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