Canadian Medicare Policy Reform: A Big Picture Fix

Canadian healthcare policy needs a big-picture fix NOT just more money.

Now that the hard part has been said out loud and I want to be part of the solution.

I am running for federal office and while I acknowledge the delivery of the healthcare system is constitutionally a provincial responsibility, the federal government is always positioned to be a funder and leader and coordinator of policy for the country at large.

Too often though, the federal government doesn’t serve the people, but just plays politics with healthcare policy.

We need Canadian Medicare policy reform: a big picture fix!

Experience in the healthcare system matters when we want to make decisions for Canadian medicare policy reform.

I am a practising physician who has either trained or worked in Ontario, Alberta, British Columbia and the Northwest Territories (with two stints in mission hospitals in Africa).
And I have worked in and led group private practice offices, attended hundreds of births, given thousands of anesthetics and done plenty of emergency room shifts 24/7/365 (my main gig now).
I have spent most of my life thinking about improving our Canadian Medicare.

What is the purpose of our healthcare system?

Our system anchors itself to a 1984 version of the Canada Health Act whose stated purpose is to “protect, promote and restore the physical and mental well-being of residents of Canada and to facilitate reasonable access to health services without financial or other barriers”.

There are five organizing principles for the Canada Health Act:

Public Administration,
Comprehensive,
Universality,
Portability,
Accessibility.

The Canada Health Act sounds good on paper. Yet the reality? The system too often cannot deliver the healthcare folks need.

Do you personally have access to a family physician or nurse practitioner for primary care?

Not everyone does. In fact, many don’t.

Have you considered that access to a waiting list is not access to healthcare?

Just because you got yourself on a waiting list for any number of services doesn’t mean you get access to healthcare any time soon.

I think we need to tweak our list of five principles and add two principles to that list: timely and patient-centred medicare.

Canada has excellent providers and good facilities. So what slows Canadian healthcare down?

Two words: government bureaucracy.

Too many people now have a career centred around running a system that serves the system, not the patients.

We have decades of evidence that demonstrate that tweaking medicare plans and its coordination systems doesn’t get to the heart of the issue. And the nature of health care and systems is radically different today than in 1984.

Nearly forty years since the Canada Health Act was enacted: it’s time for a renovation.

Did you know that of twenty-eight (28) countries in the world with universal health care, only one (Canada) has a government monopoly?

Why is Canada the outlier?

I guess we could brag if the healthcare system served its residents, but it doesn’t. It’s the exact opposite case.

The heart of the issue is that most Canadians live within a system that doesn’t provide universal healthcare; rather, it is inefficient, slow, and inadequate.

We need a new way of looking at the system and we need to stop stifling innovation or incentives to change.

Many of the bandaid solutions that have been applied to pressure points just worsen other problems (such as a shortage of primary care providers) because central planning lacks the ability to be nimble with its one size fits all approaches.

Funding should follow patients and not just be system based.
Dollars must flow with work and patient care: this is the Patient-Centred part.
No money should go just to “administer stuff” or run programs that don’t see people in a timely fashion with good outcomes.

Medicare should be available for all. Period. That would be our safety net.

And yet Canadian residents and providers have a pent-up demand for new upgrades and options. These upgrades and options should be allowed to thrive and be a source of improvement for each Canadian medicare recipient.

Artificial rules suppressing this innovation and improvement won’t work. Canadians with dollars just travel for their unique healthcare options anyway creating an extra tier of care in an international realm that deserves to stay in our country.

Let local innovation reign.
Reward timely provision.
Grant special travel allowances and patient transport infrastructure for rural and remote areas.
Fund patient transportation networks so comprehensive healthcare is not just an urban reality.

These are a taste of my ideas on how to reform Canadian medicare. What are yours?

Share your best with all of the rest. Leave your comments below.