The Collapse of Canadian Public Healthcare

Sign the open letter to protect public healthcare in Canada

Here's the text of the open letter:
To Prime Minister Trudeau and Health Minister Duclos,

We the undersigned are calling on you to take immediate action to prevent further collapse of our healthcare systems across the country.
Our public healthcare system is the pride of Canadians and you have the power to protect it. Medical professionals, nurses unions, and tens of thousands of everyday people are calling for:

• Predictable and sustained public funding
• Immediate introduction of universal pharmacare
• Implementation of long-term care standards and funding to enforce them

We urge you to take action now before it's too late.

Patient dies while waiting hours to be seen in New Brunswick emergency department

The death of a patient in the waiting room of a Fredericton hospital's emergency department this week is prompting calls for major improvements to the province's health-care system.

John Staples, a residential support worker, witnessed the incident early Tuesday morning as he waited with a client at the Dr. Everett Chalmers Hospital and posted details on social media.

He said the man appeared to be in a lot of pain and discomfort as he waited for hours in a wheelchair but eventually appeared to fall asleep.

"The ER attendant came out to check on people and checked on him," Staples said in an interview Wednesday. "She scurried back to the ER very professionally, not to raise any alarms and came back with a few other people. They wheeled him to the back and as they did, they called a Code Blue," he said, referring to the hospital code for a cardiac or respiratory arrest.

"Unfortunately the gentleman passed away right there with us. He was literally at the threshold of getting medical attention and did not get it."....

Once again, it seems using an old operating system is preventing me from signing the petition.

It really is disturbing how privatization options are mushrooming all over the healthcare landscape as we fail to properly fund universal healthcare. The Canadian Blood Services deal with a giant foreign pharamceutical giant is alarming.

In the U.S. having to go bankrupt because of health care bills isn't a laughing matter.

Who said it was?

JKR wrote:

In the U.S. having to go bankrupt because of health care bills isn't a laughing matter.

That's the conundrum.
Prices in the US are insane, but you get immediate access.

In Canada it's covered, but you could wait 6, 8 months for a test meanwhile an illness is just exploding inside your body. By the time you're tested 8 months down the road surprise, it wasn't caught in time to save you. Or your kids.

Mental health services is another good (bad) example. People wait years to get mental health support and help. How many people die by suicide or addictions while they're waiting? I know of a young man who just ended his life a few months ago while waiting for mental health services.

How much did the visit to the hospital in the US cost or did you have travel insurance. The way to get people to accept the erosion of our public services is to under fund them. The US needs single payer insurance and Canada needs to invest in health care at all levels. Across Canada we have had two or three decades of successive governments who "trimmed the fat" in health care. Its like the same MBA's who invented just in time inventory systems were let loose in our health care system. The BC Liberal's fired tens of thousands of health care workers, in breach of their Charter rights.

I remember when my brother was in the hospital ten years ago there were signs everywhere showing how efficient they were at throwing people out of care. So efficient he was in and out of the hospital numerous times for the same conditions before they had plateaued. As a disabled person on government assistance he would have not even got close to a hospital in the US to get the less than optimal care he received here.

kropotkin1951 wrote:

How much did the visit to the hospital in the US cost

Not a single dollar. My employer paid for it. I would still rather pay thousands of dollars to have my kid tested now than wait to have them tested in 6 months for free.

I'd rather pay to have their broken arm fixed now than have it fixed for free in 18 hours.

Paramedics feel the pressure, as a city runs out of ambulances

quote:

With lights flashing and sirens blaring, they race to the call's address and assess the patient; he needs to go to the hospital. Moving quickly, the drive to the Queensway Carleton Hospital, in Ottawa's west end, is fast. But as the paramedics arrive at the hospital, the rush of activity stops. 

There are six ambulances already parked outside and the emergency room is packed. 

The two paramedics will have to wait with their patient, monitoring him, until his care can be transferred to the hospital. "Essentially, we're stuck here," said Waterhouse. 

The experience is known as an "offload delay." It means their ambulance will stay parked at the hospital for now, rather than head back out on the road, where it can respond to other incoming 911 calls.

"While I'm here with this patient, I might be here for hours. I can't respond to a call. All of these paramedics are taken out of commission while we're waiting to get out of the hospital," said Waterhouse. "So you have a smaller amount of circulating ambulances in the city to respond to emergencies."

That waiting time adds up. Last year, the Ottawa Paramedic Service took 72,000 patients to hospitals and spent 49,000 hours waiting in offload delay. During the first five months of 2022, paramedics in Ottawa have spent 25,000 hours waiting at hospitals, with the 28,000 patients they have taken there.....

..with the new legislation coming it could fit right in with the privatization of health care. 

Why we’re about to hear that Big Pharma is the victim

It is a peculiar time, to put it mildly, to be arguing for higher drug prices in Canada. Inflation is surging in every part of the country, confronting poor and working-class people with excruciatingly difficult choices. As wages and benefits erode, a growing share of Canadians are forced to ask themselves: do I pay the rent, buy groceries or fill my prescriptions?  

But in anticipation of pharmacare legislation, Big Pharma’s defenders are bravely leaning into this difficult task. In the upside-down world of pharma industry propagandists, “economic fairness” is about getting Canadians to pay three and a half times more than they currently pay for prescription drugs. 

Shrill denunciations of Canada’s modest attempts to control drug prices are common fare for the industry’s hired guns. Brett Skinner and Nigel Lawson of the Big Pharma-linked Canada Health Policy Institute have portrayed the Trudeau government’s half-hearted efforts to bring drug prices in line with European levels as “extreme” regulation that “reflects Soviet-style thinking on price controls.” 

In another piece criticizing Canada’s “unhealthy obsession” with lower drug prices, Lawson (with a co-author from an industry-funded patient group) accused “out of control” federal regulators of waging “an anti-industry, anti-patient witch-hunt.” 

Reading the Financial Post opinion pages, one might expect to see pharmaceutical executives marched off to the gulag any day now. In fact, relations between Justin Trudeau’s Liberal government and the industry have never been warmer. 

The government agency tasked with regulating pharmaceutical prices, the Patented Medicines Price Review Board (PMPRB), has done a poor job keeping a lid on drug price inflation. Canada’s drug prices might be lower than the U.S., but they are much higher than all other wealthy countries. A 2015 10-country study found that on average, Canadians paid 60 per cent to 105 per cent more for prescription drugs than other countries, all of which had universal public drug insurance. 

Costs have been soaring, with severe consequences for low-income people’s access to medications. Nearly a quarter of Canadians (23 per cent) tried to make a prescription last longer by splitting doses or not filling a prescription in the past year because of cost, according to a 2020 Angus Reid poll. 

Undeterred, Richard C. Owens has taken up the noble cause of explaining to Canadians why they should feel sorry for these massive corporations in a recent Financial Post opinion piece. Times are tough for Big Pharma, Owens tells us, due to “confiscatory” price controls which mean companies can barely afford to do any research into new drugs anymore. Pharmaceutical companies are “victims” of a regulatory regime that amounts to government-backed gangsterism. 

Rather than move in the direction of greater affordability by adopting European-style policies of universal pharmacare, Owens would have Canadians suffer the same fate as Americans (“the only honest payers”) in the name of defending pharmaceutical profits. Incredibly, Owens claims that patients would be “the greatest beneficiaries” of letting prices rise to American levels—though it is hard to see how lower-income Canadians could possibly benefit from drugs they can’t afford.

Owens, an intellectual property lawyer and academic affiliated with the Macdonald-Laurier Institute, fails to mention that Americans have the highest rates of medication rationing in the advanced capitalist world, because of the inflated costs of drugs. High prescription drug prices in the U.S. are costing working-class people their savings, their health, and even their lives. It’s no wonder that politicians on both sides of the aisle are calling for action to reduce drug prices for Americans......

Out-of-province partnerships to speed up hip, knee replacements for Manitobans: task force

Three recently inked partnerships with out-of-province clinics will help hundreds of Manitobans waiting on hip and knee replacement surgeries access care quicker.

The partnerships were announced by Manitoba’s Diagnostic and Surgical Task Force, the group formed to shrink the province’s lengthy backlog for surgery and diagnostic testing.

The clinics are in northwestern Ontario, North Dakota and Ohio.

Task force chair Doctor Peter MacDonald said people can begin to seek care at these locations in the coming weeks. He said once someone is approved for out-of-province care, their physician and members of their health-care team will work closely with out-of-province providers to ensure a smooth process.

He said the province is putting in place for the first time a process to allow patients to self-identify if they are interested in travelling out of the province and are on a waitlist already for hip and knee replacement.

Eligibility requirements can be found on the task force’s website.....

..i would like to see mental health added to the integrated teams talked about below. all said this sounds like a beginning point of a conversation about how we shape a universal health care system going into the future. 

Breaking the Primary Care Logjam

Physicians and voters support the solutions. What should we do if politicians won’t implement them?

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The recent tsunami of primary care-focused media reminded me that I was asked in 2015 by the Institute for Health System Transformation and Sustainability, a non-profit that gathers, develops and shares evidence about British Columbia’s health-care system, to explore with family doctors how they practiced their craft, and how they would like their practices to function. The resulting report, “Physician Heal Thyself,” was oddly prescient in illuminating paradigms for how primary care should be delivered, and eerily similar to the ideas reverberating in today’s public conversation around the future of primary medicine.

We interviewed 30 family physicians individually or in small focus groups, representing a variety of practice formats including individual and group practices, integrated care teams, walk-in clinics, locum placements and hospitalist positions. They represented a wide range of experience, from newly practicing family doctors to those close to retirement. Almost all had worked in walk-in clinics at some point, either during the project or in the past. (Our focus was limited to physicians, as nurse practitioners were only just becoming more prominent in the primary care system; in hindsight, the lack of nurse practitioner input is one shortcoming of the report.)

quote:

When asked to imagine their ideal practice, for themselves and their patients, participants instead described working in a group practice or an integrated health-care team, with characteristics that included:

• Compensation via salary, based on number of patients rather than payment for each specific service performed. Complexity of patient health issues could be considered in this model, physicians suggested, so that salary might be based on a combination of number of patients and complexity of care;
• A full-time practice would be capped at a maximum of 1,500 patients per physician, with a lower maximum for practices with higher numbers of patients who presented complex health issues, including but not limited to disability, being elderly, addiction, pain and diabetes. Duration of each patient visit would vary from 10 to 30 minutes, depending on the complexity of care required;
• Benefits including vacation pay, their own health-care plan, pensions and possibly some formula to reduce debt from medical school tuition, perhaps forgiving a portion of student loans for every year in practice after medical school; and
• A provincially funded administrator to manage the business component of a primary care group practice.

Many physicians wanted to see practices with an integrated team that included other health professionals covering areas such as mental health, substance use, nutrition and physiotherapy. Most physicians also supported including nurse practitioners on these integrated teams.

Group practice, physicians said, would allow for the scheduling of evening and weekend office visits, with doctors taking occasional slots in addition to their scheduled weekday availability.

One surprise from our interviews was that many physicians believed there were enough doctors in B.C. to adequately serve our population. If group practices made good use of nurse practitioners — and if the province moved doctors away from walk-ins, towards group practice — there would be enough available family physicians to go around. 

quote:

This begs a question: why can’t we just get there?

It’s not COVID — while the pandemic has had serious negative impacts on the delivery of pretty much every aspect of health care, the primary care shortfall has been a prominent issue for Canadians for decades.

Instead, it’s political.

Our provincial and federal governments often favour policies with the appearance of action — but without the bold systematic changes required to solve runaway issues.

quote:

So perhaps it’s time to take control of how primary care is structured away from health and government experts and try a different approach.

A citizen’s assembly, in which a representative slice of 150 or so B.C. residents spend six months studying and then proposing how primary care should be delivered, might be one way to break the logjam that currently separates 900,000 British Columbians from primary health care.

Citizen’s assemblies are especially useful when there’s been a long-term lack of progress via electoral or traditional public policy avenues, as is the case for primary care. And they can be particularly effective when linked to a commitment from government to implement their recommendations.

The tepid and largely unsuccessful government responses to the primary care crisis in B.C. and Canada are just not providing the health care we need and deserve......

Ontario's healthcare system is 40% private already - wow, I had no idea? What is the % in other provinces? I had no idea how badly the erosion of our universal healthcare system was. 

It's truly alarming and many of these politicians on the federal and provincial levels are probably going to use the pandemic as a pretext to further gut the public system and we sheep will follow willingly to the slaughter of our public healthcare system. 

Well I guess it depends on what their definition of "private" is, JKR. I agree, family doctors and specialists outside the hospital setting and including clinics are operating as private small businesses but they bill our universal public insurance system so there are no charges to the patient/client. But in some provinces, there are corporate run health services like imaging services that for the time being are covered by public health. 

..this was an actual study reported on in 2017. and acted on. 

Medically assisted deaths could save millions in health care spending: Report

New research suggests medically assisted dying could result in substantial savings across Canada's health-care system.

Doctor-assisted death could reduce annual health-care spending across the country by between $34.7 million and $136.8 million, according to a report published in the Canadian Medical Association Journal on Monday.

The savings exceedingly outweigh the estimated $1.5 to $14.8 million in direct costs associated with implementing medically assisted dying.

"The take-away point is that there may be some upfront costs associated with offering medical assisted dying to Canadians, but there may also be a reduction in spending elsewhere in the system and therefore offering medical assistance in dying to Canadians will not cost the health care system anything extra," said Aaron Trachtenberg, an author of the report and a resident in internal medicine at the University of Calgary.

quote:

After June 17, 2016 when Bill C-14 became law, provinces began rolling out their plans to deal with requests for doctor-assisted death.

Manitoba has set up a Medical Assistance in Dying team (MAID). More than 100 patients have contacted MAID, with 24 receiving medically assisted deaths as of Jan. 6.

"In a resource-limited health care system, anytime we roll out a large intervention there has to be a certain amount of planning and preparation and cost has to be a part of that discussion," Trachtenberg said, adding the provinces' differing plans could impact the cost structure of implementation.

"It's just the reality of working in a system of finite resources."....

NDP accuses Manitoba government of health-care privatization plan again after premier talks up partnerships

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NDP Leader Wab Kinew says Stefanson's comments show the Tories are forging ahead with plans to privatize health-care, while the public system struggles under the weight of severe staffing shortages and long waits for care.

"Knowing what we know about the PCs, knowing what we know about the people who have the premier's ear, we know that they want to increase access to private health care in Manitoba and they're going to continue testing the limits of private health care and what they can get away with," he told a news conference Tuesday near the Health Sciences Centre in Winnipeg.

The Opposition leader referenced the province's decision to send 150 to 300 spinal surgery patients to Fargo, N.D., as one example of the encroachment of private health-care into the public system.

quote

Kinew, however, alleged the Tories are pursuing private options before first bolstering the public medical system.

With a provincial election coming next year, Kinew said an NDP government would spend more money on health care and promote a better vision for improving the system. He said they'd also work with nurses and their representatives to stop reliance on mandatory overtime.

Kinew also suggested an NDP government could mend the relationship between the province and health-care workers.

quote

Although he expressed hesitation about the surgery partnership with Fargo, Kinew wouldn't rule out all private partnerships, such as the procedures done with the Western Surgery Centre in Winnipeg. Kinew said he would abide by the Canada Health Act, which ensures Canadians have access to quality health care without financial or other barriers.....

I heard interviews with her caregiver who was with her when she died and another close friend of hers who met her as part of an online community of disabled people in Winnipeg. Their sorrow was palpable and it was heartbreaking to hear. The key message I heard was not a total lack of supports, but a bureaucratic approach to support - meaning hospice care or institutionalized long term care.

Her home, her garden and her dog where lifelines to her sense of wellness and keeping her there was not supported enough :-(

Patients, unions unite to fight Ford

The Ontario Health Coalition (OHC) held a dynamic organizing conference over two days at the start of October. It brought together hundreds of activists from across the province, in person and on zoom, representing grassroots groups and unions. A large number of local organizations have developed in the last years in many towns and cities under the umbrella of the OHC. It has brought together both residents and health care workers committed to fighting the attacks on our public health care system.

There was a real sense of the urgency from those participating both from urban and rural areas. They felt that their work against the privatizing of health care has led to a 5% drop in popularity for Premier Doug Ford since the provincial election. The Conservative government had passed legislation forcing seniors out of hospitals into long term care (LTC) facilities far from their homes unless they are prepared to pay $400 daily. They have no choice. The OHC activists are committed to continue the fight against this callous disregard of people’s needs. 

The key issues people across the country are concerned about are the cost of living and health care. The reasons are obvious. There has been a concerted drive by governments for decades to assist for-profit corporations in taking a larger and larger portion of the sector. The government has created a crisis and put this forward as the only solution. There is a huge need for more spaces to relieve the pressure on hospitals and families. 

The province of Ontario is providing money for 30,000 badly needed new and rebuilt LTC beds, but the vast majority are going to for-profit companies. They have the worst record of resident deaths, neglect and inadequate care during the pandemic, but it doesn’t matter to these free market ideologues. There were demonstrations in front of many of these institutions, rallies at the provincial legislature, summits across the province, meetings in community centres and union halls, and yet nothing was done and now these same corporations are being rewarded. There is an ideological assault on public services and the OHC has taken a strong stand against it, mobilizing communities to raise their voices and fight back.

It has strong support from hospital unions, and private sector unions are supporting the organizing as well. There were contingents from many of them at the conference lending their weight to the campaign.

The fight against the rising cost of living is also continuing. The Canadian Union of Public Employees (CUPE) just had a 96.5% strike vote among support staff at Ontario schools.....

..3.16 min video. transcript available.

Busting myths about privatized healthcare