Imagine being told you need medical treatment, but have to wait for more than two months before you can get it. This is the average wait time experience for more than 900,000 Canadian patients. While some of them may be lucky enough to wait for their treatment without an impact on quality of life, others may endure weeks of pain and suffering. In some cases, patients waiting for treatment may no longer be able to do their jobs properly and may be forced to take time off work and forgo their income.
I had a vision of cultivating a practice where patients felt heard and cared for, and where I could provide full-spectrum family medicine care, including obstetrical care. My practice embraced the principles of patient-centered collaborative care. It employed the latest in 21st-century technology. I loved my work and my patients. But after five years of constant fighting with multiple private insurance companies in order to get paid, I ultimately made the heart-wrenching decision to close my practice down. The emotional stress was too great.
Young women with breast cancer present our healthcare professionals with difficult cases. They are often diagnosed with aggressive forms of breast cancer that require tough therapies. And the powerful treatments needed to stop the cancer can cause many complex side effects for young women, including early menopause.
Many doctors who work in group practices are now paid a flat fee, per patient, per year. It essentially means the physician gets the same amount regardless of whether you have just one appointment or 10 appointments a year. So a doctor paid on that basis doesn't really lose money if a patient misses an appointment. However, protecting the doctor's income is not the sole motivation for imposing a "no-show" fee.
The Liberal government of New Brunswick appears to be stepping back from the brink of mandatory prescription drug insurance. And so they should. The drug plan chosen by the Conservatives was designed on a false premise: that the private sector can better manage things than government can. In many sectors, that might be true. But not in health care.
The so-called "jewel of Canada's health system" is, in fact, exactly what sets us apart from the top-performing universal access health care systems across the developed world. Freeing patients to seek care on their own terms with their own resources actually more closely follows the European approach to health care where universally insured residents of countries like Sweden, Switzerland, Germany, the UK, and others have always had the option to choose private parallel care.
Those who suggest changes to the health care system are generally met with cries of "treason" and are invited to move south of the border. The superiority of our model to that of the U.S. has become such a part of our national identity that we've become reticent to experiment with new ideas. Calls for reform invariably spark fears of a plot to put an end to the free system and make us more like the Americans. So we're better than The United States, but should we really aim so low?
We actually know quite a lot about what makes Canadian health policy so effective. Population health approaches to improving social conditions, as well as public health prevention and health promotion measures taken across the country, have helped to reduce both chronic disease and acute illness. The Canadian portrait compares favourably to the American, but how does our healthcare investment compare to other developed nations in the study? Here, Canada falls short. Canada ranked 8th of 27 countries, while the US came in at 22nd.
In our quest for solutions to big health care challenges, we can sometimes overlook the low-hanging fruit -- i.e. the small, practical changes that can bring about substantial savings and better health outcomes. Case in point: the cost-savings opportunities in medication adherence through incentives, health IT and data applications.
Over the next three years, the Ontario government plans to begin partially funding hospitals based on the number of patients they treat and the quality of care they provide. It's an ambitious plan that could fall flat or set a new global benchmark. No country has yet managed to set a price on high-quality care.
Policy planners and health-policy experts can build their models and do their studies, but patients want high-quality service now, they want it free and they want it effective. They pay their taxes for a health-care system that is among the most expensive in the world. They are not getting enough value for money. Why not?
Last week, the family that owns Shouldice Hospital announced that it would like to sell its facility to Centric Health, a for-profit company. When it comes to providing complicated medical and surgical care that must be customized for each individual patient, non-profits are generally better. Selling medicare off, piece by piece, to large for-profit companies is the wrong approach.
Many Canadians have developed an insidious culture of self-satisfaction that comes with being told repetitively by politicians and media that we have "the best health care system in the world." We have somehow taken this patent lie as a slice of authentic Canadiana. It makes us feel good, safe and comfortable. But you don't have a "comprehensive and universal" system if it takes two years to get a hip replaced, or eight months to get an MRI after a hard knock to the head. How can we keep a straight face and call our system a caring and "universal" one if many have no where to go?