Terry. How was your vacation?

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I think not. Harper has zero relevance to what l posted.

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Let’s put it this way. In Stephen Harper and Justin Trudeau we have been blighted with two of the worst prime ministers in our modern history. Their personal styles couldn’t be more different, but they’re both guilty of running a highly centralized, autocratic PMO, in whose governments their ministers and MPs have been reduced to nobodies who can’t blow their nose without the PMO staff’s say-so.

Harper was an authoritarian bully; Trudeau is a sanctimonious poser, but they're evenly matched, scandal for scandal; outrage for outrage. We have been badly served by the both of them.

We deserve better, but with the likes of Pierre Poilievre slouching towards Ottawa (not to mention all the petty dictators in our provincial capitals), we're not going to get it.

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You've hit the nail on the head perfectly.

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... slouching towards Ottawa. I love that!

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I'm sorry, but l cannot agree.

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With all due respect, our editors in their coverage of the Liberals arguably have missed a story, namely Minister Freelunch's fate.

What about all the rumours circulating not too long ago that Madam Minister was being groomed to take over from His Exalted Self and be the standard bearer in the next tilt against the Cons?

And deservedly so if you think for a moment about how loyal she has been for almost seven years now. Respectfully walking a few paces behind Junior at public appearances, making great strides in the art of head bobbing* as she learned to master her gag reflex listening to her boss burble his interminable breathy nasal woke addled bromides.

But as any observer will have noted it is Junior and not Minister Freelunch who is flitting hither and you like Tinkerbelle these days going from one high profile public event to another.

While the boss is consorting with the Chancellor of Germany, Madam Minister has to make do with meeting with the mayor of some god forsaken duckburg in Alberta.

Will all that craven, servile, sycophantic adulation of her will turn out to be all for naught?

Is there not a story worthy of note if, as it appears, Madam Minister has truly been kicked to the curb?

*This comment should not be read as an affirmation that Madam Minister has head bobbing skills equal to those of Minister Monsef. In that regard the bitterly missed Maryam stands in a league of her own.

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We’ve talked about Freeland’s career many times before. I suspect we will again on Friday.

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I watch all the polls. I mostly rely on averages of the latest series of them, though.

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Polls do not always = voter turnout Terry. And I don’t agree that the Cons should be seeing a bump without a leader. They’re guns have been basically silent though the race. Libs disregard and diminish PP at their own peril. Hoping they wake up to this.

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I have no illusions we’re going to agree here. But here’s what I’ll say.

1.The playbook won’t work the same on PP. Abortion rights are not going to conquer and divide here - Canada is not the US and the Libs make that comparison at their own peril.

2. What you may think will be “triggering”’to PP will not be - those types of attacks will only strengthen him. He is expecting this and needs it. PP has been very successful in his criticism of PMJT, not of the party, but of the leader- in fact I would argue it’s the sole reason he’s going to now be leader himself. This is the wrong match up for the Libs and they don’t seem to see it.

3. PMJT has not been successful electorally- he’s won 2 minority governments in a row with the smallest % of the pop vote in history. If that’s the metric being used to argue his success it’s a terrible one. I wish Libs would reflect accurately on that when they assess whether to continue with PMJT. I thought they would- it doesn’t seem they are. This is a mistake

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I was listening to something/someone who was saying something to the effect that Canadians don't know Skippy. And as they do learn more about him they like him. Part of the interview touched on young voters too. PP is not your 50 yr old pol. I laughed out loud.

Pierre will probably win the leadership of the Con Party. A dream come true for him.

Everyone knows who PP is and how he is and what he is. Canadians know Skippy. Some like him, others shake their heads and others are gobsmacked that he's as seemingly popular as he is. I really doubt there is going to be a huge wave of young, new voters skateboarding into the polling stations to vote for the kid. The 43 yr old, 20 year senior politician kid who can land on his pension when he loses a couple of elections.

Funny thing with this lot, my kids are almost exactly the same age as JT and PP. I can't help but compare:) The eldest toyed with local politics, the younger is far too smart. I am grateful though I would have liked to visit Ottawa.

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Should the Prime Minister of Canada not meet with the Chancellor of Germany?

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Fat lot of good it did him.

No LNG and a non-binding agreement for delivery of H2.

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That is not the point is it?

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PMJT to run on his great understanding of all things ethical?

And here I thought he would be making his hatred of white male privilege the cornerstone of his campaign, you know that phenomenon whereby well connected males with no qualifications leverage their connections to obtain positions of power. JT abhors this, and rightly so!

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I worked in a welfare office in Toronto once upon a time. You’d be amazed at what people choose to buy even when they’re on benefits. Everyone can afford $40 to spend on their health. It just might mean they’d have to go without a Netflix subscription or takeout for a week. And those that are truly destitute have benefits to cover the fee. This is a no brainer. We’re just so used to getting everything we want we’ve forgotten how to prioritize what’s really important.

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What should they have spent $40 on?

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No such critter. Even cat food costs more!

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Tell me you worked in a welfare office because you wanted to help people.

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Sep 7, 2022·edited Sep 7, 2022

Well, considering I “worked in” in a welfare office, I’m sure I have known more people on benefits than you. It’s not a great place to be, but that doesn’t detract from my comment. Lots claim they’re hungry and can’t pay the rent - many who aren’t on welfare - but have nicer phones than I do along with a brand new tv. Priorities matter cuz the good times are over. Thanks for the chat.

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Ah yes…the school food programs. I’ve been involved in school food programs too. Great excuse for parents to drop their kids off at school without feeding them first because they expect the school to do it for them. Life has never been easy, we just expect the system to pick us up and take care of us all when we stumble. But the system is broke due to rampant abuse, and here we are. Don’t like your job? Better learn to fake it, and perhaps pick up a second job like the rest of us, to help pay the rent. Enjoy your day.

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Disagreeing with the groupthink mentality doesn’t align me with any political affiliation or bias towards poor people. We can disagree, and valid points of view. It’s called having a civil conversation. Good day.

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Sep 6, 2022·edited Sep 6, 2022

Every doctor seems to have a different opinion on why the healthcare system is broken. So there cannot be only one main reason as to what the problem is. I am sure many, as has been shared by the editors here, believe it is a supply issue. However I have personally heard from some doctors that rather it is abuse of the system which is causing absolute chaos for everyone else. Furthermore, Federal and provincial legislation prohibit many Canadians who have trained in the US and elsewhere, to practice medicine back in Canada once they have become qualified. There are many hoops to jump through …not to mention the convoluted and long winded process for foreign doctors immigrating to Canada. Many of them wait many years to even write an exam, then wait many more to actually practice. So unless the legislation is addressed, no amount of lobbying for more doctors will make any difference.

Personally I’m all for user fee services in Emergency departments. Everyone can afford a $40 fee and it might actually stop some of the abuse that is currently the norm in most doctor offices and emergency rooms. And when we have success stories like the Shouldice centre that is probably saving the public system money, why not offer similar services nationwide?

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"Everyone can afford a $40 fee" ... That's not necessarily true. I'm fortunate (as it sounds like you are) that $40 would not be a barrier to accessing healthcare if I needed it. But that's not true for all and I'd hate to see someone who truly needed assistance not seek it as they were already struggling to make rent and put food on the table that month.

I also suspect the challenge in accessing non-emergency care in a timely manner is part of what drives people to emergency departments -- at least here in Ontario, lots of people are struggling to find a family doctor.

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Hey editors! Welcome back after a short pause last week. I agree with your assessment of the Canadian health care system. But a few weeks ago on your podcast, one of you mentioned something about a story you were working on. I think you described it as being about information about the health care system that was being withheld (?). Any progress on that story? All the best.

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Perhaps you could also start covering this MAID, killing people is a great way to save money, to quote

Many of us were shocked (myself included) when Global News reported in mid-August that a veteran suffering from PTSD was offered the option of Medical Assistance in Dying (MAiD) by a VAC service agent, ‘unprompted’. This was mere days after a previous story was reported by the Associated Press and quoted in a National Post article, about a Canadian who was suffering from degenerative brain disorder and had been offered euthanasia because his treatment was costing too much.

Our shock was due – at least in part – by the fact that in today’s fast-paced world of social media, we do not remember the conversations that we have had in the past. Luckily for me, someone did remember, and posted on Twitter this story that appeared on CBC website in January 2017, i.e., a short time after MAiD policy came into effect, titled ‘Medically assisted deaths could save millions in healthcare spending: Report’. The CBC story was based on a report published in the Canadian Medical Association Journal. It said that “Doctor-assisted death could save millions in healthcare spending across the country by between $34.7 million and $136.8 million”.

Via Darshan Maharaja

https://darshanmaharaja.ca/for-a-few-dollars-less/

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Rob, why am I not surprised that you agree and quote a dreadfully one-sided take on MAID? There is far more to it than saving money by killing people off before they become a drag on the health care system.

That there would be savings is not surprising. We have long known that keeping people tubed and hooked up to lifesaving equipment when there is no chance of recovery has been the route taken more often than not. For decades we watched this being pretty much how people died, struggling to live when there is no more fight. When people know that their entire quality of life is gone, that they'll never leave that hospital bed, that machines are necessary to do everything your body once did on its own, and that's not mentioning the pain, the weakness, the fragility and the fear. If they were aware of what was going on.

If I had a degenerative brain disorder I would hope someone would suggest MAID to me and mine. And not because I'm so altruistic that I want to save the gov some money. That is not how MAID works in any case. Also, think of family and friends. I wouldn't want mine hanging about waiting for my DBD to eat me from the inside out.

We almost used MAID a couple of years ago although, in the end, we didn't need to. But the calm, the peace that descended on everyone was a gift. No more wondering if it will be tomorrow or next week or maybe later. Goodbyes were said, tears were shed, laughter was shared and I guess we saved the government a few bucks when all was said and done. Good on us. We listened to music and we talked about a lot of things except dying because we talked that out a while before. What happens is acceptance without the dreadful anticipation.

It was late Dec and it was a bit difficult to find someone to administer the drug at home due to the holiday season. There was a 2 week waiting period (at least there was a couple of years ago) but our doctor found a nurse and Dec 29th was the date. On Dec 27th he died quietly at home with me. He found it amusing that he jumped the gun as he was never on time for anything. He just dozed off and never woke up. Much as the MAID process would have been.

The alternative, the usual way of doing things, would have had him in hospital (he hated hospitals by that point), rigged up with tubes in and out of him, if not in actual pain but very uncomfortable and distressed because you give up all autonomy when they tie you down like that. And you know what the prognosis is going to be, you just wait with all the machines doing the jobs you just want them to stop doing.

MAID is an excellent program. Of course, we need "gatekeepers" (your Darshan is so scornful of) to make sure that no aspect is abused. Especially when it comes to the disabled. Extra care must be taken. But even the disabled can say "enough". And of course, we need more palliative care beds for those who want them. Even there, MAID can be requested.

Interestingly enough, with years of assorted doctors doing all they could, a great GP who I'll love and admire forever (I know I'm lucky I have a GP) and also being very aware of what the ultimate resolution was to be, neither of us knew about MAID. I asked our GP if there was anything we could do. She was surprised that we didn't know. Everyone assumed someone else must have mentioned it but no one did.

So before you damn the MAID program in its entirety, explore it a bit. Put yourself in someone else's shoes and imagine why you might want to die, with dignity, with autonomy, with peace.

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Looking forward to the Grand Resumption.

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Dropped a nickle in my corner of BC. $1.89.9 Woopee! This after weeks at $1.95 and over $2 for weeks before that. About $1.25 in Alberta. That bloody pipe is going to do what for BC exactly? Pffftt!

Kenney is a moron.

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Removed (Banned)Sep 8, 2022
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That's right ... rub it in. :)

BC prices are truly wonky. From $1.65 to $2.30/l depending on where you are. The trouble is, it's 20 cent jumps are areas right near to each other. All the reasons given for the price of gas, taxes, blah blah blah just does not wash. But I hear profits are way up.

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Removed (Banned)Sep 8, 2022
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yup!

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