GOLDSTEIN: Our healthcare is broken — fear-mongering won’t fix it

how to, goldstein: our healthcare is broken — fear-mongering won’t fix it

Sylvia Jones, Deputy Premier and Minister of Health takes her oath at the swearing-in ceremony at Queen’s Park in Toronto on June 24, 2022. Ontario’s health minister is emphasizing today that people in the province will always be able to access health care without paying out of pocket, a day after she came under fire for refusing to rule out further privatization in the system.

Ontario Health Minister Sylvia Jones touched the third rail of Canadian politics last week when she said the Ford government wouldn’t rule out private healthcare to improve services to patients.

Critics immediately invoked the spectre of “U.S.-style, two-tier healthcare,” whereupon Premier Doug Ford responded: “There’s one thing we’ll guarantee: You’ll always be covered by OHIP, not the credit card.”

In the real world, healthcare is 30% privately funded in Ontario (the Canadian norm), our health care system isn’t “free” (it’s the largest single expenditure in the provincial budget, consuming almost 40% of all revenues, also the Canadian norm) and OHIP doesn’t cover the cost of all medical services.

Meanwhile, “private” healthcare in the U.S. is almost 50% publicly funded, which is not an argument for invoking the U.S. model here, which no government in Canada is talking about.

What Ford and Jones were talking about is expanding the existing role of private healthcare providers in Ontario in delivering medical services that are 100% paid for by the government — for example lab tests — on the grounds this may save taxpayers’ money.

This is an ideological battle that has been going on in Ontario healthcare for decades between governments looking to save money and public sector unions and some patient groups who argue this makes the system more expensive.

It’s a fight that has little to do with what people care about — timely access to medical care, paid for by their tax dollars.

The problem is we don’t have timely access to medical care and a lot of it isn’t paid for by government.

Ontario, and Canada, have some of the longest wait times for surgeries, treatments and diagnostic procedures in the developed world.

Our healthcare outcomes are mediocre compared to similar countries with universal healthcare systems.

That’s not the fault of healthcare providers. It’s the result of a broken system.

More than 1.3 million Ontarians don’t have access to family doctors, which increases medical wait times because family doctors are the gatekeepers to medical specialists.

The reason Ontarians are increasingly denied medical services paid for by their taxes is that provincial governments of all stripes, have been decreasing the number of services and drugs covered by OHIP to save money.

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People who can afford it take out private medical insurance — through their employer or individually — to help make up for deficiencies in our healthcare system — for example the lack of timely access to publicly-funded physiotherapy needed after hip and knee surgeries.

They can also go out-of-province to pay for diagnostic tests much faster than in the public system and pay extra for “executive” healthcare services in Ontario for more timely access to care.

There’s no magical solution for fixing these problems, all of which have developed over decades.

The COVID-19 pandemic simply tipped things over the edge, lengthening already unacceptably long wait times for treatment and adding emergency room and ICU bed closures to the mix in many hospitals because of staff shortages.

One of the things we most need are more chronic care beds and homecare, along with the necessary staff to care for patients who are stuck in acute care hospitals because there’s nowhere else to go, which is the root cause of hallway medicine.

The real issue is not public versus private medicine, but how to pay for everything in a system with infinite demand and finite resources to pay for it.

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