The Private Sector Must Get a Larger Role in Canadian Health Care

Gwyn Morgan
April 4, 2020
Canada has so far ducked the extreme growth in the Covid-19 hospitalization and mortality rates afflicting some other countries. The worst is certainly still to come, however – and when it does, the shortfall in Canada’s health care capacity will be laid bare. The vulnerability was largely avoidable, points out Gwyn Morgan, if Canada like nearly all other countries had only allowed private health care delivery alongside its public system. When the nation comes out the other side of the pandemic, Morgan writes, a health care policy reckoning will be long overdue.

The Private Sector Must Get a Larger Role in Canadian Health Care

Gwyn Morgan
April 4, 2020
Canada has so far ducked the extreme growth in the Covid-19 hospitalization and mortality rates afflicting some other countries. The worst is certainly still to come, however – and when it does, the shortfall in Canada’s health care capacity will be laid bare. The vulnerability was largely avoidable, points out Gwyn Morgan, if Canada like nearly all other countries had only allowed private health care delivery alongside its public system. When the nation comes out the other side of the pandemic, Morgan writes, a health care policy reckoning will be long overdue.
Share on facebook
Share on Facebook
Share on twitter
Share on Twitter

The Liberal government’s plan to use Canada’s “fiscal firepower” to help Canadian families and businesses weather the Covid-19 pandemic has received widespread support, even from normally critical sources like the Fraser Institute, which termed it “a measured, well-targeted response”. But no amount of cash can change the terrible reality that Canada’s health care system is one of the least prepared to deal with the crisis. 

For decades before Covid-19 struck, Canadians in every province and territory were suffering, and some dying, on ever-lengthening waiting lists. In an already overloaded system with virtually zero spare capacity, treating burgeoning numbers of Covid-19 patients will necessitate further delay for other patients with time-critical afflictions such as cancer. And that’s already happening. Among the many examples, over the past few days two Ontario women had their cancer surgery cancelled so hospitals could free up capacity for Covid-19 patients.

Long waits on a good day: Canada’s health care system has almost zero spare capacity, plus fewer ICU beds per capita than many other countries.

Canada’s hospital capacity has been in steady relative decline. The latest available statistics comparing 24 developed countries show that in 2017, Canada ranked dead last in hospital beds per capita at just 2.5 per thousand population. Germany, Austria, Hungary, the Czech Republic, Lithuania, France, Slovakia, Belgium and Latvia all had more than twice that ratio.

The United States was only marginally better at 2.8 per thousand, but that’s where the similarity ended. The occupancy level of Canada’s hospital beds that year averaged 92 percent. That effectively meant zero unused capacity since logistics and staffing issues make 100 percent utilization impossible. By contrast, hospital bed occupancy in the U.S. averaged only 64 percent. 

And for intensive care unit (ICU) or critical care beds, which are crucial for successful treatment of the more serious Covid-19 cases, the U.S. ranked first of the 24 countries with 35 ICU beds per hundred-thousand population. Canada had only 12 per hundred-thousand, the same proportion as overwhelmed Italy. With the number of diagnosed infections rising significantly each day, Canadian doctors may before long face the daunting prospect of deciding who will be treated and who will not. Those life-and-death decisions must be made not only for patients with Covid-19, but for other seriously ill patients who are displaced.

Morgan - Inset 2 (above)
When a system cracks: Chaotic scenes in Bergamo, one of Italy’s hardest-hit cities.
When a system cracks: Chaotic scenes in Bergamo, one of Italy’s hardest-hit cities.

A Fraser Institute report released last October on health care in 28 countries found that Canada ranks second-highest in per-capita health care spending, but dead last in access to treatment. This is truly shocking. How could this have been allowed to happen? When the crisis ends, that’s a question that Canadians grieving for their lost loved ones will want answered. But that answer is already clear. 

Canada is virtually the only country in the world that outlaws private health care. Prime ministers, premiers and health care administrators have known for years that our government-run monopoly system was suffering from the dual afflictions of unsustainable cost growth and ever-lengthening waiting lists. Meanwhile, anti-private-sector unions and other entrenched interests vigorously perpetuated the myth that Canada has the “world’s best health system” and engendered baseless fear of “for profit” health care.

The much-maligned private U.S. system has gleaming facilities and ample spare capacity in many states, like the Mayo Clinic in Rochester, Minnesota, pictured.
The much-maligned private U.S. system has gleaming facilities and ample spare capacity in many states, like the Mayo Clinic in Rochester, Minnesota, pictured.

Now, hearkening back to past world wars, Canadian industry is being asked to “retool” to produce the ventilators and other equipment needed to treat Covid-19 victims, along with equipment to protect health care workers valiantly risking their own health to save others. I’m sure industry will do everything possible to help, and the response is already underway. But a question that must be asked is why, two weeks after Canada’s first Covid-19 case was identified on January 25, the federal government sent 16 tonnes of that same personal protective equipment to China. And isn’t it ironic that the private sector is being asked to make up for the failure of a government monopoly that is ideologically opposed to its involvement?

Repeating history? A makeshift Second World War field hospital near Utah Beach in Normandy, France.

Dr. Andy Thompson, a respected rheumatologist with Ontario’s Arva Clinic and Associate Professor of Medicine at the University of Western Ontario, publishes a daily blog sourcing data from national health authorities that compares the spread of Covid-19 in Italy, Spain, Germany, France, the UK, U.S. and Canada. The comparisons are alarming for Canadians.

Because countries are at various stages of the pandemic, to provide clarity regarding the infection’s progression in each country, the comparison is standardized from the date that a nationwide total of 150 cases is detected. For Canada, that day was March 12. By March 30, Canada had 7,708 confirmed and probable cases. This made our ratio of cases per million population – around 205 – about the same as in the U.S. and Italy 18 days after their 150-case mark.

Teutonic efficiency: Germany’s well-organized testing process and health system have helped minimize the country’s Covid-19 death rate.

And here’s where our health care system’s lack of treatment capacity comes into stark perspective. At that same 18-day mark, Canada had the second-highest ratio of cases per hospital bed – just behind overwhelmed Spain. As of March 30, Canada’s cases were doubling every four days. If that rate continues, it will take only two more weeks for total cases to reach 92,496.  

Canada’s doctors, nurses and other healthcare workers are world-class and highly dedicated. We know they will risk their own health doing everything humanly possible as they face an egregious lack of facilities and equipment even without the Covid-19 pandemic. They deserve our support, consideration and admiration. But once this crisis is behind us, Canadians must demand that Canada’s hopelessly dysfunctional and dangerous government-monopoly health care system be opened to private-sector competition, like nearly every other country in the world.

Gwyn Morgan is the retired founding CEO of Encana Corporation.

Love C2C Journal? Here's how you can help us grow.

More for you

It's time for an open, rational debate on immigration policy in Canada.

Can Canada Handle a Rational, Polite and Fact-Based Debate About Immigration?

It seems as if a new taboo is foisted upon Canadians by the week. Immigration is already among our established taboos – while the limits on its remaining areas of policy discussion grow ever-tighter. Canadians as a whole want less of it, while our elites are convinced that only good can come from more of it – and that increasing our diversity of origin is so important that it shall require uniformity of thought. Academic economist and former Parliamentarian Herbert Grubel says nuts to that, offering his take on key elements of immigration policy, plus the facts to support it. Part I of a two-part analysis.

It's a gross example of government overreach for there to be policies directing the diet and exercise of the population.

The Right To Be Fat: Pushing Back Against Government Overreach

Would beloved comic actor John Candy have lived longer if government forced him to eat less? What about Orson Welles? Or Luciano Pavarotti? Perhaps. Would they have been happier or more successful? We’ll never know the answer to the first, and as to the second, almost certainly not. Candy built his career around a lovable portliness, Welles often played menacing fat men and Pavarotti’s girth helped him belt out arias. A few extra pounds, in other words, offers both advantages and disadvantages − and it should be up to the individual to decide how to balance the scales. As governments ramp up policies designed to put their citizenry on a diet, Matthew Lau sallies forth in defence of eating what you want, and exercising only when you feel the need.

Pictured is Gulliver tied down by the Lilliputians. Illustrating the plight of civil servants under increasing regulation.

Slow Death by Regulation, the Great Public-Sector Disease

When do the words “transparency” and “accountability” mean the opposite of what an untutored citizen might think? Why, when they’re passing the lips of a Canadian civil servant. The federal bureaucracy also seems the one place where the digital revolution made everyone less productive. And while this sounds amusing (if pathetic), the federal bureaucracy’s power and intrusiveness just grow and grow while the freedoms of individuals and voluntary associations shrink and shrink. Former citizenship judge Joe Woodard takes a wry look at these trends and with good humour tracks the deadly serious slide of Canada from a free society in which everything that isn’t specifically forbidden is allowed, into something sadder, darker and more constrained.

More from this author

Will WE be the same after this Trudeau ethics scandal?

The Biggest Question Mark in Trudeau’s Latest Ethics Scandal

We are now onto Prime Minister Justin Trudeau’s third official ethics imbroglio. Mr. “blind spot”, as a previous ethics commissioner termed him, is back at it, once more trailing cabinet ministers and political flunkies. The blind leading the blind, as it were. This time around it’s a close to billion-dollar sweetheart deal offered to WE Charity – an organization with close ties to Trudeau and cabinet ministers. As the Opposition and media focus on the mechanics and legalities of the growing scandal, Gwyn Morgan probes the deeper question of why anyone would think shovelling vast sums into yet another summer jobs program for students was a good idea. The possible answer is downright diabolical.

Stone statue wearing masks during the government lockdown

The Lockdown Contrarians Were Right

The days are at their longest, everything’s blooming, summer is nigh and Canadians are increasingly going about their regular lives. Spirits are lifting. And serious questions are being asked. Like Plato’s cave-dwellers emerging out of the darkness, we are blinking in the dazzling light of our 5 am northern dawns. What just happened? Do the claimed but unprovable benefits of the pandemic response stack up against the staggering quantifiable damage? Could we have done better? Gwyn Morgan takes a clear-headed look at these questions and prescribes some principles to dig our way out and avoid a needless repeat.

Canada Needs its Oil and Natural Gas Industry More than Ever

You don’t see news media reporting that Germany has declared Audi and BMW to be obsolete companies from yesteryear. Nor that Switzerland has come to regard its banking sector and watchmakers as sunset industries. There’s been no announcement that South Korea is shuttering Samsung. Nor that the Greeks are tearing over hill and dale torching their olive and orange groves. Everywhere you look, countries are leaning on their proven economic strengths to power their post-Covid comeback. So why is Canada’s federal government, seemingly alone in the world, intent on euthanizing this nation’s number-one source of export earnings and inter-regional tax transfers – the oil and natural gas sector? Gwyn Morgan moves briskly through the recent madness and declares that this is one instance of ideological folly the country simply can’t afford.

Share This Story

Share on facebook
Share on twitter
Share on print

Donate

Subscribe to the C2C Weekly
It's Free!

* indicates required
Interests
By providing your email you consent to receive news and updates from C2C Journal. You may unsubscribe at any time.