The front entrance of Victoria General Hospital in Victoria, B.C. (Credit: Dirk Meissner/The Canadian Press files)
How often do you hear of parents who have taken a sick or injured child to a hospital emergency, only to wait agonizing hours before even an assessment from overwhelmed admission nurses? The eight-year-old daughter of a carpenter doing some work for us recently waited in great pain from noon until 11:00 pm before triage for a serious injury.
Unsatisfactory care is not uncommon in Canada’s health care system. How many families lack a family doctor? How many injured workers wait so long for treatment that their deteriorating skills make them permanently unable to return to work?
As economist Nikolai Wenzel reminded us earlier this year in a post for the Foundation for Economic Education, the long wait times in our health care system are the symptom of a deep problem: “In 2023, more than 1.3 million Canadians abandoned emergency room visits due to excessive wait times. Some hospitals have exceeded 200 per cent capacity, forcing patients into hallways and onto floors.” Two years on, Canada’s government health care monopoly has deteriorated even further.
Research by Calgary think tank secondstreet.org has found that upwards of 15,000 Canadians a year die while on waitlists for diagnostic scans or surgeries, with the true number likely being higher, as not all provinces report this statistic. And, as Fraser Institute senior fellow Nadeem Esmail points out in a recent commentary, despite our universal system being one of the most expensive in the world, we have the longest waits among rich countries to access physicians, diagnostic scans and hospital beds. Noting that while running for office Mark Carney promised to “defend the Canada Health Act and build a health care system that Canadians can be proud of,” Esmail concludes that “unfortunately, to have any hope of accomplishing the latter, he must break the former.”
Another Fraser Institute commentary by Mackenzie Moir and Bacchus Barua references the results of the U.S.-based Commonwealth Fund’s annual health policy survey of high-income countries. Canada continues to rank last or next to last on timely access to care. One likely reason? All countries except Canada allow, or even encourage, private-pay access to health care.
How did things get so bad? In his recently published memoir, My Fight for Canadian Health Care, Dr. Brian Day, orthopedic surgeon and former head of the Canadian Medical Association, describes how through the 1980s Medicare dealt with tight budgets by progressively reducing surgical time, from 20 hours a week all the way down to five. Day and several associates eventually decided to open Cambie Surgery, a small private surgical centre that offered many types of surgery, often at half the cost of the public system, sometimes even less. “Prior to our opening,” he writes, “many complex procedures were only performed in public hospitals. By transferring them to our centre, public hospital wait times were reduced and capacity was increased.”
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Dr. Day’s clinic operated without much government interference until 2009, when the B.C. Nurses Union pressured the provincial government to shut down private clinics under the new provincial Medicare Protection Act. Thus began a long and costly legal challenge that went from provincial court to the B.C. Appeals Court. The Appeals Court ruled against Cambie Surgery despite the judge’s acknowledgement that “wait times in considerable measure flow from government rationing of health care.” His further comment, “I will await the Supreme Court’s decision,” made it clear he fully expected the case to be decided by the Supreme Court of Canada. A retired Supreme Court justice who had been advising Dr. Day’s challenge said, “They’ll have to hear the case because very few matters are more important than health care.” But in the end the Supreme Court decided not to take the case.
How does Mark Carney plan to fix our dangerously dysfunctional health care system? A Liberal media release during the election campaign promised to “add thousands of new doctors.” That would require a big increase in medical school enrollments.
That many more doctors, if they could be found, would certainly help. But the over-arching problem is that the Canadian health care system is a dysfunctional government-run bureaucracy, made much worse by the disallowance of private competition. Government-run bureaucracies almost always fail and usually at a very high cost. There’s no higher cost than the tragic toll taken on millions of ill, injured or dying Canadians.
Financial Post
Gwyn Morgan is a retired business leader who has been a director of five global corporations.