Daring to hope on health care
The shortage of primary care providers in Kawartha Lakes has put us in a terrible place — one we’d never have imagined even a decade ago.
If you do have a doctor or nurse practitioner, regardless of your relationship with them, you’re told you should feel lucky and pipe down. And if, like thousands of your neighbours, you’ve spent months or years with no one to call for an appointment when you’re concerned about your health, no one has to explain how stressful the shortage is.
The reality hits when you try to explain the situation to someone from another country and realize how outrageous it is that so many are without a primary care provider. It’s harder than it’s ever been to defend, let alone praise, a healthcare system that hasn’t been able to come up with an answer for people who cannot find a doctor.
That’s why the glimmer of good news from the provincial government amid the health-care gloom feels so thrilling. Could it possibly be that the system’s evident shortcomings are finally bringing about a sensible way to ensure everyone in Ontario has a health-care provider?
Emerging from the work of Dr. Jane Philpott, former federal health minister, the overhaul would see primary health care teams, which include several professionals covering medicine, counselling, nutrition and more, taking responsibility for residents in a given geographic area. No more hopeless calls to see if doctors are accepting new patients. No more crises when a community’s sole nurse practitioner moves away.
It feels too good to be true, doesn’t it? But like so many things in life, maybe the situation had to get this dire before somebody finally took the drastic steps required to address it. And kudos to the Conservative government or being willing to choose transformation rather than more of the same.
Even the four years it will take to set up these primary health care teams feels reasonable in the circumstances. A return to a norm where everyone has a health-care provider they can actually get an appointment with and feel heard by is unquestionably worth the two billion-ish dollars it’s projected to cost.
Sure, there are still many aspects of Ontario’s system that need fixing, from its reliance on private-sector testing to hospital food to elder care. But for most of us, our doctor is the person who knows us best and whom we trust most when it comes to our health.
Although it’s infuriating and unfathomable that we ever reached our current crisis point, the possibility of sensible, long-term change for the better is welcome indeed. Here’s hoping for better, healthier days ahead for all people in Ontario.
The Canadian social contract refers to the unwritten agreement between Canadians and their government, defining the rights, responsibilities, and expectations of both parties. With respect to healthcare, that social contract is an implicit agreement built on principles of equity and solidarity, signifying a collective commitment to providing accessible healthcare for all residents.
In plain english, Canadians are just supposed to get healthcare when they need it. Full stop.
Free Healthcare is one of the fundamental differences that Canadians are quick to point out when someone compares Canada to the United States. It’s right up there with Canadian Tire, Butter Tarts and Tim Horton’s as differentiators.
Healthcare should be too important and too big to fail, but it did fail. And importantly, there wasnt a darn thing we as citizens could do about it. It wasnt like there was a “Check Engine Light” glowing on on health care dashboard and that we had advance warning.
The Canadian health care system is centrally planned and adminstered. The government will provide for your medical needs, except when it fails to do so. It’s the same management philosophy used in the Soviet era Russia. One central monopoly system, no duplication and striving for efficiency. But when the central planning system fails, everyone is in a problem. Remember the bread lines of the Soviet era being on the news in the late 1980’s?
The doctor shortage in Ontario has been an ongoing issue for several decades, with roots tracing back to policy decisions in the 1990s. These decisions, including reducing medical school seats and residency positions, aimed to address concerns about the cost and quantity of healthcare services, but ultimately contributed to the current crisis.
The Ontario government, then led by Premier Bob Rae, implemented austerity policies that aimed to reduce the number of doctors based on the belief that there were too many tests, procedures, and prescriptions being ordered, according to the Toronto Sun.
These policies resulted in a reduction of medical school seats and family medicine residency positions, which has had a lasting impact on the number of new doctors entering the system.
We’ve all heard that the growing and aging population in Ontario, with a higher proportion of seniors, has increased the demand for healthcare services. We all know that the number of family doctors is not keeping pace with the growing population and demand, and many doctors are also retiring or shifting to niche areas of medicine, according to the Canadian Medical Association.
It’s not hyperbole that Millions of Ontarians are now without a family doctor, and wait times for a new family doctor can be extremely long. Research indicates that more than 2.2 million people in Ontario lack a family doctor. The shortage is expected to worsen as more doctors retire or shift away from full-service family medicine, and fewer medical school graduates choose family medicine as a specialty, according to the National Post.
Our centrally planned health care system is now broken. Municipalities, who have not traditionally had a role in health care are now taxing residents and paying for doctor recruitment and retention programs for their communities. It’s a capitalist twist in that centrally planned health care system we have. A pay to play system that divies up available doctors to the highest bidder. Some Ontario Municipalities are mad as heck about it.
The City of Belleville is now offering up to $150,000 over six years to medical students, residents, and doctors who commit to practicing in the community for a five-year term. What if our Municipality cant compete with Belleville to attract the best doctors, or to recruit any doctors for that matter? How is this efficient? Does this not fundamentally break that social contract? Where’s the equity and solidarity?
The work of Dr Philpot is certainly heading in the right direction. Your article is very correct in saying that hopeful times are ahead.
On a relative basis, the work of Doctor Philpot will make this better.
But lets not stop there – Let’s push for better so this cant happen again.
Fixing the present doctor shortage and getting everyone with adequate primary care is just the first step. We need to go farther and make sure this cant fail again. How do we prevent this breach of the social contract for future generations of Ontarians?
Redundancy is the concept of having a back up, or a second option. It’s like the spare tire in your trunk in case you get a flat.
Comparing the Australian and Canadian healthcare systems, both are publicly funded, but differ primarily in their structure and degree of private sector involvement. Australia operates a mixed public-private system, while Canada’s system is predominantly single-payer, with a stronger emphasis on public funding and delivery.
Australian Medicare, the public health insurance scheme, provides universal coverage for essential services and a significant private sector exists alongside it. Australians can opt for private health insurance to access private hospitals and specialists, often with shorter wait times and greater choice.
This is redudancy. There are two ways to access care, and if the public system is not fully capable, citizens can elect to engage the private system and have their care needs met, albeit at extra cost. The participation rates in both public and private systems are a good metric to judge whether the public system is meeting the needs of citizens.
Our health care system needs that spare tire in the trunk. We need to stop trying to centrally plan health care because the central planning system itself is a single point of failure. When it fails, it fails big.
Adopting the Australian model and measuring participation rates in both systems would provide better service, and would provide a real time metric about how the public healthcare system is delivering. Australian health care is not perfect, but it looks a lot better than what we have today.