ANALYSIS: Why Canada’s Health Care Is in Crisis

The ballooning number of people dying while waiting for medical treatment is just one of the many symptoms of Canada’s current health-care crisis.

Surgical waitlist deaths have increased 64 percent nationwide since 2018, according to the think tank SecondStreet.org, which gathered health-care data through access-to-information requests.

The public policy think tank has also found that more than 3 million Canadians are currently on waitlists for surgery, diagnostic scans, or an appointment to see a specialist. That’s some 140,000 more than in 2022. The number could be upwards of 5.1 million, as some provinces did not report all of the requested data.

Over 6 million Canadians are without a family doctor, while thousands of doctors and nurses are commuting across the border for better work conditions in the United States, SecondStreet president Colin Craig told The Epoch Times.

“We’re definitely in a crisis,” he said. “You'll hear people suggest that our troubles are due to COVID. I would argue that Canada was in a very bad situation before COVID.”

He referred to a chart published by his organization showing the steady growth in the number of deaths while awaiting diagnostic scans in Ontario. The chart starts in 2015 with about 1,300 deaths and rises steadily to 9,400 deaths in 2023.

Many more such statistics have filled media reports this year, along with high-profile cases that put faces on those stats.

About a year ago, a 37-year-old mother named Allison Holthoff died after waiting for several hours in a crowded emergency room in Amherst, Nova Scotia. Not long after, 67-year-old Charlene Snow died under similar circumstances in Cape Breton, N.S., spurring a probe into the province’s hospital wait times.

In December, two people died in the crowded emergency room of Anna-Laberge Hospital in Montreal. The hospital was consistently over-capacity, up to 200 percent, says Dr. Gilbert Boucher, president of the Association des spécialistes en médecine d'urgence du Québec.

“At 200 percent there are people everywhere. You basically put patients anywhere they will fit. Computer systems have problems keeping track of those patients. The ratio of nurses per patient explodes,” Dr. Boucher told CTV.

The Epoch Times spoke with Mr. Craig and Dr. Shawn Whatley to discuss the root problems and possible solutions. Dr. Whatley is a practising Ontario physician and author, whose latest book is “When Politics Comes Before Patients: Why and How Canadian Medicare Is Failing.”

‘Faulty Thinking’

“Part of it is just simply faulty thinking,” Dr. Whatley said. For example, the lack of hospital beds isn’t so much a matter of resources as it is of planning, he said.

Beds are always available in the maternity ward because hospital administrators aim for 80 to 85 percent capacity, he explained. But the thinking has increasingly been that other wards can regularly go up to 90 percent or 100 percent. He says once you set the norm that high, the flow stops.

“If you aim for a bed capacity over 83 percent, it will block up. You can’t get people in; you can’t get people out. The flow of the whole system stops,” he said.

It’s related to queueing theory, a mathematical theory that’s long been used to look at the flow of people anywhere there’s a queue.

“If a mom wasn’t able to get a bed in the hospital when she’s delivering, the minister of health would lose his or her job. There would be protests on the streets. Society will not tolerate that, so hospitals always maintain that capacity [in the maternity ward],” Dr. Whatley said.

If the maternity ward mentality were applied across the board, he said, Canada could return to the level of care it once offered.

He noted how the number of hospital beds per 1,000 people has decreased over the decades until finally Canada is among the worst countries for hospital capacity in the developed world.

In 1976, Canada had nearly 7 hospital beds per 1,000 people. That number steadily declined, dipping below 3 for the first time in 2007, and was at 2.58 in 2021, according to Statista.

Among 34 Organisation for Economic Co-operation and Development (OECD) countries, Canada is fourth last for the number of acute care beds, with 1.97 beds per 1,000 people in 2019, according to latest OECD statistics published in 2021. Japan had 7.7 beds per 1,000 in 2019.

Paramedics are seen at the Dartmouth General Hospital in Dartmouth, N.S., in a file photo. The Canadian Press/Andrew Vaughan

Canada’s population is aging, something experts have long expected, Dr. Whatley said. The hospitals should have prioritized increasing the number of beds, he said.

“We’ve done it. We did it all through the ’60s, ’70s, early ’80s. It was only in the 1990s, at least in Ontario, that we really started cutting beds. So it has been done. I’m not sure why we couldn’t do it again,” he said.

While there’s much talk about staff shortages, Dr. Whatley said, that could be alleviated by cutting down the amount of paperwork physicians have to do. They would be free to see more patients.

He gave the example of the paperwork involved in examining a child with an earache. In the 1980s, a doctor would write a couple of quick shorthand notes: “AOM” for acute otitis media (an inner-ear infection) and a quick note that he prescribed amoxicillin.

“Now, you not only need to document everything that led up to that patient presenting to you, you need to document all the things that you thought could be going on that aren’t going on,” he said.

For example, a doctor may note the child doesn’t have a stiff neck, didn’t hit his head, doesn’t have tonsillitis, and so on. Doctors also include notes like “no evidence of trauma, good interaction with the parent,” and other social issues, Dr. Whatley said.

Private-Care Options

Mr. Craig of SecondStreet said staff shortages are aggravated by poor working conditions in government hospitals.

“When we talk to nurses in Ontario who choose to work across the border in Michigan, they‘ll tell you things like, ’Well, I like working in Michigan because I can work a nine-to-five job, have that stability,'” he said. “They can plan their lives around it, rather than having rotating shift work or being offered part-time positions and having to constantly pick up shifts randomly here and there to make a living.”

While many fear private facilities could drain qualified staff from public hospitals, Mr. Craig believes an increase in private-care options could help.

“We went to Sweden this year to talk with people over there about how their health-care system works. One of the people who’s been involved in reforms for years noted that when you have more employers in health care, you end up with more employees,” he said.

Canadians are already travelling out-of-country to get private treatment, Mr. Craig noted. Adding more private options while continuing the public system in Canada could be a good solution, he said.

Ontario, for example, is increasingly allowing patients to use their provincial health card to get publicly funded surgeries at private clinics. Saskatchewan has also had success with this model, he said.

Mr. Craig cited the recent case of cancer patient Allison Ducluzeau in British Columbia. Doctors gave her a couple of months to live, saying they couldn’t help her. She was offered medical assistance in dying (MAID), she told Global News.

She then sought care in the United States and is now recovering well.  She has been trying to get reimbursement from the B.C. government for the care she received across the border.

Mr. Craig said the European Union has a patient-first model, where patients can go to other countries for surgery if the wait times are longer in their home country. They’re then reimbursed by their government for the cost.

Governments in Canada have long known about the aging population now affecting the health-care system, but they’ve failed to prepare for it, Mr. Craig said. They have also increased spending per person at double the inflation rate over the past 30 years, he said.

“They’ve spent 30 years throwing money at the system and hoping for the best, but they never took the time to reform the system,” he said.