Medicine for the Medical System

Canadians are known for being deeply attached to our universal health-care system. Governments have been made and broken over it, at both the federal and provincial levels. Indeed, the upcoming Ontario election has seen a spike in discussion about health care, especially given the upcoming negotiations between Ottawa and the provinces over the system’s financing. The current national health accord has been relatively successful, but expires in 2014, so negotiations must begin soon. And change is in the air: Ontario, NWT, Newfoundland, Prince Edward Island, Saskatchewan and Manitoba are all holding elections this year. If Ottawa wants to move one way and the provinces—or their populations—another, this could set off some big electoral sparks. Whether the Conservative government will show its cards so far in advance, however, remains to be seen.

Universal health care has always dominated our politics, and as our population ages, it promises to become even more dominant. The state of the system is understandably important to senior and late-middle-age Canadians, but increasingly, young Canadians are also taking notice of the system that they will eventually inherit, and come to depend upon. Calls for increased funding, efficiency, more doctors, improved access and wait times all are coming from younger demographics. After all, it is the way we handle the smaller problems of today that will make or break the system of tomorrow.

The way the system is currently co-financed by the different levels of government needs to be overhauled and streamlined to weed out waste and improve distribution of funds to appropriate sectors, such as training and equipment purchases. The current government, to its credit, has called for a single accord in lieu of separate pacts with individual provinces—continuing this practice from the previous accord is a strong step toward increasing efficiency. Further, Health Minister Leona Aglukkaq has called for heightened accountability to ensure health care dollars are spent wisely and transparently. Considering the near $200 billion annual cost of the Canadian health system to taxpayers, it’s a call that is sure to meet welcome ears.

It’s no secret that a wise investment starts with the basic building blocks of a project—the people who make it happen. In this case, we need to invest in health infrastructure and, particularly, in education. Canada needs a comprehensive national strategy (or, at the very least, stronger federal-provincial cooperation) to ensure we’re training more doctors, and training them better. Canada has some of the finest medical schools in the world, but many are notoriously difficult to enter. Some would argue that the harder it is to get in, the better; after all, don’t we want only the best of the best in charge of our health? At the same time, as important as grades are, they don’t necessarily make for great doctors. Schools need to fund programs to help attract medical students from different fields, bringing different things to the table. For example, in a population increasingly made up of immigrants and elderly people, a doctor who has studied, say, international languages and not just science may have a certain advantage in situations where patients need help communicating their needs. A commitment to researching and recruiting these kinds of students to the medical profession would be a boon to Canadian health provision, especially in our largest cities.

When it comes to actual training, putting money into smarter programs to train home-grown doctors would give us a competitive edge. Presently, a good number of Canadian medical students to do some or all of their training in the U.S. The problem with this, of course, is that it can be difficult to retain their expertise back home where it’s needed. The American system can pay bigger dividends, and the lure of money can be powerful, especially considering the debt load most doctors take on to finance their educations. Helping ease that financial burden and making access to assistance easier could be part of the new national health strategy to encourage those doctors to stay at home.

Whatever comes of the impending health care debate, whether it’s a strong discussion or an all out federal-provincial battle, let’s hope we see some smart choices about how and where to place our focus and spend our money. If we work to address the challenges now, we’ll be rewarded with a stronger health care system, better trained doctors, and a more streamlined approach that will benefit all Canadians, both now and in the future.

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