Help us raise $150,000 by December 31
The US spent the weekend gripped by the story of a man who assassinated the head of a healthcare insurance company notorious for denying claims. It felt as if the country was ready to storm the Bastille. But Canadians shouldn’t feel smug while watching Americans’ outrage boil over; at the same moment, Canadians are struggling to survive and make ends meet after being diagnosed with cancer or other major illnesses.
Universal public health insurance has long been a point of pride in the country, a system often touted as fundamentally or uniquely Canadian. But our system is not uniquely Canadian, nor is it the envy of the world. It may be the envy of many in the United States, where millions are without health insurance, leading to hefty medical debt and insurance premiums, and even bankruptcy. But we really should set the bar higher than that.
The tendency to let ourselves off the hook by comparing our healthcare system to the US and by ignoring that other countries have universal healthcare, too (often better systems than ours) allows us to downplay or ignore altogether the deep flaws and outrageous consequences of our own crumbling system.
The Canadian system is preferable to the American system, but that shouldn’t leave us satisfied with the status quo. As the Toronto Star’s Janet Hurley reports, medical diagnoses, including cancer, can devastate patients beyond the immediate risk to their health. The Canadian Cancer Society finds that cancer patients, on average, are left to pay $33,000 to manage their cancer, a figure that includes lost income and travel for care. Few people can afford that cost – or even a fraction of it.
If you factor in other elements of total healthcare, including dental care, prescription drugs, vision care, and mental health care, the costs Canadians incur are quite high indeed, notwithstanding recent efforts by the federal government on dental and prescription drug plans for some Canadians. Considering ancillary costs, like the aforementioned medical travel, foregone income and others, gives us a better picture of what illness actually costs Canadians.
Healthcare spending itself is merely a part of the cost of care. In 2024, the federal government transferred roughly $264 billion — about 12 per cent of GDP — to the provinces for health care. That’s an enormous sum of money, but it’s still not enough when you consider that an illness can disrupt someone’s capacity to make ends meet. What about broader social spending and economic security? Do people make enough money? Do we spend enough on social welfare to take care of people?
We don’t.
A 2023 Leger poll found that nearly half the country was living paycheque to paycheque, on the edge of being unable to pay their bills, including rent or mortgage. That leaves Canadians at risk for losing their homes should an emergency or unexpected expense —like a major illness — arise. Our various employment insurance, welfare, and disability programs are a farce, leaving millions without a true social safety net – which is what the welfare state was meant to provide before decades of neoliberal austerity ripped it apart.
As if a cancer or other major medical diagnosis isn’t tragic enough, long wait times to see a doctor and to get that diagnosis in the first place contribute to morbidity and suffering. In 2023, the median wait time for medical care in Canada across all provinces was roughly 28 weeks (more than six months) from meeting with a family doctor, to seeing a specialist, to getting treatment. That’s appalling.
The wait was much shorter in Ontario, at 22 weeks, than in Nova Scotia, at 57 weeks. Indeed, the Atlantic provinces had much higher wait times than the rest of the country, suggesting that not only does Canada have a healthcare treatment wait time problem, but also an equity problem. While provinces have constitutional authority over healthcare, more or less, we ought to strive to ensure that care is equally good, and swift, throughout the federation.
Americans should be outraged at the state of their healthcare system. That’s a given. But Canadians should be outraged at the state of our system, too. Looking to the U.S. as a guide for what not to do will not impel us towards a comprehensive, effective, and just system here. And as many will chronic and serious health concerns already know, naive gratefulness for Canadian healthcare underwrites its inadequacy.
We can at once want better for people beyond our borders and for those within them. Canadians deserve better wait times, better access to family doctors, and better support for both direct medical costs and the indirect costs we must pay when faced with illness.
Ensuring better care requires us to confront our healthcare system as it is, our increasingly weak social welfare state and an economic system that leaves workers underpaid and endlessly on the brink of ruin. What we have isn’t enough. We need and deserve more from our governments, and we ought to be united here, and across borders, in demanding that every person have sufficient care and support, especially during times of personal crisis.
Comments
Yes it is awful. I say this as someone who was around for 20 years or so before Medicare as it was known then was approved and I witnessed how it transformed the lives of pretty much everyone. Us poor folks just did not get medical care short of dying. We could not believe that government payment was even possible.
I worked for different governments and helped build these programs through the 70s into the 80s, and then in deep dismay as funding and support faded in the 90s and even more into the 21st century.
Currently a senior now and in need of care in a failing system I am terrified of what we are becoming.
But can I just say that while the feds failed over and over citing jurisdictional withdrawal, some specific blame needs to be assigned here. It is the provincial governments, mostly hard right (and unrecognizeable to me as a once time progressive conservative) who are deliberately underfunding and under supporting health care and driving us into the American model. They re taking federal health transfers and building, say, roads.
Which let us be crystal clear, the US model is devastatingly worse: much shorter lifespans, bankruptcy laden, even more inaccessible and medievally cruel(looking now to limit anesthetics).
So when you re calling out the shortcomings of this once magnificent system, please do not ignore that massive mastodon in the room. People might just think changing the federal government control to pp and his handlers will solve the problem instead of rushing it to utter ruin.
Your perspective is most welcome, and needed more than ever before.
Many thanks...
There’s an elephant in the room here. It has been proven beyond a doubt that what we eat contributes to our level of health. The new Canada Food Rules confirm that fact. As long as we eat meat, dairy and lots of sugar, we are setting ourselves up for more cancers, more heart issues, more diabetes, and more health care costs. The US is sick because their diets are sick. Lots of the same applies in Canada. If doctors were trained to encourage good eating habits in patients, if levels of poverty didn’t stop many from eating healthy diets, health care costs could go down and the money could cover more aspects of care, like travel, etc
This is not rocket science, but a rational and necessary way to look at our health, and consequently, our spending on health care.
Definately all excellent points that create more issues with the healthcare system. In addition, add all the chemicals we are exposed to that the government is excessively slow at banning, especially when every other country has already placed bans on for years.
Good eating habits don't include fast food that is consumed way too much and isn't really that healthy for us from the get-go.
The other issue is affordability of fresh fruit and vegetables that are becoming more out of reach of many Canadians due to current prices. The less healthy we eat; the more healthcare visits will be required overall. It doesn't take a rocket scientist to figure out why things like cancer or heart issues are occurring more often and at a lot younger age. Our governments are ignoring the issue to ensure corporations can continue to make profits, while slowly killing off the population.
So many comments boil up, hard to summarize:
1) Public health - that VERY primary care, where you have regular physician time, advice on lifestyle, early diagnosis because the physician pro-actively spotted it - that can get you better health care outcomes for very little money. Everybody should read about the amazing success of Costa Rica, for peanuts:
https://www.newyorker.com/magazine/2021/08/30/costa-ricans-live-longer-…
...Costa Rica was a pandemic superstar, too.
Of course, the "zeroth care", before primary, is better diet, yada yada; the eternal refrain. But all you can do on that is proselytise and teach in school, and we are. (I hope.)
2) Everybody should get and read Nora Loreto's "The Social Safety Net" from just a few months back, where she chronicles the slow death-by-starvation of our medical system since Mulroney. And Liberals never reversed it when they had power.
3) A lot of the misery Mr. Moscrop notes here is just financial stress that's a separate issue - for which we need UBI, frankly. I don't know how else to address "lost income"...
I'll check your link to the article on Costa Rica. Meanwhile, the more I read about UBI the more of a beneficial policy I think it could be. It could come with a defined floor and ceiling to ensure poor folks have a comfortable way to meet all their basic needs, and to prevent higher income people from wasting a valuable financial resource.
I believe too much power in Canada has devolved to the provinces. Ergo a patchwork of healthcare standards is now our reality. To think the formula was a simple 50/50 when the feds first introduced public health insurance in 1966.
Did you even READ the Canadian Medical Association link offered in this article that points out how the provinces are just assumed to be good-faith actors in public health care because that's always been one of our Canadian flagships, AND because they were always on board with that in the "before times?"
Fast forward to the present, where we are at a precarious political juncture, and as a relatively prominent political writer for the progressive media, should you NOT, first off, provide the novelty of never-more-important context, not only in direct contrast with the hegemony of the regressive right-wing media's dedicated, signature CONTEXT-FREE style, but also to capture ever-more-jaded readers' attention by simply CALLING conservatives what they now actually ARE, which is a bunch of garden variety, low-life, bad-faith "cons," straight up, lacking even the saving grace of being con "artists?"
And secondly, point out that in keeping with the whole concept of "news" (because this phenomenon HAS "arrived" relatively recently, and it IS a phenomenon) these "cons" have now not only totally hijacked the political right wing, but have gained enough power to actively threaten the very existence of ALL democracies by taking down the flagship U.S. which, because it's right next to us, puts OUR vulnerable, much smaller country directly in their crosshairs. But it also creates the opportunity for us to "punch above our weight," a proud Canadian tradition, and set another very different example, ALSO a Canadian tradition.
However, that is only one of the things that will only be possible if we maintain a progressive government; maintaining some semblance of our former public media that was open, and respected is another. Poilievre being uncharacteristically open about destroying the CBC, another flagship, is also another example of important context that should be repeated as relentlessly in all self-respecting media that still exist. Imagine flipping the script to not only get more attention but also more respect.
Also, in keeping with this refreshing truthfulness, "neoliberalism" should be DEFINED when you talk about "neoliberal austerity" rather than ignoring widespread ignorance of what all these "isms" MEAN, thereby enabling the understandable but WRONG association with the Liberal Party (not to mention, it's YET another con-worthy, nasty slag lost in the deluge of the tsunami against the Liberals via Justin Trudeau that smacks more and more of being against the whole shining idea of Canada and what we have aspired to; where is our MORE measured and therefore more respectable patriotism when we need it most) INSTEAD of, and again, in contrast to, the ever-more-dangerous and ever-more-derivative "Convoy Party of Canada."
Someone has to at least put a finger in the dike of such madness by doing more of the unexpected, i.e. more of the truth, to meet the moment we're all drowning in.
Thank you.
The Truth has become a lost and shivering pup in the wilderness.
Will anyone save it in time?
Our healthcare system at one point was great, but over successful provincial and federal governments has slowly eroded the system to the point, funding the health institutions we depend on. It has gotten so bad with funding cuts, many things are no longer covered, insufficient money to cover the required staffing levels and discouraging man doctors from even wanting to practice in this country.
With reduced staff levels, burn out is now taking its toll on a system already suffering by funding cuts.
Though better than what the USA has, being one of the worst health systems in the world for everyday Americans, except the wealthy who can afford their coverage, Canada is not far behind and a total disgrace to other countries.
In Ontario, Doug Ford has pretty much destroyed what is left of our healthcare, with the help of the incompetent Health Minister. You can also add the incompetence of Stephen Lecce who has screwed up our education system at the same time in Ontario. Can't wait to see the mess Lecce will leave behind as Minister of Energy and Electrification. Keep in mind that Lecce is another Stephen Harper misfit previously.
While successive federal governments have eroded and neglected health care, with the federal Liberals bearing their share of the blame particularly in the 90s when Paul Martin was busy balancing the budget by cutting transfers, basically all federal governments except probably Harper's actually did want to keep public health care.
But various Conservative provincial governments fairly clearly have been and are hand in glove with groups that want to kill public health care so they can make a killing like down south. Much of their mismanagement, cuts, and blunders are not just because they are incompetent (although modern Conservative governments generally are incompetent); rather, they are strategic screwups, trying to break the system, make it not viable so they will "forced" to get rid of it. It's not just stupidity, it's stupidity in the service of treachery. They are perfectly happy to kill their constituents in order to put money into the hands of the people who bribe them.
Nutshell