It is common for strangers in a foreign land to feel disinclined to critique its customs and practices. Sharing my experience with the Canadian healthcare system here makes me an exception to the rule.
Discussions about healthcare in Canada often focus predominantly on the strengths of the current system, particularly when compared to complementary systems around the world. As the debate around healthcare rages on in the United States, many references are made to the successful Canadian alternative. Nevertheless, significant evidence suggests that the system is not as flawless as it is made to appear.
In August 2016, I rushed to the emergency room at Mount Sinai Hospital. As a result of a freak accident, I had gotten a papercut in my eye. I found a receptionist behind a desk and a couple of doctors in the hallway, all of whom seemed utterly unaffected by my red eye and tearful pleas for urgent help. The fact that I waited for two and a half hours to receive medical attention was an unexpected surprise — I had heard many people speak highly of the Canadian healthcare system in the past.
Dr. Andreas Laupacis, Executive Director of the Li Ka Shing Knowledge Institute at St. Michael’s Hospital, wrote an article in the Toronto Star that accurately sums up my experience. Laupacis argues that the staff within the medical system have become so accustomed to the endless waiting line within and outside the ER that they have become desensitized to its heartbreaking impact on patients.
Unaffected staff seem to be the just the tip of the iceberg that plagues the Canadian healthcare system. It is also extremely difficult to book an appointment the day a medical problem occurs, or even on the day after. Furthermore, timely access to specialists for patients seems like a luxury. The problem is further compounded because long-term medical care facilities, such as hospitals and nursing homes, are overburdened, while home care options for patients are limited. This creates a vicious cycle — patients who require a lower degree of care cannot leave the healthcare system, while others in need cannot enter it.
As illustrated by my experience, and those of many others, the Canadian system faces some serious problems that need to be addressed. At the same time, if we are to engage in a balanced, productive debate about healthcare reform, it is also important to acknowledge what Canada is doing right.
Notably, I cannot help but admire the principle of universal, equal access to medical care. When compared to the developing world, Canada’s system becomes even more pronounced. In my home country, India, for example, an underfunded and inadequately staffed public healthcare system makes access to proper medical care extremely difficult for most people.
There are also some things that the United States can learn from Canada. In the context of the present debate on healthcare accessibility, the best example is the principle of universal coverage. The Patient Protection and Affordable Care Act, more commonly known as “Obamacare,” reflects this principle to a degree, given that the act expanded the scope of Medicaid to adults who could not afford adequate healthcare and made universal health insurance mandatory. However, The Republican Party, who currently hold a majority in both the House of Representatives and Senate, want to overturn this legislation on the grounds that it hinders job creation and burdens too many business enterprises.
This also raises several questions about how public healthcare should be managed, the most of important of which was whether it should be publicly or privately insured. In the US, as in India, private insurance companies dominate the healthcare sector. To remedy this, Obamacare made it illegal for private insurance providers to deny coverage to those insured based on pre-existing terms and conditions included in policy documents.
Though many people in Canada also have private health insurance, most Canadians are not dependent on their employers for the healthcare benefits and security they need, unlike their American counterparts. It is incredible to me that the medical costs of Canadian citizens and permanent residents are covered by taxes paid to the government. This means that the average Canadian pays less than the average, insured American for the healthcare they receive. Even international students attending Canadian post-secondary institutions in Ontario are covered by the University Health Insurance Plan.
Moreover, the federal government subsidizes the cost of several non-prescription medical drugs. The flip side of this is that prescription drugs in the country are exorbitantly priced, making them inaccessible for many people. The CBC estimates that Canadians wasted approximately $15 billion — of $81 billion spent — on prescription drugs in the last five years.
The divergences in healthcare regulation strategies adopted by Canada, the US, and India shed light on the fundamental question of how to make access to healthcare simultaneously efficient and low-cost. There is little difference between Canada and the US in this regard: a study conducted by the Commonwealth Fund placed the Canadian healthcare system ninth out of the 11 developed countries surveyed, while the American system ranked 11th.
This indicates that both systems yield inefficient results, despite being driven by different economic principles. Furthermore, the case of uninsured prescription drugs shows that economic barriers can sometimes make healthcare just as inaccessible in Canada as it is in the US.
Considering Canada in international context is beneficial, for there is much that Canada can learn from ongoing healthcare debates. For one, the American example shows us that policy changes in healthcare cannot be made suddenly, which is something the Canadian government must realize when it modifies the existing system.
Ultimately, the Canadian healthcare system is a mixed bag of benefits and drawbacks — all of which must be acknowledged if we are truly committed to improving our system. When we have conversations about healthcare in Canada, we should adopt a balanced perspective or risk disregarding the areas that are most in need of reform.
Rohit Khanna, writing for The Walrus, observes that “Healthcare becomes the embodiment of a nation,” and therefore it too, must be looked after. The alternative is painful, hazardous disillusionment.
Sonali Gill is an incoming fourth-year student at St. Michael’s College studying Criminology and International Relations.
