The coronavirus hit Canada in March 2020. By the time that first wave had subsided in the summer, hundreds of thousands of scheduled surgeries had been postponed. But before that huge backlog could be reduced, a second and then a third wave of the virus struck, increasing the backlog by thousands more. Adding to the clinical risk of these surgical delays is the mental health impact of living with aggressive afflictions such as cancer.
Just as hospital wards became available to regular surgeries last spring, a fourth wave driven by the delta variant overwhelmed ICUs in Quebec and Ontario before moving west to plunge Saskatchewan and Alberta hospitals into their current crises.
The pandemic will eventually subside. While COVID deaths can be tallied, the death toll due to all those delayed surgeries is virtually impossible to determine, the path of each patient’s affliction being different. But given the hundreds of thousands who experienced both physical deterioration and mental stress due to treatment delays, that toll seems almost certain to be much higher than COVID deaths. COVID deaths were clearly a heavy blow, but so were the physical costs, heightened stress and, in some cases, accelerated deaths of those with other serious conditions who were denied access to health care.”
The real tragedy for families who lost loved ones due to COVID-triggered treatment delays is that those deaths occurred because our health care system was woefully less prepared than in other developed countries. Canada is the only country that went into the pandemic with zero unused hospital capacity and long waitlists. A 2020 Fraser Institute report comparing the performance of 28 countries with universal health care found that, despite having the second-highest spending per capita on health care, Canada ranked dead last in timely care, with the longest waitlists.
Our other health care resources have also been in steady decline. Canada ranked second to last in hospital beds per capita, which helps explain why so many surgical patients were displaced by COVID patients. Out of 28 countries, we ranked 26th for the number of doctors per capita and were also near the bottom in diagnostic equipment such as MRIs and CT scanners.
Canadians are prone to thumbing their noses at the American health care system, but our neighbour’s much-disparaged health care system was vastly better prepared for the COVID crisis. Compared with Canada’s virtually zero spare capacity, hospital bed occupancy in the U.S. was just 64 per cent at the beginning of the pandemic. The U.S. was hard hit by COVID but because it went into the crisis with ample unused hospital bed capacity and a world-leading 35 ICU beds per thousand population, nearly three times Canada’s meagre 12, it weathered successive COVID waves with little displacement of non-COVID patients.
How was our health care system allowed to fall into this sad, dangerous state? As the COVID crisis winds down, that’s a question grieving Canadians should demand an answer to. Given that we’re one rung from the top in the Fraser Institute’s ranking of 28 countries, the answer isn’t lack of funding. Then what is it?
Among those 28, Canada is the only one that outlaws private sector participation in the delivery of health care. Can you imagine if you could only get food from a government store or a vehicle from just one government company? Quality? Service? Innovation? Not likely! Gradual deterioration of quality, customer service and supply? Almost certain. And the outcome? Rationing via waitlists.
Prime ministers, premiers and health-care administrators have known for years that our sclerotic government-run monopoly system suffers the dual afflictions of unsustainable cost growth and ever-lengthening waitlists. Unions and other interests opposed to private clinics and hospitals vigorously perpetuate the myth that Canada has the “world’s best health system.” But the 28-country comparison clearly shows precisely the opposite.
Entrenched fear of private-sector participation impacted the recent federal election campaign when Liberal candidate Chrystia Freeland posted a Twitter video of Erin O’Toole stating he would allow provinces to “experiment with real health care reform including private for-profit and non-profit options.” Twitter later flagged Freeland’s post as “manipulated media” because it omitted O’Toole’s words “inside of universal health care.”
Liberal Leader Justin Trudeau repeatedly ignored that clarification, saying “Erin O’Toole confirmed he wants to bring private, for-profit health care to Canada …” It’s ironic, given the Liberals’ campaign focus on the perils of internet disinformation, that Trudeau’s use of Freeland’s deliberate deception helped the Liberals return to power.
Canada’s doctors, nurses and other health-care workers are world-class and highly dedicated. They have continually risked their own health doing everything humanly possible to balance the needs of both COVID and non-COVID patients, even as they face an egregious lack of facilities. They deserve our support, consideration and admiration.
But once the pandemic is behind us, Canadians should demand that Canada’s dangerous and dysfunctional government-monopoly health care system be opened to private-sector competition, as in every other country in the world.
Gwyn Morgan is a retired business leader who has been a director of five global corporations.