A version of this commentary appeared in the Montreal Gazette, the Hill Times and Victoria Times Colonist
There’s nothing like an American health care debate to make Canadians feel lucky.
As his first act in office, Donald Trump signed an executive order, taking the first step to repeal the Affordable Care Act. With the stroke of a pen, 20 million Americans may soon find themselves without health insurance.
It wasn’t that long ago that many Canadians faced the same challenge.
When my grandparents Jacques and Sarah arrived in Montreal in 1951, they had left behind everything and everyone they knew in Egypt. The burden of building a new life in this new country fell heavily on Jacques’ shoulders. It was a role he assumed dutifully. Until, a year later, when he suffered a heart attack and was hospitalized for nine weeks.
The ordeal diminished him — physically and otherwise. Respiratory symptoms and other complications lingered. The cost of drugs and visits to the doctor were as crippling as the pain in his legs and he was barely able to work. For my grandmother, the twin pressures of caring for an ailing husband and holding the family together became overwhelming.
It was, to say the least, a grinding existence.
The story ends with my grandfather’s death at the age of 54 in 1966 — the same year that Parliament passed legislation to create Medicare. Had it been in place, how different might my grandparents’ lives have been?
Our system of health care is about more than money and medicine. It is about the values that define us as a society — are we there for one another when we’re at our must vulnerable? Do we place well-being above wealth? Do we believe that good health leads to good outcomes — like a stronger economy, more cohesive communities and more fulfilling lives?
And in the setting of the debates taking place today south of our border, we should never take the answers to these questions for granted. But let’s be honest. There are a variety of problems with our health care system in Canada.
People struggle to find a family doctor. They wait too long for specialist consultations and elective surgeries. Service could be better. Outcomes should be boosted. Spending must be sufficient, but it must also be sustainable.
We need, in a word, to make health care in Canada better.
For that reason, it’s time to shift the debate. Let’s quit bickering over whether we can sustain public health care in Canada and in Quebec. Let’s focus on how to sustain it.
The solutions are neither magical, nor beyond our grasp. And most of them don’t actually require more money — in fact, some of them will produce savings. In my book, Better Now, I highlight six such ideas that, if implemented, could produce important and wide-ranging transformation. For example, there is no reason we can’t ensure that every Canadian has access to a family doctor with whom they enjoy a trusting relationship. In fact, by working together in teams with nurses, physiotherapists and pharmacists, we could deliver truly patient-centred care.
Wait times for surgeries could be brought down by pooling lists among specialists. We can do a better job of protecting patients from adverse effects and outright harm by reducing unnecessary tests and procedures. And if we were to bring prescription medicines into medicare by creating a national pharmacare system, we could save money and provide everyone with access to life-saving drugs.
Ideas like these could unleash dramatic improvements in Canadian health care right away. All that’s required is the political and popular will. And, perhaps even more fundamentally, a commitment to maintaining the principle of universal access that underpins our system and which seems to, once again, be under fire in the United States.
Our system of universal health care is a fundamental expression of our values and a testament to Canadians’ commitment to fairness. It is a system built upon the basic principle that care should be based upon need, not ability to pay. That’s not a value that goes out of style.
But if we believe that medicare is a worthy endeavour then we must also live up to those values and accept the responsibility to make that system work — and work well. It’s time to make it better.
Danielle Martin is an expert advisor with EvidenceNetwork.ca and author of BETTER NOW: Six Big Ideas to Improve Health Care for All Canadians, released earlier this month by Penguin Random House. Dr. Martin is a family physician and Vice President Medical Affairs and Health System Solutions at Women’s College Hospital in Toronto.