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Canadian Health Care Must Be Revamped, Not Replaced

We aren't dismantling our system; we are building on the vision of what our system was always meant to be

12/01/2017 10:02 EST | Updated 12/01/2017 10:03 EST

Recently, United States Vice President Mike Pence warned Congress about the "failings" of the Canadian health system and the threat of a "collapse into single-payer health care." Shortly thereafter, Vermont Senator Bernie Sanders congratulated us on our universal approach — and even encouraged Canadians to " ...stand up and fight for what you have achieved and defended."

Although 64 per cent of Canadians say they're proud of our health-care system, we know that same system is under-performing, plagued by chronic issues such as long wait times for everything from emergency room visits to elective surgeries and long-term care beds, escalating costs, and the seeming inability to move from the hospital/doctor model to one more suited to home-based, community-focused care. There is an inherent tension between how we feel — or want to feel — about our healthcare system, and the reality of the situation.

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Ontario Premier Kathleen Wynne welcomes Vermont Senator Bernie Sanders at the University of Toronto where he delivered a talk on Canadian health care on Oct. 29, 2017.

As a Canadian, I cherish our access to healthcare. As the CEO of the one of the largest health-care delivery companies in the country, my outlook is somewhat less rosy. Not only are we failing to live up to our potential as a global model of exceptional care, but patients are the casualties of our myopic response to a changing healthcare landscape.

The burden of an aging population is often the go-to justification for why many of our processes seem clogged. Indeed, this changing demographic puts pressure on an already-struggling system, but people are aging around the world and many systems are faring far better than ours.

According to the Canadian Alliance for Sustainable Health Care (CASHC), our current healthcare system is plagued with inefficiencies that can't be blamed on simple demographics. We are burdened by outdated management, financing and governance models, and have been slow to adopt the "strong information and communication technologies" that CASHC states represents "the best opportunities for greater efficiencies" in our system.

So, it seems Pence and Sanders are both correct: we are failing to fulfill the promise of our health-care model, but we need to continue to fight for it.

There is no longer any excuse for not incorporating technology into our medical practices

We also need to remind ourselves of the five core principles of our system, according to the 1984 Canada Health Act: "universality (all citizens are covered), comprehensiveness (all medically essential hospital and doctors' services), portability (among all provinces and territories), public administration (of publicly funded insurance) and accessibility."

The Conference Board of Canada's Summit on Sustainable Health and Health Carein2012 challenged us to "fix the gateway to the health care system" and prioritize the development of interdisciplinary, primary care teams.In the last number of years, we have seen expanding scopes of practices for health-care professionals, including nurse practitioners, pharmacists and physiotherapists.

Why? Because the nature of primary health care is changing in significant ways and these professionals are tragically underutilized. If we truly believe in the "patients first" approach to care articulated in Ontario's Action Plan for Health Care that delivers on those core principles, we need to increase access to the range of health-care services, delivered by highly trained, regulated, allied health-care professionals other than physicians.

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Likewise, there is no longer any excuse for not incorporating technology into our medical practices. We have the ability to talk to each other in real time, to share information about patients in a secure, coordinated and highly effective way. We live in a technology-enabled age, yet continue to deliver modern health care with archaic tools. When health-care professionals are supported and empowered by accessible technology, there is a marked, positive impact on their efficiency, productivity, and the health and lives of their patients.

We also need to rethink our measures of success. Let's have open, even uncomfortable, conversations that focus less on what we spent on the system and more on the return on that investment. Are Canadians better off because we have spent our money as effectively as we could? Does our input correlate to acceptable outputs? Have we clearly established what those outputs should be?

Finally, we need health-care strategies that outlive four-year political mandates. Health-care decisions need to be made in the best interest of Canadians, not in the interest of the election cycle. We can't be afraid to do what must be done. We aren't dismantling our system; we are building on the vision of what our system was meant to be. We're fighting for the good of all.

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