The biggest barrier to Canadian health care reform? Mythology.

One of the best pieces of wisdom I’ve ever heard came from Dr. Jack Kitts, the CEO of the Ottawa Hospital. He said, (and I’m paraphrasing): “One of our biggest challenges is persuading Canadians that our health care system is not the best in the world.”

For those of us who work in advocacy, trying to improve our health care system, the biggest challenge, indeed, is generating the sense of urgency in the public that is necessary to prompt political action. Political leaders only respond to political pressure, and that pressure can only come from Canadians themselves.

Part of the problem is that, historically, Canadians are somewhat reluctant, afraid even, to question the status quo in health care. To do so, many believe, is to somehow reject Canadian values of inclusion and egalitarianism and to embrace what is often called, “American-style” health care. And so the status quo is perpetuated, bolstered by the common mythology that Canadians have “the best health care system in the world”.

There are certainly many good things about Canadian health care. And I am delighted that the most recent survey shows that Canadians are generally happy with the quality of care they receive once they finally get in. That is heartening for those of us on the front lines who are doing our very best for our patients. And it’s good that virtually all of hospital and doctor costs are publicly funded; patients do not pay out of pocket. This is rightfully a point of national pride.

However, the good news stops there.

We rank dead last in a survey of affluent Western countries when it comes to access. That means Canadians wait longer in Emergency Departments, for surgeries & procedures, and for appointments with specialists than people in all these other peer countries. Most of us are not able to get same or next day appointments with our family doctors.

Our hospitals across the country are bursting at the seams. Occupancy is routinely over 100 percent. It’s called, “Code Gridlock” and it means that patients are in hallways, that surgeries are cancelled, that Emergency Departments are filled with admitted patients with no place to go. This is now the norm; it is everyday life in the hospital.

And how about this: 15 percent of all acute care hospital beds in Canada are occupied by patients who are not acutely ill. They’re there because they have no where else to go. They’re waiting for home care, or, more often, for a long term care facility bed. Fully 50 percent of all Canadians currently waiting for long term care in this country are currently languishing in a hospital bed, just waiting. In NB, my home province, 10 percent of these hospitalized patients wait over two years in that hospital bed until they get to the long term care bed.

Two years!

Who wants to live in a hospital!!

Not only are we not serving these frail seniors well, we are creating intolerable hospital congestion that creates incredible economic inefficiencies, poor quality care, long waits, and siloed patient experiences.

We must and can do better, but we need you – the public – to be outraged that this is happening. As patients and families, you should demand ( that we do better for our seniors. As taxpayers, you should ask your elected representatives why Canada has one of the most expensive health care systems in the world, but one that ranks at the very bottom in international rankings of quality, value for money, access and outcomes.

The solutions are within reach, but we need vision, we need leadership, and we need solidarity from Canadians. The starting point? Let’s acknowledge that Canada doesn’t have the best health care system in the world. But then, let’s be relentless in our drive to make it so.

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