There are many root causes. No, we can’t blame the SARS-CoV2 virus because we had horrible care and ballooning costs already prior to the Covid-19 pandemic. In 2017 the health authorities admitted that the system had been operating at 104.5 per cent capacity for at least five years.
Spending at the provincial level has increased by 10% in the last three years. Do you feel like we are getting 10% better healthcare? The pandemic mitigation efforts actually decreased the dissemination of healthcare services, and even when you factor in runaway monetary inflation, we should at least be
seeing comparable healthcare to other nations in the developed world. That’s simply not the case.
The Fraser Institute ranked 28 universal healthcare systems in high-income countries and found that while Canada spends the second-most per capita, it ranked in the bottom in almost every single category, including wait times, beds per capita and doctors per capita.
Commonwealth Fund annually ranks 11 nations and Canada usually finishes 10th – just ahead of the
United States of America.
There are solutions to it at all three levels of government, but the provinces generally have the most opportunities for positive change.
Provincial
First and foremost, the easiest action would be to bring back the thousands of healthcare workers that have been barred from helping, healing, and caring for patients. The jury is in: the shots originally intended to prevent Covid-19 illness and death do not produce the results required to justify the exclusion of anyone from participating in our healthcare system. See: freedomtochoose.ca
Also, there are more than enough spaces available for every doctor that graduates from medical school in the province. The College of Physicians and Surgeons of BC (CPSB), and Doctors of BC, need to advocate for easier access to all fields, and not just the positions that are politically popular to fill.
The NDP government recently announced that they have reworked the compensation for family doctors, in hopes of attracting more from out of province and encourage more students to go into this field.
Great.
But why is it we needed EIGHT premiers in 31 years to get to this point? Both NDP and Liberal governments have had ample opportunities to remove restrictions on healthcare workers, but instead they’ve just doubled-down bad policies.
The real solution should be to give doctors that have their own practice more autonomy and flexibility. There are many restrictions on family doctors on how many patients they can see in a day and what level of care they can provide. In most instances a doctor is not allowed to address more than one or two health concerns in one appointment.
This year a news story came out about a doctor requesting a $125 per month fee to be a patient, but
in exchange would provide longer appointments, address multiple concerns per visit, potentially do home visits, would help cover the costs of building costs, staff employment, cost of reusable, software and maintenance of patients record, and employment of allied health professionals, including mental health
councilors.
Instead of lauding the medical practice as catering to the needs of their patients, the Minister of Health disapproved. He admitted block fees are legal, for services not covered by MSP, but “must be optional.”
“The rule in general is that extra billing is not allowed.”
But, why? Why should doctors be barred from providing improved care for their patients?
And to further articulate that the government is at war with British Columbians, it is taking Telus Health to court because it is accused of extra billing. In reality, the services covered by MSP are dwindling each year, so Telus Health is simply attempting to fill in the gaps formed by a neglectful government system.
With thousands of Canadians dying on waitlists each year, it’s time to at least look at allowing those with the means to get OFF the waitlists to do so.
Federal
However powerful the province is to dictate health outcomes, it is the federal government that holds the keys to truly freeing practitioners to provide timely and improved care for Canadians.
Dr. Brian Day has challenged the constitutionality of the Canada Health Act in court, and time after time judges have ruled that it is better for Canadians to suffer on waitlists and potentially perish from lack
of care than it is for them to have the option to compensate a physician directly for additional care.
This is immoral. To me, it is crystal clear that not just our politicians but also our judicial system is standing in the way of Canadians obtaining adequate healthcare.
The federal government has threatened provinces that have entertained alternative methods that federal healthcare transfers will be withheld unless they get in line. Already underfunded, no premier could afford to pass up billions of dollars.
Solutions
Legalizing private healthcare sector to grow would be a huge step towards giving British Columbians better healthcare. The federal levels need to enshrine Canadians’ rights to acquire the best healthcare available. Expediated care needs to be available to all British Columbians, not just politicians,
WorkSafeBC, the RCMP, and prison inmates as it currently stands. In Quebec, a 2005 court ruling already gave Quebecois the right to the best care available, but this privilege has not been applied to all Canadians.
But there are more-radical changes that would benefit British Columbians. And one concept – Direct Care – comes from our neighbours to the south.
It is clear that the USA’s healthcare system struggles to serve all its residents and is also ridiculously expensive.
One of the reasons for the high cost of care is the insurance companies’ incentive to drive up costs for primary and emergency care. But this can only occur in an environment where costs are hidden behind a veil.
Canada suffers from the same problem, despite our single-payer system.
One of the workarounds is to clearly post the costs of each level of care. When you go to a restaurant the fee for each item is clearly posted. And, similarly, when you go to a massage therapist or aesthetician you usually know the fees ahead of time. If we knew how much primary care actually cost I think we’d see a change in the behavior of British Columbians.
But, there is an even better option available: legalize Direct Care.
Direct Care is when the patient pays the provider directly. No third party required.
By cutting out the middleman (insurance companies and administrators) there are huge cost saving opportunities. Doctors in the USA that have Direct Care practices declare that they’re able to save up to 90% on costs of most routine procedures and medications.
This concept also points out the most obvious way to make paying for healthcare more efficient: decrease administration costs.
Susan Martinuk’s book Patients at Risk: Exposing Canada’s Health-care Crisis lays out some hard truths.
While Germany had basically zero wait times for surgeries and specialist appointments, they also had only ONE TENTH of the healthcare administrators per capita as Canada – 1,415 versus 15,545.
This seems like the low-hanging fruit and we should be angry that our healthcare leaders are not doing more to remedy the problem. That includes not just all level of government, but also the College of Physicians and Surgeons of BC, and Doctors of BC.
Local
At first glance it may seem that our municipal governments don’t have much say in the deployment of healthcare and the costs associated.
But when you dig a little deeper your local city council can have a large influence on what level of care is available.
It’s common knowledge that our paramedics, members of BC Ambulance, are funded and paid for by provincial health authorities.
We need to ask: why?
Police and fire services are handled at the local level. Why not ambulance services as well?
As it stands now, firefighters are often the first responders to a health emergency, not an ambulance. This needs to change. As much as we should feel assured that firefighters are qualified to provide a high level of first aid, we should be focusing on getting the best-trained services on the appropriate
service calls.
It wouldn’t be cheap – currently zero funding exists for such an endeavor, and municipalities usually can only raise funds through property taxes, and homeowners do not want to have more taken from their pockets.
But if less was provided to fire departments – a heavily-unionized and well-established voting bloc – they’d have an opportunity to fund a municipal ambulance service to compliment the current provincial service. It would take a lot of political will to make this adjustment, and I’m not overly-confident
that many would have the vision and backbone to get this done.
Meanwhile, zoning is another area a local government can make a difference.
All healthcare-related businesses should be able to set up shop in any area they choose, regardless of what type of zoning it is. If your business is improving people’s health, you should have no barrier to putting up shop. Yes, “health” is a broad term and can be interpreted many ways.
But I know of an abundance of healthcare administrators that would be happy to help.