Healthcare is in crisis. We need smart solutions
Healthcare in Ontario is broken with the system on the verge of collapse. Certainly, those have been the headlines in recent months. Some might question the veracity of such statements pointing to the frequent sensationalizing by the media but no matter which way one looks, there is an air of truth to the claim. The present provincial government has announced plans and has started to implement the privatization of some areas of the public healthcare system in Ontario namely knee, hip replacement and cataract surgeries.
The slippery slope argument is a tricky one that I try to avoid but again with this argument there is an air of truth in reality. The start of the privatization of the public healthcare system is certainly a slippery slope that will inevitably result in a 2 tier system of healthcare in Ontario whereby if one has the money to pay, one will get higher quality care whereas if one does not have the money to pay, a likely lower quality of care will be provided.
My previous writings and thoughts would clearly demonstrate to the reader that I am a proponent and supporter of capitalism, with strict consumer protection regulations in place. Capitalism by and large has been a force for incredible progress in technology, science, medicine and our general overall quality of life. However, just because capitalism has been a force for progress and increases in quality of life in various areas of society, it does not mean that it should be treated as holier than thou or as a divine system that can be applied carte blanche to any and every aspect of society.
To this end, healthcare should never fall to the whims of capitalism simply because the chances of societally catastrophic and disastrous consequences are very high, should sufficient regulation not exist or is not enforced. We have seen time and again in advanced liberal democratic capitalist countries, the deregulation or under regulation of various industries which results in the average person, the consumer, being harmed. The latest example of this is the Norfolk Southern train derailment in East Palestine, Ohio which did enormous damage to the environment and the thousands of residents of surrounding communities. The full extent of the damage is as of yet unknown and will become more apparent as time goes on into the future.
Healthcare is a fundamental human right and as such, should always remain a public good. That is not to say that there cannot or should not be innovations and efficiencies within the system. We must always strive for progress in all aspects of society and similarly our public healthcare system is not exempt. But my biggest problem with the present provincial government’s approach and the approach to privatize parts or all of the healthcare system is that it is lazy, lackadaisical, dishonest and above all, being done without having exhausted all other means.
There is no doubt there are problems within the public healthcare system in Ontario. There are record wait times and surgical backlogs that are affecting the quality of life of real people. These are hard problems to solve but these problems can never be solved if we do not engage with them directly. Throwing our hands up and saying that we have no more options, privatization is the key to solving these problems is inaccurate, irresponsible and imprudent.
Based on the latest Ontario government financial reports, almost 35 cents of every dollar paid in taxes goes towards healthcare yet we are still having these massive problems. We need to engage with this and get to the bottom of what is really going on. Leading figures within the healthcare industry point to the fact that a lot of this money is going towards administration, and program management. That is to say, a significant portion of the money is not going to front line care workers such as doctors, nurses, respiratory therapists and others but rather to program managers, administrators and other bureaucrats. There is obviously a need for some level of program management and administration to ensure the system runs smoothly however given the dire circumstances, we must find efficiencies within the system to allocate more money to frontline care.
Another big obstacle is the present government’s draconian legislation Bill 124 which has arbitrarily restricted wage raises for nurses and healthcare workers to 1% per year when inflation is nearing double digits. This level of disrespect has led to largescale attrition from the field leaving a larger workload for the remaining workers leading to them being overworked. This will inevitably result in fewer nurses and healthcare workers entering the system as they see their current compatriots being disrespected. This draconian legislation must be repealed because it is exacerbating a staffing crisis within the healthcare system which is the root of most of the delays, backlogs and problems.
Lastly, instead of giving money to private institutions to perform surgeries, the provincial government would be much better served by building more ambulatory surgical centres (ASC) such as the one attached to the London Health Sciences Centre. These centres are factories for surgeries and have been shown to be highly efficient. Running an operating room in an ASC costs 40% less than in an adjoining hospital. Building ASCs with every hospital would be far more efficient in the long run both financially and in terms of reducing the surgical backlog.
These are just a few solutions put forward by some of the leading minds in healthcare. There are many more solutions that require the political will to execute that would protect, and preserve our public healthcare system. There is no reason to pursue privatization without having exhausted all other reasonable means and based on the evidence, we are far from that point. We have to be willing to do that hard, dirty, labourious work or we will lose a valuable and lifesaving institution. Incredible institutions do not collapse over night but rather over time incrementally, piece by piece. The fall of the Roman Empire took nearly 250 years but it did fall; today it is nothing but ancient ruins. What kind of future do we want for our healthcare system?