Our medical system's worth more - Keith Roulston editorial
As someone who has experienced the world with and without universal health care, the current situation with Canada’s health care is concerning during a time when we try to adjust to the stresses put on our system by the COVID-19 pandemic.
As I mentioned recently, I was among those affected by the pre-universal medical care system when I suffered from the now-forgotten rheumatic fever in the 1950s, before Prime Minister Lester B. Pearson created the national government-supported medicare system in the 1960s. My parents would have been financially crippled by the bills if I had been taken to hospital for a lengthy stay in the time before this was a government-sponsored service.
Instead, my doctor agreed I could be kept at home, in the days when most mothers stayed home anyway. A bed was set up for me in one end of the living room where mother was just a call away (and I’m embarrassed to remember, she was frequently called). I spent two months in that bed, visited regularly by my family doctor who had to plunge through snow up our thankfully-short laneway in those days before snowblowers, until I could go back in school.
Even in its current chaotic state, our system looks good by comparison, but it could be much better. In a Dec. 16 editorial, The Globe and Mail pointed out that one in seven Canadians 12 and older – almost five million – doesn’t have a family doctor.
Although the federal government got most of the credit for universal health care, the provinces, in Canada, are responsible for health care. Initially, the federal government picked up half of health care costs. Gradually it paid less, reaching a new low when the federal government found itself in financial trouble 20 years ago.
The provinces, though reluctant to accept universal health care, soon realized it was hugely popular. So, they began a revolution in our health care system with more, and larger hospitals. But as the public bought into the system, costs rose and provinces became concerned. The long-time provincial Ontario Progressive Conservative government lost power when it proposed closing hospitals, like those in Clinton and Chesley, in the late 1990s.
So other ways of saving money were sought. The Globe points out that Canada has the fewest doctors (2.8 per 1,000 population) of all the countries in the Organization for Economic Co-operation and Development (OECD). By comparison, Germany has 4.8 and Sweden 4.3.
It’s hard to get into Canadian medical schools. There are 2,800 first-year seats at 17 schools. Of those applying to get in, nine out of 10 are rejected. Many of those rejected go overseas to study, but it’s hard to be accepted in Canada after they graduate, so they work elsewhere, since they are highly coveted in a world where the World Health Organization says some six million doctors are needed.
Meanwhile, Canada is not only difficult to access for those Canadians trained elsewhere, but for foreign-trained doctors, too. Less than 40 per cent of foreign-trained doctors (about 5,000 doctors who immigrated to Canada between 2015 and 2020) have been working with patients. The rest are driving cabs or doing other less-meaningful work, awaiting permits to practise.
Meanwhile in Blyth, we no longer have a single family doctor to look after our needs. When I moved to town in the 1970s we had one doctor who lived and practised here and others from Wingham who had an office here. When that doctor retired, a doctor from Seaforth opened an office on main street and I became a patient. That office has been closed for years, though I remained a patient but had to go to Brussels or Seaforth. That doctor, too, recently retired but fortunately had a replacement.
Brussels hasn’t had a resident doctor for years, but fortunately has a medical/dental clinic, built as a centennial project, which still operates.
Family practice is not the most popular form of medicine for doctors in training. It’s much easier to be a specialist who works more-regular hours and gets paid better than a family doctor who works irregular hours, often having to serve hospital supervision when not in the office (though they work fewer, and more-regular hours than doctors of my childhood). So, fewer and fewer people have been choosing family practice, further reducing the care available.
Many doctors are nearing retirement so things could get even worse. To make our system work, we need more family doctors. We need to increase the number of training positions open, particularly for family doctors. We need to make it easier for properly-trained doctors to qualify to practise here by qualifying more, and faster.
Canadians have shown that government-supported medical care is important. If it means more expense, then we have to pay for it.