How do we ‘fix’ Canadian health care? Not by forcing patients to pay

Posted on July 7, 2022 in Health Debates

Source: — Authors: , – Opinion/Contributors
July 6, 2022.   By Katie Arnup, Amit Arya, Contributors

If the pandemic has taught us anything, it’s that we need our publicly funded health care system to be there for all of us.

Nobody denies that our health care system is under immense pressure right now. About 15 per cent of Canadians — 5,000,000 of us — don’t have a regular primary care provider, which leads to many patients spilling over into emergency departments, sometimes waiting days for a bed. Wait times for elective surgeries are longer than usual, with millions of procedures having been postponed or cancelled because of the pandemic.

Chronic understaffing made worse by the pandemic means that health workers are experiencing burnout and emotional exhaustion at record levels and some are making the difficult decision to leave their professions.

To solve these issues we need to strengthen, not dismantle, our publicly funded health care system.

It is dangerous to say we should “fix” our problems with private pay health care.Why? Because public funding isn’t the cause of our problems. The Supreme Court of British Columbia made this abundantly clear in 2020 when it ruled against the Cambie Surgery Corporation’s attempt to overturn key provisions of B.C.’s Medicare Protection Act, including the part that prevents doctors from billing both government and patients for medically necessary care.

Sure, private pay might give faster access to those who can afford to pay, but it would also poach doctors, nurses and other highly skilled workers from the public system, where they are desperately needed. And with the costs of everyday essentials like groceries and gas skyrocketing and record-high inflation, it is especially cruel to promote solutions that would force people to pay for medical care.

Canada is not alone in facing this challenge. All health-care systems around the world have been pushed to the brink during the pandemic. All countries are dealing with backlogs and trying to manage wait lists. Even countries with a multi-payer system, like Australia, have rapidly growing wait lists — so creating a parallel private pay system clearly won’t solve our problems either.

The bottom line is that publicly funded solutions are required to improve access to care for the many, not the few.

So let’s focus on proven innovations and systemic changes that will increase capacity in the public health care system; things like centralized wait lists for the next available surgeon and expanding operating room schedules in order to tackle surgical backlogs and reduce wait times.

We can alleviate the strain on our emergency departments by urgently investing in a strong primary care system — the foundation upon which our entire health care system is built — to address the root causes of what sends patients to the ER in the first place. We can provide better care in the community and end decades of penny-pinching for home care and long-term care — respecting older adults’ wishes to “age in place.”

By expanding access to publicly delivered dental care, implementing universal pharmacare and addressing the social determinants of health, we can improve the overall health of our communities, which will in turn further alleviate some of the strain our system is feeling.

We must build up our health care workforce in a proactive and sustainable way. Governments can tackle this with solutions to improve working conditions (e.g. fair wages, benefits, less involuntary part-time work), implementing national licensure so doctors and nurses can practice anywhere in Canada and credentialing internationally trained health professionals.

With Canada’s premiers set to meet in Victoria, B.C., we are likely to hear them ask for significant increases to federal transfer payments for health care. But is more money, alone, good enough? While we undoubtedly need to invest more public funds in our health care system, we need to do it transparently and strategically.

Premiers and provincial/territorial health ministers need to be held accountable to implement solutions that will reduce wait times for care. The federal government can also play a more active role in guaranteeing timely access to high-quality care from coast to coast to coast.

Those looking to hand our health care system to corporate investors see a lucrative opportunity in private pay health care. It’s a seemingly simple and neat solution — but it’s wrong. If the pandemic has taught us anything, it’s that we need our publicly funded health care system to be there for all of us.

We cannot afford to look back on this time in future years and wish we’d done more to rebuild medicare when it was in crisis. We need politicians of all stripes to come to the table with commitment, courage, and action. The time is now.

Katie Arnup (@Karnup) is the executive director of Canadian Doctors for Medicare (@CdnDrs4Medicare).Dr. Amit Arya (@AmitAryaMD) is a palliative care physician, researcher, educator and board member with Canadian Doctors for Medicare.

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