It’s Not the Spending Model That’s Broken; It’s the System

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The story is the same in every province in Canada. Emergency rooms are overwhelmed, hospitals are understaffed, and the intensive care unit can never seem to keep up with the extraordinary pressures, whether from a local disaster, a flu epidemic, or a spike in COVID-19 cases. As waiting lists for medical professionals continue to grow, finding GPs has become nearly impossible in some areas.

Public health services is a popular political football for every opposition party. They lay down any negative medical consequences at the feet of the ruling party and imply that the reason is a lack of funding. While it may lead to good policies, it is dishonest to blame inadequate funding for health care problems. Since the COVID-19 pandemic began, every province in Canada has dramatically increased funding for their systems. Despite all these investments, even though the pandemic has subsided, health systems continue to swing on the brink of collapse.

Healthcare is the largest expenditure for every province in Canada as it consumes 30-40 percent of every budget and rising costs put pressure on every prime minister. Last week, state health ministers formed a united front, demanding that the federal government increase health transfers to cover 35 percent of state health care costs from the 22 percent currently transferred. Health ministers had a solid case to be made, given that under the original Medical Care Act the federal government was required to cover 50 percent of healthcare costs. Talks fell through as Federal Health Minister Duclos set conditions for increased transfers and all parties walked away in frustration.

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The federal government has gone overboard financially on all fronts, with rising debt service costs and an looming recession. Liberals are unwilling to commit to the massive spending increases demanded by prime ministers. They knew the strings attached to increased healthcare transfer to the states would likely kill the deal. It was a political maneuver designed to get themselves off the hook.

The elephant in the room that nobody at the federal or state level wants to talk about is that it’s the system, not the spending model, that’s broken. The nation needs to change the way it provides healthcare instead of spending more money on healthcare. But such talk is a political blasphemy in Canada.

According to a recent report from the Fraser Institute, Canada spends more on healthcare than most OECD countries with universal systems, but lags behind in every performance indicator. We are 28th among 30 countries in the number of doctors per thousand people, 23rd in terms of hospital beds, and 10th in terms of waiting times for specialists. If spending is the only path to positive performance in healthcare, Canada should be the leader.

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Canada has embraced the myth that we have the best healthcare system in the world. In 2004, CBC produced a game show style series to determine who was the “best Canadian”. After 13 episodes, Tommy Douglas was determined to be the greatest Canadian of all time because he is considered the founder of the healthcare system. Anyone who questions the perfection of Canada’s system is often shouted at and accused of wanting to “Americanize” things. Politicians are afraid to propose significant changes for fear of being labeled as heartless cads who will drive people away from healthcare for lack of money.

Canada needs a candid national discussion about its healthcare system. We need to observe and emulate the most successful universal systems in the world. The problem is that every country that has a universal system and outperforms Canada’s has a more significant element of private participation in the system. This gives unions and other defenders of the status quo an opportunity to return the debate to the American system and begin to sow the seeds of doubt and fear about health care reform. Leaders need to stop avoiding this debate and start pushing their opponents back for reform.

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If we doubled national health spending today, we would have the same number of nurses, specialists and hospital beds tomorrow. Yes, we can slightly expand these capacities by spending more, but the factors contributing to our health care inefficiencies will remain in place. Frontline services continue to decline, as more funding leads to more bloat in an already bloated bureaucracy that runs the system. The government monopoly on supply will still stifle innovation and allow rival foreign systems to drive medical professionals away from us.

The discussion should move away from dollars and cents and move on to results and performance. Canadians don’t seem ready for this discussion, and that’s a shame.

To put it this way when James Carville spoke of the economy in 1992: “This system is stupid!”

The views expressed in this article are those of the author and may not necessarily reflect those of The Epoch Times.

Cory Morgan

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Cory Morgan is a Calgary-based columnist.

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