- mass immigration without social infrastructure capacity
- a system wherein the feds send money and the provinces spend it, which leads to a recursive blamestorming loop ("you don't give us enough $$" --> "we give you plenty you spend it poorly")
- a populace brainwashed into believing the only alternative is a US style system
- an endless army of people at various levels of government who bleed off money doing redundant work or work of debatable value
Politicians who scare the public with the "American Style Medical Care" rhetoric to derail any proposals to embrace the public/private hybrid system that *almost every other country in the world successfully uses* are, in my view, among the most irresponsible and detestable people in our society.
Dalton McGuinty was the absolute worst for that. *Any* question to him about Ontario's health care system automatically triggered a spasm of "blah blah the American system blah blah".
Their dying breath, as they lay in the hospital hallway cot, perishing of a disease that would have been treatable if caught earlier, had their complaints not been hand waived away during their allotted 15 seconds of time with the family doctor:
The enduring big lie is that Canada provides quality healthcare at current tax levels. Both federal and provincial governments have repeated the big lie or, when pressed, blamed the other level of government.
The initiating action was Pierre Trudeau ending a 50/50 cost sharing plan in 1977. He introduced the current annual block grants to the provinces. They followed suit and introduced block grants for their hospitals. They also restricted the number of medical students and residencies. Our healthcare became rationed via wait lists.
Until our politicians stop lying and tell Canadians that ending wait lists means higher taxes, we'll continue to get the healthcare we have.
Strongly agree that the 1977 health plan is at the root of many of our current problems.
But note that average and median health outcomes in Canada are good to excellent compared to elsewhere. It's waiting times and ERs that are the failure points.
I would argue the source of the physician shortage was the Barer-Stoddart report from 1991. The subsequent reduction in medical graduates could not be undone quickly. The time lag between entry and final specialization is considerable, and there are ceilings on how many trainees can be in a program as it remains an apprenticeship (except for the brainwashing around DEI in medicine).
Of course, a cynic might suggest that the crisis was a means to an end. Who benefits financially from a physician shortage?
The GoA is outsourcing surgical work that predominantly Boomers need, and they will hopefully focus the public health care services on the now and future. GenZ and Millenials.
Throwing more money propping up the current bureaucratically bloated system which appears to be more focused on the inside rather than on meeting the needs of its “customers” isn’t going to do the job. The Canada Health Act is a major impediment to actually creating effective change. Start there.
Please look into this issue….there are thousands of beds being taken up by patients who should be in other facilities. My partner was in hospital for more that 18 months because there was no long term care bed available. This is a huge failure of the system in Ontario…maybe also in the rest of the country. How many new facilities have been built since the Covid LTC fiasco and who’s checking on Ford’s promises? These people don’t count because they no longer vote, so there is no action. You count overflow in the ER…try looking into why hospitals are full.
BC is already using hotel rooms. I know because a family member was put up in one while waiting for an emergency surgery but being stable enough to just visit the hospital daily to have vitals checked.
Yes, the aging population has been a known problem but it seems those in charge of seat spaces in universities aren’t any better at planning than governments.
Where I do disagree is that I think there likely is demand for a for-profit emerg system. I’d pay for it if it meant getting prompt care and quick imaging in an emergency situation. Especially since it could be the difference between life and death. The stunning piece is how the a government cancelled the new hospital in Edmonton - we could’ve been closer to a pressure point easing.
This tells me that the government hasn’t actually run the numbers. The aging population isn’t going to disappear anytime soon - I checked census data recently and millennials outnumber living bay boomers. And given how chronic illnesses are starting on average in someone’s 30’s now and life expectancy is shortening, the problem is actually going to arrivemuc quicker than anyone realizes. Without a rapid influx of HCW I think total collapse could happen. Fixing the problem stars by admitting more to med school and opening up more residency spaces. Our doctor shortage is self imposed from a quota system that the medical associations control - not from lack of applicants who are qualified. Did you know the U of A acceptance rate is only 8-12%? And research papers along with hundreds of clinical hours are needed to get in - in addition to extraordinary grades. There are many many qualified students who are turned away. And that’s ignoring how many qualified doctors we have living in the province who trained elsewhere and still travel to their original country and practice medicine to stay current but then wait for single residency spots to be able to become licensed in Alberta. (Most residency spots are saved for albertan studenta. Maybe we could do something better for doctors from another country?!?)
For profit doesn’t necessarily mean patient pays. Provincial plans can still pay for procedures just like imaging clinics and doctor visits which are for profit and paid by healthcare plans.
It takes 8+ years to make a doctor, half that to make a nurse and about the same to build a hospital: that's about the same time frame it took to add about 4 million new residents to this country. Pretty sure we didn't add 10% more Dr's, nurses, hospitals, budget money, etc, in that same time frame. Politicians of all stripes should be required to at least be required to know the definition of unintended consequences..
Some things cannot be done quickly. It takes a long time to graduate a doctor and in North America they are both highly mobile and in demand. When we should have been looking at doctors and housing per person a decade ago we were not. Covid was the alarm bell for the medical system. The number of people who had to be hospitalized was relatively small compared to the overall population but it was a lot more than the planned capacity. We have increased the population by immigration and have the same problem. Maybe the two problems are related?
They definetely ‘kicked the can’ down the road’ when it came to building assisted living and long term care spaces. I’m at the tail end of the Baby Boomer generation (1959),and what we are seeing is not hopeful. Our generation built,planned and saved. Now we are a burden in the younger generations eyes. People,there is no free ride. To many feel entitled,and talk as if everyone is wrong and out to get them. Years ago there was a discussion on why should we support,care for those that continue to smoke and drink themselves to death. I am not impressed with the portion of the population that spends 6 months less a day overseas. Then expects “free medical coverage.” Hey,we all like a holiday. But,my yearlong taxed expenditures on daily living should not be expected to support them. Because they keep a Canadian address? Passport? My son said “Dad! Everybody else does it!” Son,the dollars don’t add up. Socialism bankrupts countries. Yes,take care of the needy,not the freeloaders,scammers,grifters
Been this way for awhile. Sometimes it appears to be competence vs system overload. My spouse was misdiagnosed in Victoria for something that almost killed her and left her with life-changing circumstances. Should have been caught at the doctor’s or the clinic a day later — but was picked up (very easily) by the ER the following day.
Competence. Possibly compromised by overloading. I guess our WWII parents should not have had as many kids. As it is those kids (boomers) loading up the system now.
I first noticed this about 20 years ago, when an uncle of mine was stuck on a gurney in a hallway at Royal Columbia Hospital for four days. The flack I would get in those days when I said our healthcare system was far from perfect. It's a Canadian sacred cow for some reason. People take pride in the weirdest things.
Competence is sometimes compromised by system obstructions such as social expectations. My friend in BC died due to wrong diagnosis, being told to relax when in fact she had cancer. Their system of paying doctors for a list of patients contributed to the negativity, since the system is not organized to support second opinions.
This is a reasonable article, but a lot of relevant things are omitted. Sure, the system was hurting before, but surely we can admit that the Liberals' seriously increasing immigration, giving no time for the health and education systems to prepare, made things much worse.
The Alberta system was adding doctors into triage, in arguably the most stressed hospitals, within the next 6 weeks or so. Surely we can note that triage misses resulted in outstanding ER failures. The planned change left limited time for the politically minded to raise a fuss. Was the unions' silence politics trumping advocacy for members. The media helped the politics.
Many patients believe family doctors are a delay in getting to emerg, so they don't want one. Days elapsed before the hospital informed family that a relative was cleared to leave, when staff knew there was an exit plan in place. Don't ignore system failures outside ER.
Yes, anything is better than the status quo. This article appears to me to try to give both sides their due. But one side has no ideas other than increasingly unaffordable taxes. The other side is trying. That's a massive difference.
I will also add that this isn’t a baby boomer problem. Nor does it end after the baby boomers are all cared for. There is a small reprieve wit Gen X, maybe, if millennials don’t end up needing LTC at the same time as Gen X. And then the system is really screwed.
And that’s before you consider the shrinking birth cohort sizes and population decline. There aren’t enough babies being born to actually staff healthcare at the level it needs to be staffed unless something changes with birth rates.
I almost lost my finger,waited 4 hours. They treated in the back hallway on a chair. Had an infection that spread rapidly from a scratch. The nurses,doctors and staff were dedicated and competent. I was lucky,and so are we,for this quality of care. Any and all disorganization starts at the top. I worked construction,and I could tell by the first day how this build was going to go.
Doug Ford was allegedly given billions of federal dollars to address COVID, and he used them to balance his books. This is 100% on provincial leadership who have gutted staffing, failed to provide incentives for people to get into and stay in the medical field, and millions wasted by hospitals on consultants trying to find savings and efficiencies...that likely don't even cover their contracts. The system is full of managerial deadwood devoted to "cutting costs". Funds should be devoted to the front-line staff, who actually know what their jobs require, and the equipment they need to do the job. Most shifts run better and with higher morale when there aren't supervisors hanging around....wasting oxygen. But we've got billions to give to companies to build fucking battery plants. It's about priorities. The taxpayers are no longer the priorities.
So many factors at play:
- mass immigration without social infrastructure capacity
- a system wherein the feds send money and the provinces spend it, which leads to a recursive blamestorming loop ("you don't give us enough $$" --> "we give you plenty you spend it poorly")
- a populace brainwashed into believing the only alternative is a US style system
- an endless army of people at various levels of government who bleed off money doing redundant work or work of debatable value
- the demographic crunch of aging baby boomers
Politicians who scare the public with the "American Style Medical Care" rhetoric to derail any proposals to embrace the public/private hybrid system that *almost every other country in the world successfully uses* are, in my view, among the most irresponsible and detestable people in our society.
Dalton McGuinty was the absolute worst for that. *Any* question to him about Ontario's health care system automatically triggered a spasm of "blah blah the American system blah blah".
Dalton was the absolute worst at a lot of things, and we are still suffering from it.
He truly was.
The perfect comment.
When the boomers are dying in the hallways, then maybe the friends of Medicare might be accepting of some alternatives?
Their dying breath, as they lay in the hospital hallway cot, perishing of a disease that would have been treatable if caught earlier, had their complaints not been hand waived away during their allotted 15 seconds of time with the family doctor:
"Uhhhh.. at... least... I... wasn't... an... American......."
The enduring big lie is that Canada provides quality healthcare at current tax levels. Both federal and provincial governments have repeated the big lie or, when pressed, blamed the other level of government.
The initiating action was Pierre Trudeau ending a 50/50 cost sharing plan in 1977. He introduced the current annual block grants to the provinces. They followed suit and introduced block grants for their hospitals. They also restricted the number of medical students and residencies. Our healthcare became rationed via wait lists.
Until our politicians stop lying and tell Canadians that ending wait lists means higher taxes, we'll continue to get the healthcare we have.
No magic bullets.
"They also restricted the number of medical students and residencies."
And they still so restrict. When we are crying for more doctors and nurses that is absurd.
Strongly agree that the 1977 health plan is at the root of many of our current problems.
But note that average and median health outcomes in Canada are good to excellent compared to elsewhere. It's waiting times and ERs that are the failure points.
I would argue the source of the physician shortage was the Barer-Stoddart report from 1991. The subsequent reduction in medical graduates could not be undone quickly. The time lag between entry and final specialization is considerable, and there are ceilings on how many trainees can be in a program as it remains an apprenticeship (except for the brainwashing around DEI in medicine).
Of course, a cynic might suggest that the crisis was a means to an end. Who benefits financially from a physician shortage?
The GoA is outsourcing surgical work that predominantly Boomers need, and they will hopefully focus the public health care services on the now and future. GenZ and Millenials.
Throwing more money propping up the current bureaucratically bloated system which appears to be more focused on the inside rather than on meeting the needs of its “customers” isn’t going to do the job. The Canada Health Act is a major impediment to actually creating effective change. Start there.
Please look into this issue….there are thousands of beds being taken up by patients who should be in other facilities. My partner was in hospital for more that 18 months because there was no long term care bed available. This is a huge failure of the system in Ontario…maybe also in the rest of the country. How many new facilities have been built since the Covid LTC fiasco and who’s checking on Ford’s promises? These people don’t count because they no longer vote, so there is no action. You count overflow in the ER…try looking into why hospitals are full.
In London’s University Hospital, there are 200 beds alone that meet this description.
One fellow has been there nine (yes, nine) years.
AH, but look how much Doug et al saved by closing them.....see also the homeless crisis.
Canadians are upset with the status quo, but unwilling to move toward another delivery system.
You could take every single crisis currently faced by Canadians, and apply the same observation.
We have done it to ourselves, and we have no one else to blame but ourselves.
You are so right. As a nation we prefer complaining to doing.
BC is already using hotel rooms. I know because a family member was put up in one while waiting for an emergency surgery but being stable enough to just visit the hospital daily to have vitals checked.
Yes, the aging population has been a known problem but it seems those in charge of seat spaces in universities aren’t any better at planning than governments.
Where I do disagree is that I think there likely is demand for a for-profit emerg system. I’d pay for it if it meant getting prompt care and quick imaging in an emergency situation. Especially since it could be the difference between life and death. The stunning piece is how the a government cancelled the new hospital in Edmonton - we could’ve been closer to a pressure point easing.
This tells me that the government hasn’t actually run the numbers. The aging population isn’t going to disappear anytime soon - I checked census data recently and millennials outnumber living bay boomers. And given how chronic illnesses are starting on average in someone’s 30’s now and life expectancy is shortening, the problem is actually going to arrivemuc quicker than anyone realizes. Without a rapid influx of HCW I think total collapse could happen. Fixing the problem stars by admitting more to med school and opening up more residency spaces. Our doctor shortage is self imposed from a quota system that the medical associations control - not from lack of applicants who are qualified. Did you know the U of A acceptance rate is only 8-12%? And research papers along with hundreds of clinical hours are needed to get in - in addition to extraordinary grades. There are many many qualified students who are turned away. And that’s ignoring how many qualified doctors we have living in the province who trained elsewhere and still travel to their original country and practice medicine to stay current but then wait for single residency spots to be able to become licensed in Alberta. (Most residency spots are saved for albertan studenta. Maybe we could do something better for doctors from another country?!?)
For profit doesn’t necessarily mean patient pays. Provincial plans can still pay for procedures just like imaging clinics and doctor visits which are for profit and paid by healthcare plans.
It takes 8+ years to make a doctor, half that to make a nurse and about the same to build a hospital: that's about the same time frame it took to add about 4 million new residents to this country. Pretty sure we didn't add 10% more Dr's, nurses, hospitals, budget money, etc, in that same time frame. Politicians of all stripes should be required to at least be required to know the definition of unintended consequences..
Some things cannot be done quickly. It takes a long time to graduate a doctor and in North America they are both highly mobile and in demand. When we should have been looking at doctors and housing per person a decade ago we were not. Covid was the alarm bell for the medical system. The number of people who had to be hospitalized was relatively small compared to the overall population but it was a lot more than the planned capacity. We have increased the population by immigration and have the same problem. Maybe the two problems are related?
Ross, I agree that some things cannot be done quickly but they damned well occur sooner if you actually start them!
As just one example, governments still restrict - for about the last fifty years! - enrollment in medical schools when we are crying for doctors.
Clearly, governments need to recognize that some expenditures (e.g. med school spaces) have great value and should not be skimped upon.
The bureacratic inverted pyramid at work
They definetely ‘kicked the can’ down the road’ when it came to building assisted living and long term care spaces. I’m at the tail end of the Baby Boomer generation (1959),and what we are seeing is not hopeful. Our generation built,planned and saved. Now we are a burden in the younger generations eyes. People,there is no free ride. To many feel entitled,and talk as if everyone is wrong and out to get them. Years ago there was a discussion on why should we support,care for those that continue to smoke and drink themselves to death. I am not impressed with the portion of the population that spends 6 months less a day overseas. Then expects “free medical coverage.” Hey,we all like a holiday. But,my yearlong taxed expenditures on daily living should not be expected to support them. Because they keep a Canadian address? Passport? My son said “Dad! Everybody else does it!” Son,the dollars don’t add up. Socialism bankrupts countries. Yes,take care of the needy,not the freeloaders,scammers,grifters
Been this way for awhile. Sometimes it appears to be competence vs system overload. My spouse was misdiagnosed in Victoria for something that almost killed her and left her with life-changing circumstances. Should have been caught at the doctor’s or the clinic a day later — but was picked up (very easily) by the ER the following day.
Competence. Possibly compromised by overloading. I guess our WWII parents should not have had as many kids. As it is those kids (boomers) loading up the system now.
I first noticed this about 20 years ago, when an uncle of mine was stuck on a gurney in a hallway at Royal Columbia Hospital for four days. The flack I would get in those days when I said our healthcare system was far from perfect. It's a Canadian sacred cow for some reason. People take pride in the weirdest things.
Competence is sometimes compromised by system obstructions such as social expectations. My friend in BC died due to wrong diagnosis, being told to relax when in fact she had cancer. Their system of paying doctors for a list of patients contributed to the negativity, since the system is not organized to support second opinions.
This is a reasonable article, but a lot of relevant things are omitted. Sure, the system was hurting before, but surely we can admit that the Liberals' seriously increasing immigration, giving no time for the health and education systems to prepare, made things much worse.
The Alberta system was adding doctors into triage, in arguably the most stressed hospitals, within the next 6 weeks or so. Surely we can note that triage misses resulted in outstanding ER failures. The planned change left limited time for the politically minded to raise a fuss. Was the unions' silence politics trumping advocacy for members. The media helped the politics.
Many patients believe family doctors are a delay in getting to emerg, so they don't want one. Days elapsed before the hospital informed family that a relative was cleared to leave, when staff knew there was an exit plan in place. Don't ignore system failures outside ER.
Yes, anything is better than the status quo. This article appears to me to try to give both sides their due. But one side has no ideas other than increasingly unaffordable taxes. The other side is trying. That's a massive difference.
I will also add that this isn’t a baby boomer problem. Nor does it end after the baby boomers are all cared for. There is a small reprieve wit Gen X, maybe, if millennials don’t end up needing LTC at the same time as Gen X. And then the system is really screwed.
And that’s before you consider the shrinking birth cohort sizes and population decline. There aren’t enough babies being born to actually staff healthcare at the level it needs to be staffed unless something changes with birth rates.
I almost lost my finger,waited 4 hours. They treated in the back hallway on a chair. Had an infection that spread rapidly from a scratch. The nurses,doctors and staff were dedicated and competent. I was lucky,and so are we,for this quality of care. Any and all disorganization starts at the top. I worked construction,and I could tell by the first day how this build was going to go.
BC’s ER issues are at least as bad as Alberta’s if not worse. I suspect it goes well beyond one or two provinces and is a national issue.
Doug Ford was allegedly given billions of federal dollars to address COVID, and he used them to balance his books. This is 100% on provincial leadership who have gutted staffing, failed to provide incentives for people to get into and stay in the medical field, and millions wasted by hospitals on consultants trying to find savings and efficiencies...that likely don't even cover their contracts. The system is full of managerial deadwood devoted to "cutting costs". Funds should be devoted to the front-line staff, who actually know what their jobs require, and the equipment they need to do the job. Most shifts run better and with higher morale when there aren't supervisors hanging around....wasting oxygen. But we've got billions to give to companies to build fucking battery plants. It's about priorities. The taxpayers are no longer the priorities.