In view of the tragic death of Adam Burgoyne as a result of not being given timely medical treatment, I have compiled the links to my 13 articles on what ails our healthcare system. You can access these links from here.
A SYMPTOM OF A DEEPER DISEASE
On December 13, we learned about the tragic death of Adam Burgoyne, who had gone to a hospital to seek treatment (he thought it could have been a heart attack). Having been made to wait for many hours, he decided to go home, and died soon afterwards. This news has rekindled discussion about the sorry state of our healthcare system. A lot has been said about Adam Burgoyne’s case (see this report in the National Post as an example), and I don’t have anything of substance to add. However, having written extensively about the various shortcomings of our healthcare system in recent years, I thought that making the links to all of my articles on the subject accessible via a single link would be useful. Here are those links, together with a synopsis of the subject of each article. I hope this compilation will contribute to advancing the public debate in the direction of the sorely needed reforms.
Before I list the links, it is worth noting that most of the official data that I cited in these articles dates from the period 1970 to 2019. In light of the explosive growth in Canada’s population between 2020 and 2024, and without commensurate increase in healthcare capacity, I consider it almost a given that most – if not all – of the indices relating to healthcare have deteriorated, perhaps substantially. These indices were bad enough as of 2019, and I shudder to think what they look like now.
A 13-PART DIAGNOSIS
1. Canada’s Healthcare Crisis: In this inaugural article on healthcare, written in December 2021, I took a look at the reduction in the physical capacity in our healthcare system, both in per capita terms as well as in the overall numbers. Between 1970 & 2019, the number of hospital beds per 1,000 people in Canada went down from 7.0 to 2.5. Between 1993 and 2019, the wait time for treatment by a specialist increased from 9.3 weeks to 20.8 weeks.
2.Bitter Pills: One direct consequence of the reduction in physical capacity is that a very large cohort of Canadians don’t have a ‘primary healthcare provider’. This is a weakness in the very foundation of our healthcare system. In 2019, some 14.5% of Canadians did not have a family doctor. The widely held belief that Canada has ‘the best healthcare in the world’ is divorced from reality. Quality of care is relevant only AFTER it is available.
3. Delayed Delivery: What causes the above-mentioned foundational weakness is the fact that access to healthcare is determined by an administrative paradigm rather than a medical one. The foundational defect in Canada’s universal healthcare system is that its delivery is determined by an administrative process that is singularly focused on bureaucratic procedure, at the expense of actual medical outcomes.
4. Canada’s Healthcare Spending Drives Poverty: Increased spending on healthcare (as a percentage of GDP) means that we have less money left to spend on everything else. In 46 years, our healthcare spending went up from $1 out of every $14.29 of GDP to $ 1 out of every $7.87 of GDP. This means we have 45% LESS of our (increased) income left for every other expense. This is the equivalent of THE SAME AMOUNT of your monthly auto insurance premium becoming due every 16 days, instead of every month.
5. Canadian Healthcare IS NOT Underfunded: Whenever Canadian healthcare comes up for discussion, the argument that it is underfunded comes up. This is factually untrue. Many Canadians are convinced that the shortcomings of our healthcare system are primarily – if not solely – due to insufficient funding. But official data shows that this is not so & hasn’t been in a long while.
6. Measuring Misery: Since I did not come across any model by a mathematical economist to measure the COMBINED effect of the deterioration in our healthcare indices, I attempted one of my own. The combined effect of ever-rising healthcare spending AND ever-lengthening wait times is a complex form of misery that, if quantified, can help us work to improve our healthcare system. Here is my mathematical model to quantify this misery.
7. Checkpoint Charlie: The infamous entry-exit point between East and West Berlin serves as a useful analogy for the obstacles to access healthcare in Canada. Inadequate capacity in our healthcare system combines with inefficient methods to thwart patients’ entry into the system at multiple points. This is partly because recovered patients are often unable to EXIT from hospitals. Incoming patients cannot be accommodated until the outgoing patients are able to leave.
8. Own Goal: Private healthcare is considered as taboo in Canada. Our fanatical commitment to keep out 2-tier healthcare system is giving birth to a 2-tier healthcare system. But it’s hidden from sight, so we can continue pretending that we have a ‘universal’ healthcare system.
9. Control Matters: This article expands on the fact that a bureaucratic system, rather than a medical practitioner, decides when a patient receives the treatment that they need. In Manitoba, 200 patients need spine surgery. The province has 7 spine surgeons. And yet, the waitlist is years-long. ‘Universal healthcare’ takes the control away from the individual (patient), because ‘the system’ has to be in control.
10. Nursing Old Wounds: One aspect of healthcare that does not get talked about as much as the others is the shortage of nurses. Since this article was written, the firing of nurses who didn’t take the Covid vaccine has made the situation worse. Shortage of nurses is among the latest hot topics in Canada right now, but the problem actually goes back at least 13 years. In trademark Canadian fashion, we are paying attention only when the problem became a crisis.
11. Passing The Buck: Our ‘universal’ healthcare system is essentially a Ponzi scheme – and like all Ponzi schemes do, it is now facing a day of reckoning. Many people are agonizing over the prospect of young workers paying for the healthcare of boomers. But a taxpayer-funded healthcare system is essentially a Ponzi scheme – and with its monopoly in Canada, there is no way out.
12. Bottomless Pit: In March 2023, there was furious debate about Premier Ford allegedly ‘underspending’ on healthcare in Ontario. Recent media reports about the Ford govt ‘underspending on healthcare by $21.3 billion’ show, for the umpteenth time, that our debates on policy are prisoners of paradigm; thinking beyond the narrow confines of the paradigm is verboten.
13. Doctrinal Bounds: This is my last article on healthcare, and Part-2 of my earlier article ‘Bottomless Pit’. Obeisance to our ‘healthcare ideology’ requires that even the most glaringly obvious facts must be ignored if they go counter to the foundational tenets of the ideology. The blame for any problem must be deflected elsewhere.
I reiterate my hope that the above examination of the various components of our healthcare mess will prove to be useful in arriving at (at least some of the) badly needed solutions, to the benefit of all Canadians. If you have any suggestions about other aspects of healthcare that I did not cover in these 13 articles, please feel free to message me via the Contact page of this website, and I will be more than happy to look into those. Public policy requires public cooperation & teamwork, and I am confident that us Canadians will not be found wanting in that aspect.
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(Image Credit: Wikimedia Commons, Author ‘Skeezix1000’; the image is at this link. Used without modification under Creative Commons Licence)