Why the Irish aren’t impressed

Posted on January 12, 2011 in Health Policy Context

Source: — Authors:

NationalPost.com – opinion
Wednesday, Jan. 12, 2011.

This week, the Irish Times newspaper published a large report on Canada’s growing healthcare crisis. In a piece entitled “Another health system coming apart at the seams,” the Times describes the “bursting” waiting room at Montreal’s Royal Victoria Hospital, quoting surgeon Michel Dunberry as saying: “Finding a doctor is like trying to get a ticket to a U2 show.” Author Lorraine Mallinder observes that “With ever-increasing sums of public money being sucked into the maw of the ailing system every year, it is clear that whatever remains of universal coverage will have to undergo serious reform if it is to survive.”

How have we let it come to this — to the point that our much-vaunted health system is now seen by other Western nations as a cautionary tale? Over the past two decades, Canadian governments at all levels have had ample warning signs of problems — lengthening surgical waiting lists, overflowing emergency rooms, desperate patients seeking treatment abroad.

Politicians have had plenty of time to come up with solutions, one of which is obvious: allow more private care into the mix, to take the pressure off the public system. Apart from North Korea, Canada is the only country that prohibits health-care services covered by its public system to be also provided by the private market. (Yes, even Cuba has enacted reforms in that regard.) This lack of competition and choice has yielded predictable results: Despite constant increases in health spending, Canadians are waiting 96% longer for surgery in 2010 than they did in 1993, according to the most recent edition of the Fraser Institute’s report on treatment wait times, Waiting Your Turn.

And yet politicians have refused to challenge the sacred cows in the room: our universal, publicly funded system, and the Canada Health Act, which hampers provincial experimentation with alternate funding models. As reported in the Times, the Organisation for Economic Cooperation and Development has called for clarification of our law, saying “there seems to be confusion about the legitimate role of the private sector in the health system.” In November 2010, in a value-for-money study comparing Canada’s healthcare system with that of 28 OECD countries, the Fraser Institute recommended a five-year moratorium on the Act, to allow provinces to conduct trials of patient cost-sharing, private competition and private medical insurance.

The reaction from Ottawa? Silence. Not surprisingly, in the absence of legislative reform, patients and health-care professionals are pursuing other avenues. Those with the means — such as former Newfoundland premier Danny Williams — seek treatment south of the border.

Still others take to the courts: The Supreme Court of Canada’s landmark Chaoulli decision in 2005 has spawned a series of other lawsuits by patients seeking timely access to care. Finally, doctors are opting out of the public system and opening private clinics. This phenomenon is particularly prevalent in Quebec, where between 2007 and 2009, the number of private family doctors nearly doubled, from 61 to 113.

But these are not long-term — or acceptable — solutions to Canada’s health-care crisis. They represent an abdication of responsibility by our political leaders. Perhaps the Irish Times article…

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EXCERPT

What follows are the opening paragraphs of the Jan. 11 Irish Times story “Another health system coming apart at seams”:

It’s Tuesday evening in the emergency ward of the Royal Victoria Hospital in Montreal. As in other inner city hospitals, the waiting room is packed to bursting. Some patients have been waiting since that morning to see a doctor and tensions are running high.

There’s the young woman with the weak heart who has yet to go through triage, for example. She grabs a doctor who emerges from the office and tells him she’s been waiting for ages to be assessed. “I’ll probably die waiting for my number to come up,” she yells.

Just then, there’s an almighty commotion as a gory emergency case, possibly the victim of a car crash, is wheeled in.

A man with a bright yellow face, who seems to have an advanced case of jaundice, groans. It looks like his wait just got longer. Some of the people here might have been better advised to see a family doctor — the mother whose daughter has a hacking cough or the man with the shooting pain in his leg, perhaps. But with severe shortages of doctors across the country, emergency wards have become the main recourse for millions of Canadians …

To read the entire article, please visit http://tiny. cc/8itq0

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