By J. André Faust
Since 1970 our healthcare system has been degrading to such an extent that it no longer meets the needs of the average Canadian as Compared to the 70s', Canadians are forced to spend a ludicrous amount of time in the waiting in emergency waiting rooms for some; the wait time proves to be fatal.
Many New Brunswickers are without a family doctor and are on a waiting list to have a family doctor or nurse practitioner assigned to them, which could be years before their health needs are looked after. Statistically, seniors who are a product of the aging process can develop health issues, and in some cases, treatment early could prevent the condition from becoming potentially lethal later.
What perplexes me is that the Canadian population, according to World Bank data available up to 2019, the population of Canada was approximately 21.37 million in 1970 as compared to today's population, which is 38.74 million and increasing. Obviously, looking at the population difference between 1970 and 2023, there were fewer tax dollars available, and GST/HST didn't exist. Yet most Canadians had family doctors, and wait times in the emergency room were nominal.
Those born in the eighties and after would have no recollection of how good the Canadian health system was compared to today's health care system.
So, what happened, in the 70s, people were paying fewer taxes, yet getting better services. Today we pay much higher taxes yet receive less.
Something doesn't add up. In trying to unpack why Canadian healthcare has digressed to third-world levels in 4 + decades. Currently, the future doesn't look promising if this trend continues.
There are several explanations for why our health system is in such a disarray,
Population Aging: Since the 1970s, the proportion of older adults in Canada has increased significantly, placing additional pressure on the healthcare system. Older adults typically have more complex health needs, and the increase in this demographic can strain healthcare resources.
The problem with the population ageing argument is that most of the war babies have died off, and because the cost of raising families limits the number of children each family has, which has become a problem within itself. With fewer Canadians being born means a loss of future workers. The population has increased because we bring in newcomers to fill that gap, which is a logical move to resolve worker shortages.
Increase in Chronic Diseases: Linked to the aging population, there has been an increase in chronic diseases like diabetes, heart disease, and cancer. Managing these conditions requires long-term healthcare services and resources, but with more and more seniors dying, there should be a corresponding decrease in the demand for age-related illnesses.
Rising Healthcare Costs: Medical technologies and pharmaceuticals have advanced rapidly since the 1970s. While these developments can improve care, they also tend to increase costs. Healthcare spending has continued to outpace economic growth and inflation in many developed countries, including Canada. How much are these costs lining the shareholders' pockets?
Workforce Shortages: There have been reported shortages of healthcare professionals in Canada, especially in rural and northern areas. This can lead to longer wait times for treatment and care, but the problem is much more profound; not only the rural areas are also experiencing a shortage, but so are the urban centers.
Equity Issues: There can be significant variation in access to healthcare services depending on where in Canada someone lives, their income level, their indigenous status, etc. These equity issues can create contribute to degradation in the overall system.
Wait Times: Despite Canada's universal healthcare system, wait times for certain procedures and specialist appointments can be long. This has been a persistent issue in the Canadian healthcare system from the 80s on.
Fragmented Care Delivery: There can be issues with the coordination of care, particularly for those with complex health needs. Patients may need to navigate various specialists and services, which can be challenging and inefficient if you don't have a family Dr.
Underinvestment in Prevention and Public Health: There is often a focus on acute, hospital-based care in Canada, with less investment in preventative measures and public health. This can lead to worse overall health outcomes and increased pressure on the healthcare system. While it may have some influence, there are many factors beyond what I have just listed.
Healthcare is a problem across Canada. One could summarize it into one main issue; that problem is all about money, and the political will is not there to ameliorate it.
We elect a government through a democratic process, first-past-the-post may not be the best system, but it remains within the concept of democracy.
Regardless of party colour, the government institution is a plutocracy.
The best explanation for a plutocracy that I have found is as follows:
Plutocracy is a term used to describe a form of government in which the wealthy have control or significant influence. The word comes from the Greek "ploutos," meaning wealth, and "kratos," meaning power or rule.
In a plutocracy, decision-making and policy-setting powers are largely or effectively controlled by the people with the most wealth, either directly or indirectly. This type of societal structure can exist within different forms of government, such as democracies or republics if the political power is heavily influenced by wealth and economic class.
That being said, history has repeatedly demonstrated the manifestation of the power elites' influence in getting billion-dollar handouts. For example, The Feds announced that Volkswagon would receive 13 Billion dollars over ten years for producing batteries for Electric Vehicles with the intent of creating thousands of jobs. If job creation is ever realized, that is another story.
The payout to Volkswagon is just on the incident. There have been many more.
From 2007 until 2019, the Federal, Provincial and local governments have given 352 Billion dollars to the Corporate welfare bums. It appears that power elites see their needs as paramount to the health needs of Canadians. Big pharmaceuticals owe the taxpayers 44 billion dollars for their role in the opioid epidemic. Add all the tax loops and tax incentives that the big corporation and money mongers receive. There should be enough money to pay competitive salaries for Doctors and anyone else in the healthcare profession.
The problem is that all governments look after the interests of the wealthy, and health care needs to be at the top of the list, not the bottom.
Another strategy is allowing qualified medical newcomers to practice medicine. If qualification is an issue, the solution is to have them do an internship.
Premier of Ontario Doug Ford is considering allowing doctors from out of province to practice in his province at salaries that exceed what the province of New Brunswick is willing to pay.
Another challenge is the debt load that a medical student must bear: four years for an undergraduate degree, then another four years for medical school at 25,000 per year, which translates to 200,000$, so why stay in a province that pays only peanuts? Since the 70s' the cost of attending post-secondary university or post-graduate has surpassed what most can afford to pay unless mummy or daddy can bankroll the costs.
The only way to change the government's priorities is through citizen action. That action may be in the form of protests. Press releases, strategic voting. The final word is "People before profits."