Medicare Meltdown: The Canada Health Act is failing Canadians - "In theory, the provinces are under no obligation to adhere to the CHA, but Ottawa can cut funding if provincial health care fails to live up to the principles codified in the Act including accessibility and universality. While the CHA has been a stable provider of health care, there’s a fundamental tension in a system where one party provides funding and another party spends it. This, as Flood points out, leads to “splintered accountability.” “I think the basic problem in Canadian health care is that when we think about the issues it has, do we blame the federal government, or do we blame the provincial government?” Flood says. “This confusion allows both levels of government to get away with not doing a good job.”... As health care costs creep upwards, federal contributions aren’t keeping up. “The provinces feel that the feds don’t live up to their side of the bargain. The federal share has dwindled significantly, while total health-care spending has gone up"... “The problem is that the federal government doesn’t really enforce those provisions of the CHA,” Flood says. “They don’t hold back money from the provinces who aren’t making sure there’s reasonable access. They’ve kind of lost their moral legitimacy to do this because they’re no longer contributing 50 percent. The provinces seem to think it’s fine that so many people wait too long for a surgery, they’ll always say ‘Well, we don’t have the federal funding.’ So you’ll always have this finger pointing.”... The CHA’s outdated conception of health-care services has led to a public insurance model that The Hub’s editor at large Sean Speer has described as a “mile deep and an inch wide.” There’s a policy case that it’s produced an inegalitarian system in which first-dollar public coverage is provided for hospital and physician services irrespective of one’s means and then there’s little public support for other services such as drugs, dental and long-term care which increasingly make up a major share of overall health-care expenditures in the country. The solution, according to Speer, isn’t to expand the single-payer model but rather to rationalize it based on need."
Ontario’s plan to clear its surgical backlog could be a crisis response, or a roadmap to our health care future - "“Every other developed country in the world has private clinics as a major part of their health system. And so as provinces struggle with the financial costs and the wait times for health care, private clinics are an option, for sure,” said Janice MacKinnon, who was a cabinet minister in Saskatchewan for a decade and has written extensively about the province’s experience with private delivery... When Saskatchewan launched its surgical initiative in 2010, it was accompanied by a goal to reduce wait times by 2014 and MacKinnon credits former premier Brad Wall’s ability to stay single-mindedly focused on that goal for its success. And while the political landscape is stacked up against any government increasing private clinics, MacKinnon said the experience of visiting these clinics is the best argument in their favour. Especially in the latter stages of a pandemic, when people are keen to avoid hospitals, a quiet clinic with lots of parking spaces out front is particularly appealing... Ontario can rest easy knowing that it won’t be taking this leap alone. The situation across Canada has grown so dire that even progressive governments are willing to put their Medicare bonafides at risk with experiments in private delivery... about 600,000 fewer surgeries were performed across Canada in the first 22 months of the pandemic compared with pre-pandemic surgeries in 2019... “wait times cost Canadians an estimated $4.1 billion in lost wages and productivity—or $2,848 per queued patient.” This is their conservative estimate; the higher cost is $12.4 billion or $8,706 per patient. The health and economic costs of waiting for treatment have prompted Canadians to find alternative solutions, with many seeking treatments in other countries... In addition to expanding capacity, surgeries performed at private clinics cost taxpayers 26 percent less, on average, when compared to hospital surgeries. In fact, provincial guidelines stipulated that the cost of services provided by private clinics had to be equal to or less than what was offered by public hospitals. By engaging the private sector, the province was able to quickly expand its total surgical capacity and free up resources in public hospitals for more complex treatments. Saskatchewan’s Surgical Initiative is generally viewed as a success. It helped the province lower its wait times from Canada’s longest (28.8 weeks in 2008) to the shortest by 2015 (13.6 weeks)."
Medicare Meltdown: Canada used to have one of the best doctor ratios in the world. What happened? - "A shortage of practitioners, and laborious wait times, are not new problems in Canada, but they are especially acute in Greater Victoria, where news reports of walk-in clinics closing down have become a frequent occurrence... Canada’s universal, taxpayer-funded, health-care system remains a pillar of national pride, but when compared to the country’s peers in Western Europe, it now ranks near the bottom of the pack. The favourite solution of the federal government and provincial premiers has been to boost funding, but it has created an expensive system that consistently underperforms in delivering quality health care when compared to similar countries. The Commonwealth Fund’s 2021 report comparing the health-care systems of 11 developed countries, put Canada in 10th place, just ahead of the United States. Canada placed 10th in equity and health-care outcomes, 9th in access to care, 7th in administrative efficiency, and 4th in care processes... In 2019, B.C. doctors were described by the CBC as being paid the third least after their counterparts in Nova Scotia and Newfoundland. Victoria is annually ranked as one of Canada’s most expensive cities in the country... Federal and provincial politicians in Canada often respond to surges of complaints regarding health care by promising to funnel millions or billions of dollars to the provinces to help alleviate the shortages. Currie says this does not solve the issue. “Our problem isn’t a federal funding issue, our problem is an effective use of health care funds,” says Currie. “Alberta has a similar health ministry budget as B.C., so how are they able to provide for all their citizens and we aren’t?”... many of the problems with Canadian health care can be traced back to the 1990s. Following the 1980s, Canada was racked with fiscal chaos, chronic budget deficits, and inflation. It prompted a major policy shift towards balanced budgets and getting government spending under control. Tholl says the federal government prioritized costs over care as part of its program of austerity and fiscal rebalancing, resulting in a reduction of enrolments in medical and nursing schools, by respective rates of 15 percent and 50 percent... Even if changes were to be made, Tholl says it could take anywhere from six to 12 years for new professionals, such as cardiac surgeons, to enter the system. Tholl cites the “South African Solution” as a way to help alleviate health care shortages in the short term. It’s a policy developed by Saskatchewan’s government to enable the province to effectively lure South African doctors, who undergo similar training to their Canadian counterparts, and push them into the province’s medical workforce. In 2016, more than half of Saskatchewan’s doctors had been trained outside Canada, with most coming from South Africa, Nigeria, and India. Immigrant doctors would be a welcome addition to Canada’s medical workforce in 2022, as many medical professionals across Canada are retiring due to burnout from the pandemic, lessening the already short supply... competition continues past medical school and affects how graduates can obtain residency training spots. The already-subsidized cost of medical school cost $17,000 CAD per year on average in 2021, and nearly $30,000 per year in Ontario. Tholl says that once students graduate, often with significant debt, they go into specializations that pay more than a general practitioner, such as becoming a dermatologist... Esmail says the Canada Health Act is limiting policy innovation because it governs what provinces can and cannot do in terms of health-care policy in return for federal health transfer payments. He says that the provinces are dominated by government-run monopolistic hospitals and a health-care system that precludes any cost-sharing of user fees... Canadians want a comprehensive, affordable, and universal health-care system, but the way it has been structured ties the provinces to a system that monopolizes the delivery of both medical treatment and health-care insurance. “This disallows cost-sharing for universally accessible services, which is unfortunate because those are the very policies employed by 100 percent of the developed world’s most effective, highest-performing universal access health-care systems”... Esmail advises understanding what countries like Australia, France, Germany, or Japan have done, all of whom deliver high quality but faster health care at lower costs than in Canada while allowing for cost-sharing between public and out-of-pocket spending"
Health care: Canadians not pleased with provinces, survey says - "In each province, at least two thirds of survey respondents thought their governments were doing a lousy job on health care. Those in New Brunswick and Newfoundland and Labrador were the most critical, with 83 per cent believing their provincial governments were performing poorly."
Liberal Party of Newfoundland and Labrador - Wikipedia - "It has served as the Government of Newfoundland and Labrador since December 14, 2015. The NL Liberals were re-elected to a majority government in the 2021 provincial election."
British Columbia New Democratic Party - Wikipedia - "Following a hung parliament as a result of the 2017 election and the BC Liberal government's failure to win a confidence vote in the Legislature, the BC NDP secured a confidence and supply agreement with the BC Green Party to form a minority government. The party subsequently won a majority government after Premier John Horgan called a snap election in October 2020."
Damn conservatives destroying healthcare to privatise it!
Matt Gurney: We are witnessing the results of our neglected health system, and Canadians are paying with their lives - "the ERs are usually jammed because the hospital wards themselves are jammed. Whether it’s an ICU bed, a diagnostic machine or a lower-intensity care ward, they’re all often over capacity, so patients in genuine need of care remain in the ER until a spot opens up. And those wards are often clogged, because patients who are ready to leave the hospital, but require ongoing support at a long-term-care facility or a rehab hospital, cannot be discharged until a bed at one of those facilities opens up. And those facilities are often clogged because there’s not enough staff available to provide community care, in order to keep people stable and comfortable in their homes and out of the system. When you add in patients arriving at ERs in very poor shape because they lack either a family doctor or access to mental health services or substance abuse treatment in their communities, it starts to seem amazing that anyone ever gets any care at all. Actually, the really amazing thing is that the system worked as well as it did for as long as it did. Years of pan-partisan neglect left us all sitting ducks, utterly vulnerable to any unforeseen event. This was obvious even before COVID... The one bright spot in Canadian health care had typically been that the system was good at one thing: if you were in real danger, it would do all it could to save your life. Everyone who was in slightly better shape would be bumped down the priority list, but a critically ill or injured person would get the care they needed. In many ways, that was sort of the unspoken deal: yeah, you’ll wait forever for an MRI or a knee replacement, but if you fall off a ladder and crack your head open, there will be a spot for you in a hospital
Cambie Surgery Case: Letting You Die Does Not Violate the Charter - "Canadians pay for government health care with our tax dollars. By some estimates that cost ranges between $726 and $41,916 per family annually. We also pay for “free” health care and its associated defects and failures with our time. Canada’s lengthy waiting times for specialists, surgeries, diagnostics and even basic family medicine have become notorious. The pandemic worsened the situation. In 2021, waiting times for surgical and other treatments increased for the third straight year... while the health care system and its government overseers apparently regard the time of individual Canadians as essentially worthless, time has real costs. These include the individual patient’s lost economic productivity, their missed opportunities to spend their own time as they see fit and, most of all, the reduced quality of life and actual shortening of life caused by waiting for medical treatment. Many patients forced onto government waiting lists suffer severe and disabling pain that only ends when they receive necessary but delayed medical treatment. Others suffer from conditions which render them functionally disabled, limiting their ability to earn a living, participate in family life and social activities, and otherwise lead normal lives while they wait... Patients with time-sensitive and life-threatening conditions also face increased risk of death. And such patients do die needlessly. Based on data compiled from freedom of information requests, the charitable think-tank Second Street estimates that over 10,000 patients died while waiting on a government list for a surgery, procedure, diagnostic or specialist appointment between April 2019 and December 2020... Multiple emergency rooms across the country have actually shut down over the past year, ostensibly due to staff shortages – sometimes all night and for entire weekends... What becomes of those who cannot wait? In many ways, they are trapped. Canada’s government health care monopoly is unique among developed countries. It is the only system that (through a combination of federal and provincial laws) prohibits patients from seeking health care outside the government medical system even when it fails to treat them. No other internationally respected democratic country has comparable restrictions – not even social-democratic countries like Sweden that are typically thought of as “to the left” of Canada. Citizens of all these countries are free to use their own resources to obtain the health care they need from private providers. How, then, can Canada’s prohibition be demonstrably justified in a free and democratic society? This is the question a group of patients and surgical clinics are asking the Supreme Court of Canada to answer. On September 29 they filed for leave to appeal their case, Cambie v British Columbia, to the country’s highest court. Cambie v British Columbia directly challenges one provincial health care monopoly law, B.C.’s Medicare Protection Act. Substantively, however, the case represents a historic challenge to the entire country’s monopoly approach – a system that was disastrously overwhelmed during the Covid-19 pandemic, in turn fuelling rationalizations for disastrous pandemic-related shutdowns. Of course, this situation was not unique to the pandemic. Because of every province’s practice of rationing health care services, our hospitals are routinely said to be “at capacity” or even “over capacity” and the system regularly teeters on the edge of being overwhelmed. The evidence at trial in the Cambie case (see also this C2C article) demonstrated that B.C.’s public health care system chronically fails to provide patients with necessary medical care within the maximum medically acceptable waiting time. The B.C. Court of Appeal later acknowledged that as of March 31, 2018 more than 30,000 British Columbians were waiting for necessary medical care beyond the maximum medically acceptable time (see paragraph 189). (Some would argue that these “medically acceptable” waits are already far too long; patients with access to high-quality U.S. or European health care often endure little or no delay at all.)... this failure is largely deliberate – because government rationing of health care services is baked into the system... there is little doubt the current NDP government’s primary objective is not to improve the public system but simply to crush private health care delivery... The B.C. Court of Appeal’s majority found that while the Medicare Protection Act may hurt and even kill patients, this is done with the noble purpose of preserving the public health care system, i.e., is for the “greater good.” This, it found, meets the test of being in accordance with the principles of fundamental justice. There were no dissenting opinions... the central issue in the appeal will be whether it is constitutional for the B.C. government to prevent patients from accessing necessary alternative health care when the public health care system does not provide care within medically acceptable times. More bluntly, whether it is acceptable in Canada for people to die waiting for government health care when private services could easily be provided that would keep them alive and, in many cases, healthy and living life to the full... 74.6 per cent of respondents... believe that patients who wait past the maximum medically accepted times for treatment in the government system should be allowed to use private insurance to access that medically necessary care."
Clearly all countries with two tier systems have American healthcare, even liberal paradises like Sweden
So much for the liberal conspiracy theory that conservatives in Ontario are deliberately destroying the healthcare system so it can be privatised
State of Emergency: Inside Canada’s ER Crisis - "The number-one issue today in Perth, as in most ERs in Canada, is overcrowding, and all the knock-on effects that follow from it. Overcrowding—loosely defined as being unable to care for patients within a maximum of four hours—was first identified as a problem in Ontario in the late 1980s. It became so severe in Toronto that in the 1990s, the Ontario Hospital Association launched a task force to tackle it. One major problem identified was a lack of beds. In the last half of the ’90s, the number of acute-care beds in the province fell by 22 per cent, even as demand rose thanks to a growing and aging population. In 1995, the occupancy rate for those beds was 85.6 per cent. That’s not bad—a safe hospital is defined as one with 85 per cent occupancy or less. By 2000 it had climbed to 96 per cent. Some hospitals in Canada now exceed 100 per cent, with patients spilling into any hallway or exam room or other corner that can accommodate them. One Wednesday evening this past July, the Lanaudière Hospital in Saint-Charles-Borromée, Quebec, peaked at 191 per cent capacity. In 2021, the Organisation for Economic Co-operation and Development ranked Canada 31st among 34 countries for acute-care capacity, with 1.97 beds per 1,000 people. (Japan, at the top of the list, had 7.74.)... In spite of it all, Canadians haven’t been deterred from visiting ERs. A 2016 analysis by the Canadian Institute for Health Information found that 41 per cent of the population had used an ER within the previous two years, more than citizens of other Western countries including the United States, France, the United Kingdom, Australia, Germany and Switzerland. Often this is because people can’t get appointments with their family doctor, or they don’t have one. And so the furious cycle continues."
Too bad he doesn't mention healthcare workers fired for not taking covid vaccines, and doesn't mention international comparisons on spending (of course more money is always the demand)
Current funding | Healthcare Funding - "The most common healthcare funding method in Canada is global budgets, where a fixed payment amount is allocated to a provider (such as a health authority or a hospital) to cover operating expenses for a period of time, usually one year... Global budgets can be an effective means to control healthcare expenditure growth through the use of spending “caps,” and they also provide financial predictability for administrators and policy-makers (Wolfe & Moran, 1993; Antioch & Walsh, 2004). One weakness of global budgets is that, under the impetus to meet budget targets, providers might restrict access to services or limit the number of admissions to facilities. Moreover, global budgets provide little incentive for innovation or to improve efficiency of care (Sutherland & Crump, 2011). Since global budgets do not provide opportunities for increased revenue if patient throughput increases, healthcare providers have no incentive to shorten patient lengths of stay or to discharge patients to lower cost healthcare settings (Sutherland et al., 2013). Global budgets do not promote coordination across service providers in acute and post-acute settings, creating a fragmented healthcare system that is often associated with inefficiencies and reduced quality of care (Sutherland & Crump, 2011; Sutherland & Repin, 2012). Most of the countries that had previously used global budgets have since transitioned to other funding mechanisms, such as activity-based funding (ABF) (Sutherland & Repin, 2012; Sutherland, 2011). In recent years there has been a shift towards changing how healthcare in Canada is funded, and experimentation with various healthcare funding policies have been initiated in provinces such as British Columbia, Alberta, Saskatchewan, Manitoba, Ontario, and Quebec (Sutherland & Repin, 2012)."
Reforming our health system is an urgent necessity - The Hub - "here we find ourselves again…slowly and painfully emerging from the fourth round of mass closures in twenty months with not only no plan in sight but the absence of even a discussion of what we could do to prevent future shutdowns. Who is to blame for the void of ideas and action on the single most important issue we face? It’s too easy to call out hyperreactive politicians and governments. Both are in survival mode caught up in case counts, hospitalizations, and polling numbers. The media sadly has shown itself to be largely uninterested in examining the hard choices required to pandemic proof our institutions. Instead, clickbait COVID headlines and “hot takes” from the country’s self-appointed COVID expert class clog our social feeds and desktops. The result is we are two years into this crisis and have yet to have any kind of coherent conversation about the steps and actions we need to take to avoid a fifth, sixth, or seventh lockdown. The real culprit of our collective inaction and paralysis is us. It’s the broad public who are deeply uncomfortable with the difficult truths COVID-19 has revealed about our single most important and cherished public institution: health care. Public health care systems were in trouble before the pandemic. We knew we were rationing care through the silent suffering of lengthy wait times. We knew the opioid epidemic was, in part, a reflection of systems that lacked the resources to address chronic illness and debilitating pain. We knew that the delivery of health care had become overly bureaucratized. But despite all these failings we clung to our single-payer system because it represented one of the last vestiges of an older civic compact based on an ethos of mutual care and solidarity... With fewer intensive care units per 100,000 people than Mongolia and total bed capacity near the bottom of the OECD, our public health systems have become choke points that strangle any effective, long-term strategy to manage COVID-19. How else do you explain a province like Ontario with almost 15,000,000 residents repeatedly shutting down when its COVID-related critical care admissions top four hundred, or a paltry one I.C.U. COVID patient for every 40,000 residents?... The rejoinder to such a clarion call is to increase government funding and build more hospitals, hire more doctors and nurses, expand not contract universality to pharma care, dental care, etc., etc., etc. We are in an emergency. The clock on the next shutdown is ticking. With most provincial budgets already allocating 40 percent or more of revenues to health care, there aren’t the resources to do what needs to be done at the speed with which a transformation has to happen. Ottawa is similarly financially constrained as our debt-addled federal government falls ever deeper into deficit spending in the tens of billions annually for years to come. If we want to be honest with ourselves the traditional response of injecting more government funding into health care wasn’t working before COVID. Wait times were increasing. Bureaucratization was growing. Patient outcomes were worsening. Health care costs were growing faster than inflation and population. The problems with the current system are structural"
Healthcare performance is still better than in the US, but it's below 8 other high-income countries
Health care’s iron triangle is hindering innovation - The Hub - "Medicare cannot change because it is locked in an iron triangle consisting of government, the medical profession, and public-sector unions. The health care triangle is stronger than any party inside it; each party holds de facto veto power over major decisions. Each party seeks to improve its standing and power within the triangle relative to the other parties. When a government attempts change from inside the triangle, it can manage only minor tweaks or redesign. For example, regionalizing services, then centralizing them, then regionalizing again. Veto guarantees that modern Medicare shares more similarities to its 1960s design than any evidence of meaningful innovation since then... In the early 1980s, Prime Minister Margaret Thatcher tackled a similar rigid coalition. John Gray, a political philosopher, described it as “the triangular relationship between government, business and the trade unions.” Thatcher set to work smashing the relationship. However, she left the welfare state “comparatively intact… the political thrust of early Thatcherism was in the direction of the dismantlement of the corporatist policies of the 1960s and early 1970s."
Weird. We are told that private schools should be banned so rich people will force public schools to become better. Yet when private healthcare is essentially banned...
Canada's low ranking on health-care report reveals an unpleasant truth - The Hub - "A new report released by the Commonwealth Fund reveals the unpleasant truth about Canadian health care. According to the authors, it’s better than the star-spangled system south of the border — but worse than just about every developed universal health-care system in the world. Canada’s poor performance (ranking 10th out of 11 countries) is neither new nor surprising. In fact, Canada has secured a similar rank on every report released by the Commonwealth Fund since 2006 (when it ranked fifth out of six), the first time it offered an overall ranking... In some ways, this year’s performance is particularly galling given that the report is missing several key measures of wait times performance, where Canada routinely fails miserably... Clearly, however, every country included in the Commonwealth Fund’s report approaches universal health care very differently from Canada. Most expect patients to share the cost of treatment, and almost all of them fund hospitals based on activity and embrace the private sector as a either a partner (such as Australia and Switzerland) or an alternative (such as the United Kingdom and Germany) — policies either discouraged or effectively prohibited in Canada."
How can we improve Canada’s ailing health system? Economist Maria Lily Shaw highlights lessons from the UK and Sweden - The Hub - "The reason why we turned to the United Kingdom and Sweden is because these two countries managed to transform their health-care systems that were previously a lot like our own, meaning monopolistic and primarily government-run. So, with some constant reforms, their systems are now more flexible, capable of meeting the needs of their population in a timely manner, whose costs are similar to, or lower than, a lot of provincial health-care systems in Canada. And most importantly, really, one of the main reasons why we actually chose these two countries is because, despite these major transformations, they managed to maintain the universality of their systems. Meaning the quality of access was maintained throughout all the reforms, and the reforms they introduced to achieve this transformation also promoted the participation of entrepreneurs in the provision of health care. They also increased the number of doctors on their territory and encouraged collaboration between government-run institutions and the independent sector... If you look at the number of physicians per 1000 population, they outnumber us, even the number of nurses which we are quite high up in the ranking usually, but they still outperform us in respect to the number of nurses per 1000 population. Even the wait times are less long, let’s say in Sweden and the UK. We do have benchmarks that we have to respect because if they surpass, let’s say, six months, it becomes a bit more dangerous medically. But even if Sweden and the UK also have those benchmarks, they manage to operate on these people sooner, which is just better overall for the wellbeing of the patients in the population... The first one being that Sweden did end up removing their prohibition on duplicate health insurance, meaning that their population could, starting in 2010, buy for themselves a health insurance that would cover the cost for care that would already be covered under the public system otherwise... While they’re waiting on the waitlist, they can’t work because they’re in too much pain, they’re waiting for the operation on their knee. But because they can’t prescribe to a duplicate health insurance policy, they can’t go seek this operation in an independent facility because they don’t necessarily have the means to pay the full cost out of pocket, which is actually the situation right now in a lot of Canadian provinces. Another policy that was absolutely key to the transformation of their health-care systems was the fact that they do not prohibit the practice in both public and private institutions simultaneously... finally, one of the most important reforms that I can think of with their transformations is the fact that they transferred the funding of their hospitals from historic budgets to activity-based funding. And this is important because it actually makes it so that the funding follows the patient. So, when a patient is treated in a hospital, that hospital receives a certain amount of money depending on the treatment that was given. They know exactly how much they will receive per patient. And they want to attract more patients, because this is their source of revenue, which is not the case in the hospitals and a lot of provinces here because they are still funded through historical budgets, meaning they will receive an amount of money that depends on the activity they had the year before... for those who are seeking services in those types of independent clinics, because there is no duplicate health insurance, it is limited to the people who can pay for all the full costs out of pocket, it’s not everyone who can actually do that. By allowing a duplicate health insurance policy to flourish in a province, you’re allowing more people to be able to access those services... in Sweden and the UK when they were doing these transformations, they had the same problem that we did, meaning they were also afraid of lacking doctors. They were wondering, “Where, with all these new institutions, these new clinics, you know, where are the doctors gonna come from? How are they going to keep treating patients?” But they didn’t just stand there and be paralyzed by that problem. They searched elsewhere, they thought that there were solutions to this problem and that was by bringing in doctors from other countries, by increasing their medical school quota, and just overall, expanding the scope of work also of their other medical professionals, like nurses and pharmacists. We can always do the same again, there’s nothing keeping us from doing that. And just eliminating medical school quotas in general, it would be a great reform to increase the number of doctors on our territory... what really helped in both cases is when they gave greater autonomy to the medical institutions themselves. So they introduced, actually, reforms that created a new type of hospital in the UK, called Foundation Trusts"
The uniquely Canadian fear of private health care: No other universal system bans it like we do - "Whenever the prospect of private health care is mentioned in Canada, the usual political reaction is to warn of an imminent descent into the inequitable hell of “U.S.-style privatization.”... An ingrained fear of privatization is even held by our high courts. Last month, the B.C. Court of Appeal upheld a Canadian ban on two-tier health care, even though the justices admitted the decision would impose “real hardship and suffering” on patients stuck in the government queue. But it’s a curiously Canadian conceit. In virtually every other developed nation that offers universal health care, private options are a common and uncontroversial part of the heath mix. While Canada may see private health care as a harbinger of American inequity, the likes of Australia, Germany and Norway see it as no different than a private school, a paid security guard or a toll road. A 2003 profile in the New England Journal of Medicine wrote that the Canadian system was “unique in the world” in that it banned coverage of core services by private insurance companies... even Communist China allows core services to be covered by for-profit private health insurance... Germany — the world’s first country to offer socialized health coverage — allows citizens to opt out of the public system and pay for “substitutive coverage.” There are tight government controls on who’s eligible for substitutive coverage; citizens must meet a minimum income threshold and they may be barred from returning to the government system. But as of 2017, roughly 10 per cent of Germans had gone the substitutive route. Private health care is even an institution in the United Kingdom, whose National Health Service is often held up as the poster child of universal care. In a 2017 New York Times ranking of the world’s best health-care system, the “truly socialized” British system won easily... While a clear majority of Canadians support the existence of universal health coverage, polls show that the country may be warming to the existence of a German or British-style two-tier system. The right-leaning think tank Second Street, commissioned a Leger poll last year finding that 62 per cent of respondents believed that “Canadians should be allowed to spend their own money for the health care they want.” Another 67 per cent favoured “governments using private and non-profit health clinics to reduce surgical backlogs as a result of the pandemic.” This is all occurring amidst an unprecedented shortage of care within the Canadian health-care system. Just last month — amid mounting wait times and surgical backlogs — a meeting of Canada’s 13 premiers unanimously declared that the country’s health system was “crumbling.”"
Of course, all the leftists claim that private healthcare must be banned so politicians cannot get rich (while quite how they would get rich is never explained). The equal misery principle must apply because no one can be allowed to benefit
According to liberals, all the premiers are "conservative" (even though two are Liberals and one is from the NDP) and are united in a conspiracy to destroy public healthcare so they can privatise it
How does Canada’s health spending compare? - "Canada is among the highest spenders on health care in the Organisation for Economic Co-operation and Development (OECD), at $6,666 per person in 2019."
Clearly the problem is conservatives underfunding healthcare
