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Canada’s healthcare system is collapsing at the worst possible time


A man wears a protective face mask as he walks past the emergency department at the Royal Columbian Hospital in New Westminster, British Columbia in 2020. One in five people in British Columbia do not have a family doctor.JONATHAN HAYWARD/The Canadian Press

For several months now, British Columbia Premier John Horgan has used his position as President of the Council of the Federation to draw attention to the urgent need for a new federal-provincial revenue-sharing model. for health care.

At times, Mr. Horgan seemed almost desperate, as if increasing health care dollars was a matter of life and death in his province. The fact is he is, and the distress in his voice is real.

The health care system in British Columbia is collapsing. It’s in a sorry state in other parts of the country, too, as more baby boomers head into retirement where they’re likely to need the services of medical professionals — not enough of them to the moment.

Mr. Horgan’s frustration was evident this week during question period. Fed up with the heckling from the Liberal opposition about the deplorable health conditions in the province, he dismissed them with a swear word for which he would later apologize.

Mr. Horgan knows he has a problem on his hand. And it’s not just him. Several of his provincial counterparts are struggling with the same problem. In this case, the statistics do not lie.

Nearly 900,000 British Columbians don’t have a family doctor, leaving walk-in clinics and emergency rooms flooded

One of the biggest problems facing these provinces is the severe shortage of family physicians. One in five people in British Columbia don’t have one, and more people are pouring into the province every day. Last year, 100,000 people arrived – a record number that only exacerbated a desperate situation.

BC Liberal MP Shirley Bond pointed out that one day this week almost every emergency and primary care center in the city of Victoria was at capacity and not accepting patients. The only one that had a 4.5 hour wait.

British Columbia currently has the longest average wait time for walk-in clinics in the country at 58 minutes. The typical wait time in Canada is 25 minutes. In Victoria, it’s 161 minutes.

The environment isn’t much better next door in Alberta, which has lost 188 registered physicians in the past three months. Some have retired, while others have moved on to greener pastures. The city of Lethbridge has lost 13 doctors over the same three-month period – and a net 62 over the past two years. Nearly half of the city of 100,000 (43,000) is without a doctor.

According to the Canadian Resident Matching Service, the portal used by graduating medical students to find jobs, there were 1,569 family medicine positions available across the country in 2022. According to Statistics Canada, 4.6 million more people 12 year olds did not have a family doctor in 2019.

Part of the problem is that graduating medical students don’t want to go into family medicine. The biggest problem is the payment model used by most provinces whereby physicians are paid a flat fee per visit – fees, they say, that do not take into account the length of the appointment or the complexity of the issues. problems a patient might have.

The shortage of doctors is a problem that has worsened over the years. Canada now ranks 51st in the number of doctors per population, according to the Index Mundi. In the 1970s, we ranked between fourth and eighth place. The shortage of nurses in Canada is equally serious.

The Organization for Economic Co-operation and Development ranked Canada 31st in the number of hospital beds per capita among the 38 countries ranked by the OECD. Meanwhile, according to the Canadian Institute for Health Information, total healthcare spending in the country was estimated at $308 billion in 2021, or $8,019 per Canadian. This figure represents 12.7% of our GDP, which places our health care expenditure among the highest in the world.

We certainly didn’t feel like we got our money’s worth.

Something is wrong, as others have noted over the years. We have a universal health care system that is administered by 10 provinces and three territories, and which is anything but universal when it comes to quality of care. The extent to which healthcare dollars are wasted or mis-spent is staggering.

While I have some sympathy for Mr. Horgan’s position, I also hear the concerns of a federal government that hands out billions of dollars in funding with little or no control over how it is spent.

Canada, as a country, has a terrible reputation for the efficiency of its health care system – even if it’s the fault of individual provinces that don’t know what they’re doing. Now everything goes home to roost.

This system is collapsing just when aging demographics and rising levels of immigration are putting more pressure on it than ever before. We will soon have an emergency on our hands, if we haven’t already.

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