Canada’s Health-Care System Is in Desperate Need of Reform

By Conrad Black

It is a notorious fact that the Canadian health-care system is a shambles, and yet, until recent promising developments in Ontario, and apart from some toleration of private medicine in Quebec, our governments, from sea to sea, are doing practically nothing to alleviate a terrible problem.

Most readers will easily remember when Canadians were so proud of their health-care system it was frequently cited as one of the reasons why it was better to be a Canadian than an American. For decades, it was a key component of the unique Canadian preoccupation of explaining why we should persevere as an independent nationality rather than fold our sovereign hand into that of our prodigious neighbour.

One must go to the often very abrasive relationships of ancient peoples of Europe to find a jurisdiction where the subject of whether it should simply assimilate to its neighbour is a regular subject of political discourse. It is understandable that these considerations would intrude into the minds of Moldovans contemplating Romania, or Greek Cypriots contemplating Greece. But that such questions regularly arose in Canada is a testament to the sluggishness of our progress, which is far from complete, from a quasi-colonial dominion and economic branch plant to a fully fledged G7 power.

Ironically, American mismanagement of illegal immigration and the lingering legacy of slavery—combined with the constitutional right to bear arms and some sort of complicated guilt complex about the overwhelming and bloodless triumph of the United States over the Soviet Union, leaving it alone at the summit of the world’s countries for a time—have effectively eliminated the temptation of some Canadians to join that country. However, despite these problems, and despite generally indifferent-to-poor government under most of the post-Reagan presidents, the United States has steadily extended its lead over Canada in per capita prosperity, and now, for the first time, every one of the 50 U.S. states has a demonstrably higher standard of living than any province of Canada.

Canadians need to know why our competitive economic position has eroded so severely at the same time that our once-vaunted universal health-care system—which Justin Trudeau boasted about with American late-night television host Stephen Colbert a few weeks ago—arrives at the brink of complete collapse.

Obviously, an economic relaunch with a less onerous tax system adapted to entice investment and take full advantage of our natural resources treasure house whose energy, base and precious metals, forest products, and agriculture are in high demand in the world, will have to be put in place by a new government as soon as it is installed. This will presumably produce greater resources to allocate health care, but it will not in itself solve the chronic problems of our health-care system.

There are three basic problems that will have to be addressed. One is Canada’s desperate shortage of doctors, having one of the lowest ratio of doctors per unit of population of any advanced or even semi-advanced country. Argentina, Cuba, and many other countries less wealthy than Canada have more doctors per capita. Another is that our system is horribly inefficient and consecrates the highest percentage of health-care expenses to administrative as opposed to direct medical care of any comprehensive national health-care system. And the third is we still are conducting a dishonourable rearguard action against private medicine, because former Prime Minister Pierre Trudeau and his health minister, Monique Begin, capriciously determined that everyone in the country should have an equal standard of health care, even though it should be obvious that goal was neither possible nor desirable.
If those of higher incomes had a greater access to health care, they wouldn’t have to go to other countries as often as Canadians do for prompt and efficient treatment, and more health-care resources would be available to economically disadvantaged people. These problems are very visible in the unconscionable waiting lists for important treatment throughout the country. It is a shameful fact—though the exact proportions of the problem are skilfully disguised—that a large number of Canadians whose lives could be saved if they were treated promptly, die unnecessarily waiting for their turn for urgent treatment.

While many Canadians were bragging about our status as a universal health-care country to distinguish us favourably from the United States, we were in fact rationing health care in many specialized areas. What we had was universal access to some level of care, but in a great many cases, an inadequate level of health care.

We’re going to have to expand very quickly and substantially the number of medical doctors that we graduate, and much more promptly admit to medical practice those that we attract from other countries. We’re going to have to overhaul the administration of our health-care system so that the heavy majority of our investment in health care goes to direct medical attention for the entire population and not to a bureaucratic morass.

As for private medicine, of course we must have it, and of course it is no business of any government to try to ensure that absolutely everyone, regardless of their means, receives an equal level of medical treatment. This is a recipe for assuring that no one receives adequate medical treatment. It is the business of government to ensure that everyone receives basic adequate prompt medical treatment, and that those capable of gaining enhanced treatment for themselves are at liberty to do so.

There is another philosophical and practical problem with the Canadian health-care system that is becoming steadily more worrisome. Partly because of the increasing breakdown of the standards of health care in this country, increasing emphasis is being placed on the virtues of encouraging sick people, and especially elderly people, to contemplate the virtues of suicide, i.e., to accept assistance in ending their lives prematurely. It is the purpose of health care to extend life, not to shorten it. Obviously, in practice, everyone has the right to end their lives if they wish, though in most cases, such wishes are temporary and surmountable, and life, not death, should be encouraged. But the fact that our health-care system is now preening its bedraggled feathers over its skill at “medical assistance in dying” (MAID), is not only aberrant and perverse but is a dangerous step towards the commoditization of life and an assault upon any concept of the sanctified or spiritual aspect of life.

Our health-care system, which was supposed to ensure better medical care for all those who had difficulty obtaining it, is now in effect starting to substitute assisted suicide for genuine care. The judicial basis for this was a very weak Supreme Court judgment, and Canada is advancing into a field of immense moral implications stealthily and with completely inadequate consideration of both the moral and practical implications of such a course.

Our entire health-care system desperately needs a radical re-examination and reform.

 

First published in the Epoch Times