Around the time in the 1960s when Ian and Sylvia Tyson were singing their homage to migrant prairie workers, Four Strong Winds, a Royal Commission chaired by Justice Emmett Hall was calling for the creation of a national system of publicly financed health care insurance.
Just like Tyson’s haunting hymn, Canadian-style “medicare” has gone on to become part of our national heritage. But unlike music that is remastered, remixed and re-recorded, our health care system has not moved ahead with the times. Until now. The winds of change are blowing across Canada, led by a movement to put patients back at the centre of a sustainable health care system. Whether in the form of British Columbia’s recently announced plan to pay hospitals based on the number of procedures actually performed, or New Brunswick’s soon to be released health care plan, or the release of the report by Quebec’s Task Force on the Financing of the Health System, the move toward sustainability and a patient-centred vision is most welcome.
Last month, the Canadian Medical Association (CMA) released a new study showing that last year patients waiting for health care services in just four clinical areas cost Canada’s economy $14.8-billion in lost productivity and health expenses. It is clear that health care rationing and maintaining inappropriate wait times for medical care represent poor public policy. A study released last month by the European-based Health Consumer Powerhouse, comparing Canada’s health system to 29 European countries, ranked us 23rd overall, and last in terms of value for money spent. We can and should do better.
Canada’s physicians believe our health care system must be overhauled to deliver efficient, effective, universally accessible health care that is second to none. Becoming a world leader in health requires strategic investment and focus in areas such as improving the use of information technology (IT) and better health workforce planning.
Canada currently spends just a third of the OECD average on IT for our hospitals. This is a significant factor in Canada’s poor record in avoidable adverse effects and hospital deaths. We must document, measure and analyze all data relating to hospital, physician and patient services. Patient care and safety often require us to share medical information. Without electronic records this is cumbersome and inefficient.
Similarly, we must develop a strategic plan to address the shortage of health professionals across the country. The federal government could show leadership by working with the provincial and territorial governments by moving now to ensure Canada is self-sufficient in terms of educating and training enough health professionals.
Significant progress has been made in restoring and adding capacity to our medical schools but to achieve self-sufficiency much more needs to be done. We must also try to repatriate Canadian medical students and doctors who are studying and working abroad.
The missing element that can harness the winds of change rising with the new patient-centred movement is clear leadership by the federal government. With the possibility of a federal election looming, Canada’s physicians believe health care must be returned now to the political agenda.
That’s why the CMA has launched an advocacy campaign called “More Doctors. More Care” to spur our federal politicians into taking action. Canadians can get involved by going to moredoctors.ca, signing an electronic postcard and sending it to the Prime Minister. These postcards tell the Prime Minister that improving patient care requires governments to address the challenges outlined above. Governments have both a legal and moral duty to ensure that all Canadians have access to the health care they need. Our political leaders are not meeting this commitment.
Our health system is at a pivotal moment in its history. Ian and Sylvia pined about “all those things that don’t change, come what may.” We must come together now to ensure that our health care system does not remain one of those things.
Brian Day is president of the Canadian Medical Association.