In this episode of Trend Line, Nik and I want to do a deep dive on one issue, health care.
I actually remember when my parents, who emigrated here from Italy, got a card that said OHIP, the Ontario health plan, and they were so happy and so excited.
I’ve heard from people who are still waiting for cancer surgery in various parts of the country and people who have actually given up and flown to the United States for an MRI.
From a polling perspective, when we look at the trend line and the proportion of Canadians that identify health care as our top unprompted national issued concern, well, check out the trend line at least back to 2005, up to present.
And you know, you can see that right now we’re at a high, even higher now than it was during the pandemic, where Canadians identify health care as their top unprompted national issue of concern.
When you go to emergency, what’s the average wait time? Twenty-two hours, when you look across the board, 22 hours.
But 22 hours with rural emergencies closing where they have no doctors and walk-in clinics, it’s just too much.
That’s a lot easier than the health-care system, which is much more complex, and Canadians are waiting to hear solutions, but I think we’re not hearing a lot, at least from a lot of our political leaders.
And I don’t see Canadians having a lot of faith because as as we all know, this has been a fight that’s been going on for pretty much as long as we’ve had health care.
But what I’ve noticed over my years of doing it, and most of my focus has been on health developments in health science.
I was at dinner with a health-care worker at one of the hospitals, and she said, ‘absolutely, every four years it changes the direction Oh, we’re going to privatize this.
And we asked Ontarians during the election, and this was for the Globe and Mail, how they’d like to fund long term care facilities or help on that front, 74% said increase public funding to long-term health-care facilities, while only 14% said that they would encourage a more private sector type stuff.
And what the survey shows is that people overwhelmingly just want to make sure that the public system is properly funded, that it can hire the people that we need.
So, you know, I think that the first step in kind of dealing with this crisis is talking about how many beds do we need, how many nurses, how many frontline health-care workers are actually needed for the public health-care system to deliver what it needs to deliver? And we’ve never talked about that.
Michael: On that note, Nik, we’ve heard a lot of surveys about burnout amongst health-care workers, where we all know we need more health-care workers.
Nik: It’s pretty clear and Avis is probably hearing this on the front line, that all health-care workers from top to bottom are under stress and some of them are just walking away.
I have a young niece who became a nurse and she’s working in a hospital and she’s only been there a few years, but she’s already talking about finding an exit ramp.
I had to see the federal government hire a chief nursing officer, Leigh Chapman, to kind of work on it on a national basis because the provinces are like, ‘Oh, we’re short doctors.
For average Canadians, they expect that generally you can get the same level of health care regardless of what province you live in or where you reside or where you happen to be.
But I want to touch on one thing that you both mentioned, planning and short term planning versus long term planning.
You’re witnessing that in Ontario, where they’re talking about privatizing and moving things topharmacies, which might be good or not, but they’re only interested in their 3 to 4 years.
I’ve seen it also with, you know, trying to lever the number of doctors, ‘hey, let’s save money by having less doctors.’ That’s what happened.
We need them on duty.’ And yet you have B.C., Ontario, Nova Scotia, saying ‘oh, no, we don’t want previously unvaccinated nurses, even if they’ve had COVID — health-care workers.’ What, is the science different in B.C.
But the reality is, that we’re going to be hitting, as soon as the baby boomers get a little older, we’re going to hit a wall, and it’s going to be a massive crisis where the demographic bubble hits what I’ll say, the H.R.
And put those two things together and say we have to deal with both of these issues, the fact that our population is aging, but also at the same time, that we need to make sure that we retain and have the health-care workers, the frontline health-care workers that are necessary.
And I noticed that when I put out a little note to ask people about what’s going on, the immense amount of skepticism among Canadians that the current system will work, ever, is very high.
And it was something that we talked about when we’d visit our friends and relatives in the United States and in other countries and stuff like that.
Avis: Well, I’ve been hearing people unhappy with the idea of how do we plan to fix this? And we understand that the prime minister and the provinces are going to be making some sort of a deal on February 7, where there will be more money given to the provinces to fix health care.
Give the federal government more power to really make the changes that Canadians want for health care and put it on a steadier ship than provincially run health care, which is that 3 to 4 year lurch between elections and Liberals and NDP and that.
And then I’d like front care health-care workers to go in and kind of tell them their story so that they can get it into their mind that they need to act, that this is more than just a political issue and that they need to start making long term decisions that are in the best interests of all the citizens of Canada.
It changed everything because that accountability that you’re talking about and that measurement and the deliverables was basically severed between at least the federal funding that went to provinces with certain intentions and what actually happened at the provinces where the provinces basically decided what to do with the funds that they received, based on what they thought was most important.
And I remember the cabinet minister saying that was the worst decision that I sat at a cabinet table that was made, because it was just wrong for Canada.
All the provinces, the provincial premiers, will be up in arms because they’ll say, ‘How dare you tell us?’ But you know what? The federal government has a responsibility.
We didn’t hear it in Ontario during the election that they were going to do more private clinics and move that direction.
Then there’s the famed Shoudice clinic, which is grandfathered in and part of that is that they just do hernias, and high volume places have the best outcomes.
Nik: Avis, to your point, I think most patients would be surprised that their physician pays for their office, pays for the staff, pays for the nurse, pays for all the equipment and stuff like that, which is why they’re a small business.
But the reality is, how many staff are they paying for it? People confuse the billing with the salary or how much a physician might be making when the reality is they’re paying for rent, they’re paying for the receptionist, they’re paying for all of the equipment, all of the overhead, all of the staff that they might need.
The ones that understand the role of private in the context of how private health care is done at the moment, understand that in order to clear things up, you might need a bit of that.
I remember a crisis in the 1980s when I was reporting on people who couldn’t get heart surgery and they were dying waiting for bypass surgery and the health system in Ontario, and I believe other places, started to fix it by having specialized centers patients would get to the next available hospital surgeon who could perform it.
I don’t think that they have generally the support of the health system, the health-care workers, I should say.
Avis: Well, a shout out to the frontline workers who have been working like crazy and are still doing the work.
But also I’ve had people say, we came up with solutions in 2002 with the Romanow report, 47 recommendations.
That report has a lot of really great ideas that if they hadn’t been implemented, might make our health-care system right now have been much more robust and look much better than it is and have much happier staff working across the board.
And I think right now, just from a governance perspective, there’s not one level of government that’s fully accountable for health care.
A kind of like a legacy issue to say, ‘okay, I’m not going to be the leader of whatever, but for the next two years I’m going to do this’ and to just push it through, push through some leadership and accountability.
Because I think the problem is, is that for anyone that’s seeking reelection, it’s kind of like Vietnam, right? Get mired in jungle warfare and you’re just in a swamp and there’s no political win.
Why don’t we use an example? If you’re in a rural hospital, you’d have to meet the national standard, but you still have some flexibility to deal with your special patients and the fact that you’re dealing in a rural hospital as opposed to a hospital in a high density urban area.
I think that’s probably the way they would go, but that it would mean a heavier hand for the federal government on this.
I think people I hear say ‘stop the political games, stop politicizing health care,’ which is what we saw happen to a large degree during COVID.
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