Can we not accept that the current, government system no longer works? If you don't like the American system (such as it is) fine. Look to Europe. Many counties have a blend of Public and Private systems. Wait times are shorter than here, treatment appears to be comparable, if not better. It's time for a change, and some fresh thinking. We can't avoid this any longer.
That the Canadian government medical system doesn’t work is pretty much universally accepted. The only thing that keeps it going is the well established fact that no politician or civil servant will ever admit that they made a mistake. So they double and triple down on a system that doesn’t work. As the saying goes, doing the same thing over and over again and expecting different results is the definition of insanity.
The only part of the “medical” system that meets deadlines is euthanasia where government paid functionaries gaslight victims into choosing MAID by pointing out that no timely alternative resources are available. Canada is now a country where you are over 50 times more likely to be killed by one of your own government’s paid medical practitioners than by a firearm. (16499/287-, 2024 data).
"hat the Canadian government medical system doesn’t work is pretty much universally accepted." Except by the proponents of the current system who, at any possible hint of a change, yell, "American style!!"
As a Canadian who received timely care in a mixed system in Germany, I was disappointed by a recent CBC article that seemed to focus on diversion of public resources over market forces increasing supply elsewhere. https://youtu.be/KMu6c9U9vE4?si=Svq849oZMwRRr2sF
Quite simply: Canada has 2.8 physicians per 100,000 people and Germany has 4.5. Supply is constrained. Public/Private doesn’t matter to me. We need to find a way to increase supply and moderate costs. We can learn a lot from Europe.
Thank you, Dr. Wiedrick, for addressing the need for fundamental reforms.
A CBC report that ignores facts to prop up the dysfunctional status quo which just happens to align with the position of the Liberal Party of Canada? I for one am totally shocked.
Besides, all Canadians know that the only alternative to Our Free Quality Universal Healthcare For All is the US system where you lose your house and all your money if you so much as set foot inside a hospital.
Patrick, it is my recollection that some years ago the governments (very much plural) found, to their immense surprise, that the more docs there were, the more that those docs billed for services. Legitimate billings for legitimate services, but more money paid by the governments. The miracle cure was to limit med school enrollments thereby limiting med school graduation thereby limiting docs billing the system.
How often have you heard of qualified medical school applicants being unable to get accepted and, if they were determined, going to a different country for medical education? I know that I have heard of such cases. And, of course, it is highly unlikely that those folks return to practice here in Canada.
A proper (but long term) approach is to increase medical school enrollments. Short term? That is another issue but one for which I do not have a prescription.
With an elderly parent, who has paid her entire life for her health care, and has never been sick until now, I have sat in ERs (even with a form for immediate triage) for 12 to 15 hours. Having no phone, I was able to watch and listen. Many were there because they had no family doctor (nor google but I digress), some did not speak either official language. Nelson is a wonderful place, with great skiing and great hiking and fishing, but you know what, that comes at a price, and that is timely health care. Living in the City is no fun, with the shopping carts going by pushed by the urban outdoorsmen and women, and the ER with their fair share of such people every night, but there is more than one Doc on call. I feel for people who have worked their whole life and wish to retire to the mountains, but many should be wary of not having a major trauma center around they age. Some doctors are darn good business people, and they have private, efficient and nice private clinics. In Alberta, Alberta Health even pays for people to attend those places. It is time, and Alberta is leading the way, despite the NDP shrills named Friends of Medicare.
Our hospitals are housing folks that no longer require medical care; they simply don’t want to leave.
University Hospital (UH) has something like 200 people taking up beds because they simply refuse to leave. They no longer require hospitalization. They are like squatters.
Extrapolate that across the Province, and the Country to understand the extent of the problem.
One fellow has been in UH for over nine- yes, nine- years.
BOOM! When Don Getty built all those hospitals ok, long term care homes, in every village in Alberta, that started the avalanche of the hospital becoming a care home. We need more long care homes which will certainly reduce capacity. My goodness, The Line its readers, and contributors can drive this change!
Canada has long cried out for a national identity. I think everyone across Canada would agree that universal health care is probably it. Possibly Hockey Night in Canada until CBC lost it.
Two tier health care has existed in Canada all my life and I am 58. Unless you don't consider dentistry, ophthalmology or psychiatric services to be health care. I don't see how they are not. People literally lose their sh#t with the mere whisper of private MRI clinics. There can be no debate. Ever. This is sacred.
There is no one universal health care system in this country. It's in name only.
This is unsolvable. If one believes it is solvable in an unserious country such as ours they need quickly to get their head's examined. Likely by a mental health professional the Canada Health Act does not recognize. I have been hearing the same complaints and horror stories about our health care system for more than thirty years.
Folks that is not the universal health care you have been led to believe. Individual doctors are privately run businesses who bill the government.
If we are to solve the unsolveable, we need to accept that we are batsh#t crazy when health care is the topic du jour.
I am amazed that there are no demonstrations in the streets about the state of our medical care. We are living in a crisis. Just another huge problem Canada is unable to face.
Birthdays represent a good time for reflection, and ours is tomorrow. Ideally, we reflect on the positives, but those seem to be in an ever-diminishing supply. The negatives have become worse across the board: costs of housing, food, utilities; all that we lump into the 'cost of living' have increased faster than our ability to pay. Putting taxes aside for the moment, the one cost in dollars that hasn't increased for the individual is health care, and the 'Friends of Medicare' are desperate to maintain this wonderful illusion that separates us from the evil US system. Unfortunately, it also separates us from many models (Western Europe, for example) that provide more doctors per capita and much shorter ER wait times.
Why can we not see that while dollar costs stay low, human health costs are spiralling out of control?
Spending on health care has never been higher than it is right now yet most Canadians still think the solution is even more money. Our single payer universal system is viewed with religious fervour and other approaches which are working better in other countries are simply not open for consideration. Politicians, knowing the whole subject is a toxic third rail, won't go near it leaving rationing of care as the only way to control ballooning costs. Eventually, maybe soon, the situation will reach the point where even Liberals will be forced to consider other options. We can only hope. In the meantime, things will continue to deteriorate as more and more of the healthcare budget is wasted and less and less is spent on doctors, nurses and medical equipment.
I believe that Dr. Wiedrick is correct in saying that the Canada Health Act is a guilty instrument.
In the name of "national standards" the CHA imposes and prescribes and prevents. The CHA doesn't really allow much experimentation in delivery of medical services and that is a severe problem.
In my province (Alberta) the provincial government is starting a new experiment in allowing docs to work both within and without the public system in an attempt to reduce demand within the public health system. The critics are crying that universal doom song of, "American style healthcare" but refuse to think that it may be Swedish style, French style, German style, etc. All they can think of is horror stories out of the US.
None of the critics seem to be aware that many docs in the US are absolutely horrified at our "socialist style" medicine and, particularly, at the wait lists, the time delays in treatment, etc., all of which is true but is just as ignorant as the Canadians who cry "American style."
The simple fact is that virtually none of the various critics of either Canadian style or American style medicine are willing to accept is that there are three basic principles in providing service - any type of service. I am a retired accountant and I long ago learned that the service industry, including medicine, operates on those principles: you can have any two of quality service, cheap service or quick service. You cannot have all three of the attributes; at best you can have two of them simultaneously and sometimes you get one or even (horrors!) none of them.
What Canada has done is to choose cheap service and quality service (kind of). By choosing universality and free (cheap for everyone) it has made demand far larger and made it more difficult (not impossible but more difficult) to provide quality. Put differently, the greater the demand, the greater the pressures on quality. By contrast, America has chosen quick service and quality service but has ignored cheap service; expensive medical service has, of course, reduced demand. None of those choices are bad in and of themselves; they simply are what they are.
Throwing more money at the Canadian system will certainly ameliorate some of the delays but one can ask just how much will improve and whether more money will increase demand. As a further point, the more types of services that Canada covers through medicare, the greater the demands on the system. One way to generate more money for the Canadian system is to de-insure some medical procedures; I don't recommend for or against that but it is a way to generate more money.
Until the proponents of healthcare are all willing to accept that you can only have two of the three principles and make appropriate compromises that result from that, there will be no possibility of systemic improvement.
Healthcare is far from my knowledge area, but the very issues Dr. Wiedrick has described I see happening in our ER in Quesnel. This is a powerful piece and I hope the medical community continues to speak up, advocate for specific changes in legislation and collective agreements to put patients first without burning out our physicians, nurses, and administrative staff.
Can we not accept that the current, government system no longer works? If you don't like the American system (such as it is) fine. Look to Europe. Many counties have a blend of Public and Private systems. Wait times are shorter than here, treatment appears to be comparable, if not better. It's time for a change, and some fresh thinking. We can't avoid this any longer.
That the Canadian government medical system doesn’t work is pretty much universally accepted. The only thing that keeps it going is the well established fact that no politician or civil servant will ever admit that they made a mistake. So they double and triple down on a system that doesn’t work. As the saying goes, doing the same thing over and over again and expecting different results is the definition of insanity.
The only part of the “medical” system that meets deadlines is euthanasia where government paid functionaries gaslight victims into choosing MAID by pointing out that no timely alternative resources are available. Canada is now a country where you are over 50 times more likely to be killed by one of your own government’s paid medical practitioners than by a firearm. (16499/287-, 2024 data).
"hat the Canadian government medical system doesn’t work is pretty much universally accepted." Except by the proponents of the current system who, at any possible hint of a change, yell, "American style!!"
Of course they will. But saying it doesn’t make the Canadian system work any better does it? I suppose anything is OK as long as it isn’t American.
As a Canadian who received timely care in a mixed system in Germany, I was disappointed by a recent CBC article that seemed to focus on diversion of public resources over market forces increasing supply elsewhere. https://youtu.be/KMu6c9U9vE4?si=Svq849oZMwRRr2sF
Quite simply: Canada has 2.8 physicians per 100,000 people and Germany has 4.5. Supply is constrained. Public/Private doesn’t matter to me. We need to find a way to increase supply and moderate costs. We can learn a lot from Europe.
Thank you, Dr. Wiedrick, for addressing the need for fundamental reforms.
That CBC report really is junk.
Most of them are.
A CBC report that ignores facts to prop up the dysfunctional status quo which just happens to align with the position of the Liberal Party of Canada? I for one am totally shocked.
Besides, all Canadians know that the only alternative to Our Free Quality Universal Healthcare For All is the US system where you lose your house and all your money if you so much as set foot inside a hospital.
Or, a Swedish system or a French system or a German system, etc., etc.
Hope I didn't turn up the sarcasm so high that it looped around and mimicked sincerity.
Patrick, it is my recollection that some years ago the governments (very much plural) found, to their immense surprise, that the more docs there were, the more that those docs billed for services. Legitimate billings for legitimate services, but more money paid by the governments. The miracle cure was to limit med school enrollments thereby limiting med school graduation thereby limiting docs billing the system.
How often have you heard of qualified medical school applicants being unable to get accepted and, if they were determined, going to a different country for medical education? I know that I have heard of such cases. And, of course, it is highly unlikely that those folks return to practice here in Canada.
A proper (but long term) approach is to increase medical school enrollments. Short term? That is another issue but one for which I do not have a prescription.
With an elderly parent, who has paid her entire life for her health care, and has never been sick until now, I have sat in ERs (even with a form for immediate triage) for 12 to 15 hours. Having no phone, I was able to watch and listen. Many were there because they had no family doctor (nor google but I digress), some did not speak either official language. Nelson is a wonderful place, with great skiing and great hiking and fishing, but you know what, that comes at a price, and that is timely health care. Living in the City is no fun, with the shopping carts going by pushed by the urban outdoorsmen and women, and the ER with their fair share of such people every night, but there is more than one Doc on call. I feel for people who have worked their whole life and wish to retire to the mountains, but many should be wary of not having a major trauma center around they age. Some doctors are darn good business people, and they have private, efficient and nice private clinics. In Alberta, Alberta Health even pays for people to attend those places. It is time, and Alberta is leading the way, despite the NDP shrills named Friends of Medicare.
You bring up several great points.
Thank you for sharing.
May I add one more?
Our hospitals are housing folks that no longer require medical care; they simply don’t want to leave.
University Hospital (UH) has something like 200 people taking up beds because they simply refuse to leave. They no longer require hospitalization. They are like squatters.
Extrapolate that across the Province, and the Country to understand the extent of the problem.
One fellow has been in UH for over nine- yes, nine- years.
BOOM! When Don Getty built all those hospitals ok, long term care homes, in every village in Alberta, that started the avalanche of the hospital becoming a care home. We need more long care homes which will certainly reduce capacity. My goodness, The Line its readers, and contributors can drive this change!
In Ontario, many of the long term care beds are taken up by folks being treated for mental illness.
They don’t require long term care; they require affordable housing.
“Our monolithic, slow-moving, bureaucracy-bound system lacks the nimbleness to meet practical realities.”
This is a critical moment for Canadian healthcare.
Like so many other files, it has been kicked down the road in favour of expediency, and to the point where we now have fewer and fewer choices.
If Pierre Poilievre wants to separate himself from the failed policies of the NDP/Liberal Alliance, here is that opportunity.
Great essay, sir. It was a disheartening pleasure to read.
My best to you.
Canada has long cried out for a national identity. I think everyone across Canada would agree that universal health care is probably it. Possibly Hockey Night in Canada until CBC lost it.
Two tier health care has existed in Canada all my life and I am 58. Unless you don't consider dentistry, ophthalmology or psychiatric services to be health care. I don't see how they are not. People literally lose their sh#t with the mere whisper of private MRI clinics. There can be no debate. Ever. This is sacred.
There is no one universal health care system in this country. It's in name only.
This is unsolvable. If one believes it is solvable in an unserious country such as ours they need quickly to get their head's examined. Likely by a mental health professional the Canada Health Act does not recognize. I have been hearing the same complaints and horror stories about our health care system for more than thirty years.
Folks that is not the universal health care you have been led to believe. Individual doctors are privately run businesses who bill the government.
If we are to solve the unsolveable, we need to accept that we are batsh#t crazy when health care is the topic du jour.
I am amazed that there are no demonstrations in the streets about the state of our medical care. We are living in a crisis. Just another huge problem Canada is unable to face.
Birthdays represent a good time for reflection, and ours is tomorrow. Ideally, we reflect on the positives, but those seem to be in an ever-diminishing supply. The negatives have become worse across the board: costs of housing, food, utilities; all that we lump into the 'cost of living' have increased faster than our ability to pay. Putting taxes aside for the moment, the one cost in dollars that hasn't increased for the individual is health care, and the 'Friends of Medicare' are desperate to maintain this wonderful illusion that separates us from the evil US system. Unfortunately, it also separates us from many models (Western Europe, for example) that provide more doctors per capita and much shorter ER wait times.
Why can we not see that while dollar costs stay low, human health costs are spiralling out of control?
"Only in Canada, you say. Such a shame".
Spending on health care has never been higher than it is right now yet most Canadians still think the solution is even more money. Our single payer universal system is viewed with religious fervour and other approaches which are working better in other countries are simply not open for consideration. Politicians, knowing the whole subject is a toxic third rail, won't go near it leaving rationing of care as the only way to control ballooning costs. Eventually, maybe soon, the situation will reach the point where even Liberals will be forced to consider other options. We can only hope. In the meantime, things will continue to deteriorate as more and more of the healthcare budget is wasted and less and less is spent on doctors, nurses and medical equipment.
I believe that Dr. Wiedrick is correct in saying that the Canada Health Act is a guilty instrument.
In the name of "national standards" the CHA imposes and prescribes and prevents. The CHA doesn't really allow much experimentation in delivery of medical services and that is a severe problem.
In my province (Alberta) the provincial government is starting a new experiment in allowing docs to work both within and without the public system in an attempt to reduce demand within the public health system. The critics are crying that universal doom song of, "American style healthcare" but refuse to think that it may be Swedish style, French style, German style, etc. All they can think of is horror stories out of the US.
None of the critics seem to be aware that many docs in the US are absolutely horrified at our "socialist style" medicine and, particularly, at the wait lists, the time delays in treatment, etc., all of which is true but is just as ignorant as the Canadians who cry "American style."
The simple fact is that virtually none of the various critics of either Canadian style or American style medicine are willing to accept is that there are three basic principles in providing service - any type of service. I am a retired accountant and I long ago learned that the service industry, including medicine, operates on those principles: you can have any two of quality service, cheap service or quick service. You cannot have all three of the attributes; at best you can have two of them simultaneously and sometimes you get one or even (horrors!) none of them.
What Canada has done is to choose cheap service and quality service (kind of). By choosing universality and free (cheap for everyone) it has made demand far larger and made it more difficult (not impossible but more difficult) to provide quality. Put differently, the greater the demand, the greater the pressures on quality. By contrast, America has chosen quick service and quality service but has ignored cheap service; expensive medical service has, of course, reduced demand. None of those choices are bad in and of themselves; they simply are what they are.
Throwing more money at the Canadian system will certainly ameliorate some of the delays but one can ask just how much will improve and whether more money will increase demand. As a further point, the more types of services that Canada covers through medicare, the greater the demands on the system. One way to generate more money for the Canadian system is to de-insure some medical procedures; I don't recommend for or against that but it is a way to generate more money.
Until the proponents of healthcare are all willing to accept that you can only have two of the three principles and make appropriate compromises that result from that, there will be no possibility of systemic improvement.
Healthcare is far from my knowledge area, but the very issues Dr. Wiedrick has described I see happening in our ER in Quesnel. This is a powerful piece and I hope the medical community continues to speak up, advocate for specific changes in legislation and collective agreements to put patients first without burning out our physicians, nurses, and administrative staff.