Many industries have been impacted by the COVID-19 pandemic, but none more significantly than the healthcare industry. This unprecedented time has manifested a new perspective on individual health, and the expectations we have not only for ourselves but for our medical providers.
It is in challenging times that inefficiencies make their way to the surface, and in Canada, the healthcare industry has shown that there are several gaps that need mending in order to provide better healthcare for all.
Defining the Healthcare Industry in Canada
According to Sciencedirect.com, national healthcare systems are organized on three planes. The first is financing, or how services are paid for, whether that be publicly or privately. The second is the delivery of services- in the manner of whether service is delegated publicly or privately. And the final plane is allocation, or how funds are allocated to service providers.
Canada’s publicly funded healthcare system is best described as an interlocking set of ten provincial and three territorial health systems. The healthcare system is funded by the Canadian Healthcare Act – which was established to ensure that all eligible residents of Canada have reasonable access to insured health services on a prepaid basis.
This covers the first two planes as defined earlier, and on paper sounds very black and white. However, the third plane- or how the funds for healthcare are delegated- has manifested a grey area in Canadian health coverage.
The Canadian Healthcare Act covers those that qualify for “necessary medical attention” in healthcare matters. However, this concept is not explicitly defined and is interpreted differently by each province. It is also up to the province’s discretion to how this medical need is treated, whether that is via hospital care or by family physicians. Services are distributed in accordance with need; and the objective of needs-based access to services remains elusive and dependent on the person and province to which they reside.
With this considered, “reasonable access” to healthcare in Canada has turned out to be ambiguous in real life. There are some key challenges that need to be addressed in order for healthcare in Canada to patch the holes in it’s system.
Main Challenges in the Canadian Healthcare Industry
The first major problem in Canadian healthcare is it’s limitations in public coverage that results in costly private services. Dental care, psychological services, and home care are all not included in the public healthcare system.
Long-term care and end-of-life care provided in non-hospital facilities are also not considered insured services under the Canada Health Act, despite the fact that there is an aging trend occurring in Canada. This is due to decreasing fertility rates and increasing life expectancy. This is significant because it causes insult to injury – increasing the patient demand in areas that are already not covered by public health – such as medications and long-term home care.
With increasing demands, families are forced to pay for the services needed to take care of their elderly loved ones. According to Elderguru.com, agency care workers can cost up to $30 an hour, registered nurses up to $70, and a live-in caretaker can cost up to $3,500 per month with the additional room and board expenses. What’s worse is only about 1 in 16 Canadians over the age of 65 will move into an assisted care facility, as the wait time to be admitted can be several months.
Unfortunately, extended wait times are not restricted to assisted care facilities – bringing us to our next major challenge in Canadian healthcare.
The provincial Ministries of Health in Canada has required the publishing of wait times for receiving care in emergency rooms and by specialists on each province’s website. A search on Health Quality Ontario’s Website showed that wait time in an emergency room for high-urgency patients not admitted to a hospital was on average almost 4 hours. An amount of time that probably wouldn’t be defined by the average person as “an emergency”.
This number can wax and wane significantly, especially now depending on the number of COVID-19 cases in the hospital systems at any given time.
In regards to the lack of psychological services, Canada dedicates only 7.2% of its healthcare budget to mental health even though 20% of Canadians personally experience a mental illness in their lifetime.The need for mental health services is only growing with the pandemic, but even before that the World Health Organization estimated that in 2020, depression would be the leading cause of disease in Canada.
This statistic applies especially to healthcare workers as the doldrums of the pandemic drag on, and they continue to sacrifice their own physical and mental health for the sake of others’.
The Underserved Population: Healthcare Workers
Unfortunately, in Canada there is no “new normal” despite the changing healthcare demands of COVID-19. Issues of a broken system prior to COVID-19 have been brought to light and amplified. Prior to the pandemic, caregivers were already underpaid, under-supported, and undervalued. Coronavirus has accelerated this and caregivers are leaving the industry in droves.
There’s much work to be done to break down barriers and disrupt old models of healthcare, which needs to start with a shift in mindset that puts patients and caregivers on an equal playing field.
In 2018, a research team led by vascular surgeon Dr. Barry Rubin, the chair and program medical director at the Peter Munk Cardiac Centre at Toronto General Hospital, surveyed physicians, nurses and allied health professionals to gauge their level of burnout. This study found that 78% of nurses, 73% of allied health professionals — such as physical, respiratory and occupational therapists, pharmacists, social workers, dietitians and speech-language pathologists — and roughly 65% of physicians felt burnout in their roles.
With these numbers in consideration: one could only imagine what they have been during the ever-worsening COVID crisis. This statistic comes from the fact that in Canada the ratio of healthcare workers to civilians is low, with only 2.6 physicians per 1,000 persons in the population.
The Canadian government should be ensuring checks and balances essential to the healthcare system, to avoid burnout in healthcare workers because of the lack of coverage and resources within the public health sphere. Canada needs more government oversight, but with better delegation and efficiency in terms of distribution.
One big way to do this is employing the use of the private sector. By privatizing responsibilities that have fallen by the wayside in the public healthcare system, the private sector can tackle some of the bigger problems and pursue more accurate care. By co-designing a new system that caps profits and is led by the patients themselves, Canada can move forward into a brighter future of healthcare.
The Benefits of Privatizing Aspects of Healthcare
Canada is in desperate need of a system that brings clients and caregivers back into symbiosis, centralizing a system where all players play by the same rules but have the flexibility to innovate. This starts by recognizing caregivers, therapists, and nurses as the experts in themselves and gives them control over all aspects of their work.
The best way to start in this effort towards healthcare evolution is by treating the root causes of our healthcare system. Step one is allowing caregivers the ability to offer valuable insights into what it looks like on the front line. They see the disparities in healthcare every day and have valuable insider knowledge on how the system can improve.
The next step is steering healthcare industry positions away from simply being stepping stones, and making them into career opportunities where the workers feel both satisfied and motivated in their role. This additionally brings more humanity into healthcare – allowing for more community-focused delegation of referrals because healthcare workers feel valued. These workers are a part of the community as well, and when they feel their place as both a human and a wellness contributor – this sanctions for a better recommendation as fit for a particular patient outside of the scripted system.
This takes frustration away from clients who are fed up with countless referrals, duplication of systems, paperwork, and being told they need to be happy with what they can get. This could be simplified with one liaison in healthcare, making for one private advocate and one medical referral per medical need. This thereby makes one traceable system for billing, scheduling, and execution of needed medical attention.
Bringing the perspective back to the value of the patient could radically change the focus of Canada’s medical industry. By privatizing certain healthcare aspects, you prioritize client success over profits. In a bigger system with many gaps and hidden corners of coverage, patients can fall through the cracks and get treated incorrectly in order to save resources or time. Or worse, they are not treated at all. Clients should have a say in who their team is and be given a voice to swap out the people they don’t feel are serving them- whether that be on a success or comfort level.
A Brighter, Healthier future
Canada needs to improve the healthcare status quo by addressing the existing social, geographical, and cultural gaps in the existing system, especially considering that populations most at risk during this time are oftentimes the most vulnerable. By applying real solutions vs. band-aid ones, Canada can start working together as a community and move away from a protectionist approach.
In life- you plan for big moments like birthdays, weddings, or anniversaries – but sometimes the things that matter most you can’t plan for. The coronavirus pandemic has shown humanity that, and changed the world’s perspective on health in a big way.
With knowledge comes power. Knowing more about your individual health, the healthcare system, and your options for wellness within it, you can move forward with confidence into whatever 2021 brings.
About the Author
Bradley is the founder and CEO of Spark Lifecare, a company often described as the e-harmony of home healthcare services and the fastest growing healthcare company in Canada. He is a venture philanthropist, the world’s top 100 healthcare leaders award winner, and self-described misfit CEO.