GOLDSTEIN: Health care is broken and our governments broke it

Can Prime Minister Justin Trudeau and Canada’s 13 premiers and territorial leaders fix our health care system that decades of federal and provincial governments of all political stripes broke?

Obviously it can’t all be done at once when they gather in Ottawa Feb. 7 to set the stage for a deal where the federal government will increase funding to the provinces and territories in return for conditions on that funding they will have to agree to individually.

The problems go back decades. Fixing them will take years.

The question is whether the agreements arrived at today will point Canadian health care in the right direction, with effective reforms.

Politicians going back decades were responsible for creating the myths that Canada’s health system care is free, publicly-funded and the best in the world.

In reality, our system is expensive compared to other countries around the world with comparable universal health care systems.

Thirty per cent of our health care is privately funded.

While there are many positive examples of excellent health care — in spite of rather than because of the current system — internationally, Canada’s medical outcomes overall are mediocre compared to similar countries.

Canadians face some of the longest medical wait times for treatment in the developed world in a system with too few frontline health care providers and insufficient operating rooms and equipment, such as MRIs.

The reason Canada has too few doctors is due to deliberate policies by provincial governments starting in the 1990s, when Ottawa reduced transfer payments to the provinces in order to balance the federal budget that was out of control at the time.

The theory — promoted by so-called health care economists within Canada’s overly bureaucratized health care system — was that graduating fewer doctors by reducing the public funding of medical schools, would mean lower costs because there would be fewer doctors treating patients and ordering tests.

What happened instead is that the number of Canadians without family doctors skyrocketed.

That resulted in higher costs, because without family doctors, patients end up in hospital emergency rooms for both minor and more serious health care issues — where it is far more expensive to treat them.

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While we don’t have enough family doctors or nurses — many burned out by the COVID-19 pandemic — we do have an overabundance of highly-paid, empire-building government health care bureaucrats, constantly creating new forms for doctors to fill out, cutting into the time they care for patients.

Data sharing of health care information often borders on the absurd.

At the height of the pandemic, governments were in many cases, compiling and sharing information by fax machine, apparently having missed the computer age.

Transferring patient’s medical histories from paper to electronic records has been laboriously slow and expensive, with governments presiding over the process repeatedly wasting time and money because of incompetence.

Overcrowded emergency rooms and hallway medicine were created by years of provincial governments failing to create sufficient chronic and long-term care beds, meaning people ended up in acute care hospitals because there was nowhere else for them to go.

It doesn’t help when fear-mongering defenders of the broken status quo in health care portray any attempts at reform as creating two-tier, American-style health care, which no one who understands the issues is talking about.

Let’s all hope for some meaningful breakthroughs on these issues in the latest round of federal-provincial-territorial negotiations.

But don’t hold your breath.

lgoldstein@postmedia.com