It has been a longstanding notion that Canada has one of the finest healthcare systems in the world, if not the best. Free universal healthcare and a higher quality of life are some of the defining assumptions that have made Canada’s healthcare system so renowned.
But are we justified in being regarded among the most elite in the world? Current evidence is suggesting otherwise.
In a summit on Sustainable Health and Healthcare conducted by the Conference Board of Canada in 2012, a number of realities about Canada’s current existing healthcare system were brought to light. The panel being comprised of healthcare leaders, practitioners, policy analysts, public servants and countless others revealed that many Canadians were incorrect in assuming their nation’s healthcare system was outstanding.
Canada received a ‘B’ letter grade and ranked 10th out of 17 fellow nations. Japan earned an ‘A’ and ranked 1st while our American neighbours received a ‘D’ letter grade and ranked 17th out of 17. These scores were based on several discerning criteria, some of which included life expectancy rates, infant mortality rates, potential years of life lost and health expenditure per capita.
Using different methodologies and principles to come to its conclusions, the summit’s findings shed insight into the quality of healthcare in Canada and ranked it average at best. Several key issues were identified and the following article takes a more in-depth look at the issues which impede the success of Canada’s healthcare system.
SIGNIFICANT ISSUES
For the large part, Canada has a reputable healthcare system where considerable efforts are being made by our government and health practitioners alike to improve the overall quality of care being delivered to Canadians on a daily basis. Despite its advantages, there are several limitations within the system that prevent it from reaching its full potential.
Fundamentally, the biggest challenge Canada faces regarding healthcare delivery is the increasingly limited access to healthcare that patients are experiencing. This is attributed to a number of reasons which exacerbate the effects of one another. At the forefront, these include a shortage of primary care staff, an aging population and a lack of health promo- tion regarding chronic and cardiovascular disease management.
Currently, there’s an inadequate supply of skilled health practitioners to effectively meet the demands of Canada’s growing population. Access to primary care is delayed where patients face considerable wait times in both clinical and hospital settings. This resulting stress placed on the healthcare system further contributes to greater patient processing times and is amplified by the effects of an aging population.
Elderly populations unfortunately require additional resources, testing and medications and typically have longer hospitalization stays. This costs hospitals more, contributes to longer patient wait times and impedes access to acute care that other patients could receive as hospital beds are occupied for longer durations.
This notion is something that has been reiterated by Dr. Jeffrey Turnbull, chief of staff at Ottawa Hospital, who spoke with reporters about this issue. “Too many senior patients with chronic conditions are being sent to acute care centres for treatment as opposed to being taken care of in long-term facilities,” says Turnbull. He goes on to explain that hospitals are risky environments for seniors. “In being bed bound for weeks, they become more susceptible to infections and do not cope well with recovery when returning home as their routines have been disrupted for so long.”
Furthermore, not nearly enough is being done towards increasing awareness regarding health promotion. Over the past few decades in North America, there has been a significant increase in the prevalence of both cardio- vascular and chronic disease. According to the Heart and Stroke Foundation, rates of high blood pressure among Canadians skyrocketed by 77 per cent, diabetes by 45 per cent and obesity by 18 per cent in the time period between 1994 and 2005. Although genetic and environmental factors are involved in the diagnosis of these illnesses, which affects Canadians of all ages, for the large part, they are preventable. This negative health trend that’s occurring is attributed to an increased sedentary lifestyle in combination with the overconsumption of processed, high-caloric foods.
Additional factors affecting Canada’s healthcare include high internal costs and inefficient budgeting, inadequate mental health services and outdated technology con- cerning bioinformatics and communication sharing amongst health practitioners.
For example, among the 17 nations whose healthcare systems were investigated at the summit, Canada ranks 4th among developed countries when it comes to healthcare spending per capita regarding the cost of its system. This works out to be approximately $4,079/capita, yet despite all this expenditure there’s still a lack of available resources such as physicians, hospital beds, CT scanners and MRI units. What’s more is that for a nation of its wealth and GDP, Canada ranked 7th in life expectancy rates, 16th in infant mortality rates and 12th for potential years of life lost.
Regarding mental health, there has been a precedent in recent years to increase access to services which is a positive indicator. However, there is still limited availability of social housing, mental and addiction health services and childhood nutrition. The scopes of these areas needs to be broadened and additional efforts are required to improve access to mental health services. Curbing these issues earlier on can prevent trips to acute-care centres later on in one’s life.
Canadian healthcare should also strive towards increasing the knowledge sharing of best practices within the different health authorities in order to provide additional information and treatment options for patients. Instead, an outdated system still remains which doesn’t effectively utilize innovative technologies or modern management tools resulting in the loss of benefits that comes with knowledge sharing. For example, the Canadian health care sector is one of the last frontiers where paper and fax machines continue to exist to transmit information. This is only one of the obsolete examples that persist and serve as obstacles that hinder the speed of which information is shared, increases work burdens and contributes negatively to improved health outcomes.
SOLUTIONS
Reforming Canada’s healthcare system is a daunting task that will take time and effort across all jurisdictions of healthcare delivery in order to be successful. According to the summit findings, one of the initial areas to focus on is to review and analyze the system itself. Unfortunately, it still operates on a model that was developed in the 1960’s. This worked well for subsequent decades but isn’t configured to operate in modern settings.
For example, outdated physical infra- structure, provider incentives, service delivery models, labour contracts and knowledge sharing constrain modern attempts at healthcare delivery. More importantly, the past system was designed around acute care emergencies, in which patients needed to be treated in hospitals, in addition to safeguarding patients from excessive financial burdens. Nowadays, much of those treatments can be delivered in the community or even at home.
Reconfiguring the system will address all areas of healthcare delivery especially in the coordination of services. What can aid this process is educating elderly patients that primary care should be the initial contact for treatment, as opposed to making their way to ER’s first. Interdisciplinary teams can be organized and trained with the tools and know-how to effectively care for seniors and other vulnerable populations.
Furthermore, investments in the areas of information and communication sharing technology will go a long way in improving Canada’s healthcare system. This will facilitate greater patient information sharing, thereby encouraging better out- comes and expedited treatments. Time and resources will be better managed leading to a boost in productivity and should minimize patient wait times.
More importantly, Canadians need to take greater ownership over their personal health thereby improving the quality of their lives and minimizing preventable trips to doctor’s offices or hospital ER’s. A healthy population will demand fewer acute care services caused by preventable chronic diseases. Better awareness regarding health promotion facilitates greater access to healthcare.
CONCLUSION
All of the aforementioned issues contribute negatively to a sustainable model of health care. They place unnecessary stress on the system and diminish patient’s accessibility to efficient and expedited treatment. Building a transparent and accountable system with realistic goals and better management should be at the forefront of the efforts to reconfigure the Canadian healthcare system.
Practical solutions utilizing best health practices will also deliver the most quality health care to Canadians and will foster greater economic outcomes. Moving forward, Canada needs to continue adopting a population health model that utilizes patient-centred care where preventative health strategies and health promotion are strongly emphasized.
