Last week, the federal government pledged an additional $46 billion over 10 years to provinces and territories for health care delivery. Primary care, health care workforce, information sharing and mental health and substance use were cited as priority areas.
This much-awaited funding announcement left more than a few people disappointed. Provincial and territorial premiers were disappointed with the amount being offered. Indigenous leaders were excluded from negotiations despite their requests for to be included. And burnt-out health professionals did not receive the immediate help they needed to continue performing their demanding jobs.
Compared to resource-poor countries with low or middle incomes, we are indeed fortunate to have the universal health care system that we do, with access to well-trained health professionals, essential medications and cutting-edge technology. But if we compare ourselves to high-income peers, our health care system falls woefully short.
Despite being one of the top spenders on healthcare among OECD countries, Canada ranks near the bottom on availability of health professionals, hospital beds and equipment. Canadians spend 11.3% of GDP on health care (second only to Switzerland among OECD countries with universal health care), yet we rank near the bottom – 25th out of 26 countries – in number of hospital beds per 1,000 people, and second to last in the number of physicians per 1,000 people.
Given this under-resourcing, it is no surprise that we perform poorly on measures of timely access to care. Canada ranked last or next to last on four of five indicators of timeliness of care such as time to see a specialist or time waiting for surgery.
But we have the knowledge and the tools to make positive changes in the health care system to improve the well-being of Canadians. In a report entitled Taking Back Health Care, Dr. Jane Philpott (former federal health minister), Dr. Alika Lafontaine (current president of the Canadian Medical Association) and colleagues map out the road to health care reform.
“Primary care, traditionally provided by family doctors, needs to be broadened”
The report calls for every Canadian to be guaranteed access to a primary care provider or team within 30 minutes of where they live or work. Access to primary care should be a universal right for all Canadians in the same way that access to schooling is a right guaranteed to all children in our country. This recommendation is based on evidence that people with a formal connection to a primary care provider live longer, healthier and happier lives.
Primary care, traditionally provided by family doctors, needs to be broadened to include care by nurse practitioners, physician assistants and teams of health care professionals. A team approach with other professionals such as dietitians, social workers and mental health counsellors further improves health outcomes. Virtual care also needs to be integrated in a way that improves access to care and supports continuity of care for all.
The second pillar of health reform outlined in the report rests on using health data to both identify the health needs of Canadians that require funding and to monitor improved health outcomes as accountability measures for funding. To achieve this, health data needs to be collected and shared seamlessly within provinces and territories and across the country.
Government leaders need to use legislation and regulations to set standards for safe, effective, high-quality care and mandate their health agencies to share data, research and best practices. Also, Canadians need to have access to their own health data and be empowered to use this information safely and effectively to improve their health.
The third pillar acknowledged in the Taking Back Health Care report is recognizing health as an important component of the Canadian economy. We saw all too clearly during the COVID-19 pandemic, that when the health of a nation is threatened, the economy suffers immensely. Protecting and reinforcing the health of Canadians through robust health systems and emergency responses is essential to keeping the economy thriving. Health investments pay dividends by providing healthy workers and a stable environment for economic activity.
Health care also plays an important role in the Canadian economy by providing jobs, income and purchasing power for many. Health care innovations in technology, pharmaceuticals and vaccine manufacturing provide reliable access to essential health supplies and therapies and make us less susceptible to supply chain and geopolitical disruptions.
Cracks in the very foundation of our healthcare system existed before the COVID-19 pandemic, but they have now been exposed in a most distressing way. Canadians are mounting pressure on politicians for change, and in the aftermath of the pandemic, every level of government wants to be seen acting to improve the health of its voters. We have the knowledge, the tools, and the collective will to make it happen. Now is the time for meaningful health care reform.
By Vamini Selvanandan© 2023. This work is licensed under a Creative Commons CC BY 4.0 license. This article was originally published in the Rocky Mountain Outlook on February 21, 2023. Photo credit: Anna Shvets on Pexels.com
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