Here’s a (not so) fun question. When was the last time the Canadian health-care system was not in a state of crisis?
Crisis is relative, of course. “Bad,” “crisis,” “struggling” — these are all terms used to describe the state of our health-care system, and all of them are, to an extent, subjective. There are metrics, of course, but even when metrics are bad, there may be pockets of good news in places. This stuff is complicated.
But, still. My question stands: When was the last time the Canadian health-care system — or, yes, pedants, our systems, plural — was functioning well? Can any of you remember?
This past weekend, Global News published an article citing the usual array of top-level experts and sober thinkers. They were asked their thoughts on the state of our health-care systems, and the news is basically uniformly bad. Here’s a smattering of quotes, lifted from the Global article: “Doctors are raising the alarm over [the system’s] ability to stay afloat.” “ER doctors say this season is the worst they’ve ever seen.” “The CMA released a statement Thursday saying unless major systemic changes are made, the problem in emergency departments will keep unfolding. ‘You know, if you talk to any emergency department, we can stand being busy. We don’t mind being busy, but overcrowding kills and that’s what we’re starting to see.’”
That’s four quotes, selected at near random. Read the whole Global article. It just goes on and on like that. It’s relentless.
But you know what else is relentless? The succession of stories every year, year after year — particularly around this time of year, when the usual annual mix of respiratory illnesses are circulating — telling us things that are basically exactly like what you just read above.
Things have changed. We’ve now added COVID-19 to the annual brew of circulating viruses, and that has raised the baseload demand on the system — permanently, in all likelihood. The system(s) went through COVID, too, of course, meaning they’re damaged and eroded. The baby boomers are, right on schedule, getting older, and their needs are mounting. The point above isn’t to deny that we are grappling with new issues and challenges. We are.
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But, for all that, nothing being reported this year, or in recent months, hasn’t been reported before. We don’t have enough family doctors, and I don’t remember the last time we did. Thinking even as far back as my university days — and believe me, those were a while ago — it was damned hard to find one, even in the GTA. I tried to find one in Waterloo, where I went to school, and gave up. I clung onto the family doctor I had at home, driving back and forth for appointments or prescriptions when ill, because I couldn’t find someone closer to where I lived.
Long-term care? My grandfather has been dead almost 14 years (I had to do the math, and, wow, it’s been that long) and when we got him into an LTC before he died, we were incredibly grateful to have endured only a brief wait for a bed in a home close to our family. Even 15 years ago, the long waits and travel times were baked into every expectation we had of the system — which is why we also chose a partially private facility, incurring an enormous cost. We didn’t dare trust what was clear would be his final months to the public system.
My grandmother had her hips replaced a few years before that after long surgical delays. Nothing new there; you’d hear the same thing today. A friend of mine with serious mental-health issues is struggling to find a psychiatrist in her area — again, the GTA — and that’s frustrating but not novel, as she’s been struggling to find or keep a psychiatrist since we were in high school. She finds one, gets care for a few years, and then they take a sabbatical or retire, and she’s right back where she started. That’s a problem she’s had to grapple with for 25 years. It won’t change — and, if anything, it’s getting worse.
And ER wait times? Come on. Let’s be serious. I’ve been seen quickly in an ER twice in my life. Once, I was carried into ER by three shockingly strong orderlies accompanied by a surgeon who’d found me keeled over in a hospital corridor; he was convinced my appendix was rupturing at that moment. (It was a kidney stone. That was much worse.) The other time, a dislocated rib was perfectly mimicking the symptoms of a heart attack. Want fast service at an ER? Show up with chest cramps, shortness of breath, and radiating pain down your left arm. No matter how many times you tell them you fell off a Jet Ski and landed on your left side, they will still insist on checking you out fast.
And you know what those experiences had in common, other than me being grumpy? Even through my irritation and pain, I remained grateful in both of those instances that I had cleared the bar: I was sick enough, or at least potentially sick enough, to be seen quickly. It wasn’t going to be like the time I was twirling a box cutter and ended up cutting myself down to the bone. That day sucked.
I do not remember a time when the same serious and sober-minded people were not telling us all that we didn’t have enough family doctors. Or LTC beds or rehab beds or mental-health supports or community-care nurses. I do not remember a time when our ERs were not routinely over capacity, when every few months didn’t bring us some tragic story of someone dying because they couldn’t get access to care in a timely way. There probably have been such times. I do not remember them. I am increasingly skeptical that we have anyone in the system that could and does.
I have no hope to offer and no suggestions. This is not a political problem, in the sense of its being the fault of one party or another. They’ve all failed in remarkably similar ways. So there’s no chance of voting ourselves out of this mess, since all the options are proven failures. Writing about it in the media won’t work — I’ve been reading about this stuff since before I was writing about it, and the stories I write today sound a lot like the ones I was reading 25 years ago.
You all know the definition of insanity, right? That joke? It says that the definition of insanity is doing the same thing over and over and expecting a different result. You may think I’m referring to the things we’ve tried to do to fix health care. But I’m not. I’m referring to hoping it’ll ever be different. That’s the thing we keep doing over and over that proves we’re all bonkers.
I honestly don’t know how bad things will have to get before things change. I’m not sure there’s an answer. If now isn’t bad enough, how could next year be? What are we waiting for? What’s missing? I’m begging for an answer. What will it take?
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