Commentary  Healthcare reform: universal taboo

Reassessing attitudes toward our system

When asked, Canadians will inevitably cite universal healthcare as a defining national characteristic. Ask the same Canadians if they would consider reneging on the system in the name of fiscal responsibility, and they would answer with a resounding ‘no.’

The healthcare system is so institutionalized that abandoning this cornerstone of modern Canadian identity is politically, and perhaps morally, unfeasible. That is perfectly fine and well. I support universal healthcare in principle, and I hope it endures. Yet dismissing even the slightest suggestion of change has led us into a difficult predicament.

As unfortunate as it may be – almost akin to discovering Santa Claus isn’t real – it is important that Canadians recognize the problems endemic in the system. This is especially important if future governments will expect complicity from the general public when instituting some aspects of privatization to reform healthcare, like raising taxes or cutting other social programs.

While the global postwar development of welfare states has shown potential for success, their implementation does not mean they should stay static. That the state has a role in maintaining the health of its populace is not justification for never-ending blank cheques from the government. Extensive institutional bureaucracy, exasperated by Canada’s unique provincial-federal relations, and the tacit acceptance of sub-par management policies have produced a system that does not fulfill its true potential.

At present, Canadian healthcare does its best to meet the medical needs of its population. In many respects, such as acute emergency care, the system thrives. Yet it is in the system’s shortcomings that the need for change is evident. Provincial governments are perpetually scrambling to balance budgets, and the task becomes more difficult with each passing year. The system has created a serious gap between jurisdictional responsibility and the practical application of provincial revenues, with cash being disproportionately funneled into healthcare. Provincial governments’ plates are full, and their pockets empty.

We proudly compare Canadian healthcare extensively with its neighbour to the South – to the Canadian system’s detriment. This kind of Michael Moore-emboldened self-congratulation has run its course, and only serves to further consecrate our only-average system in the collective nationalistic psyche. This seems akin to celebrating the superiority of the handling of Exxon Valdez’s oil spill compared to BP’s.

The Canadian system falls short of its counterparts across both the Atlantic and the Pacific. Other countries, like Japan and the UK, offer more comprehensive and fiscally responsible healthcare to larger populations at a fraction of the Canadian price tag. The system also neglects non-emergency cases: unless life-threatening, Canadians can expect the longest wait times in the Western world.

It lacks adequate alternative points of access to the system, which revolves around hospitalization and the ER. Meanwhile cheaper, more efficient, more appropriate alternatives are neglected – such as preventive care, community outreach, education, and increased promotion of walk-in clinics. Persons with chronic conditions like diabetes or AIDS, and the elderly, would better benefit from cheaper healthcare settings outside the hospital.

Most importantly, Canada’s system has been the subject of makeshift band-aid solutions. The Canada Health and Social Transfer program dramatically cut federal transfer payments, yet resulted in widespread hospital closures across the country. Paul Martin’s $4.5 billion offering from 2004 to reduce wait times has only temporarily alleviated the problem, putting more medical professionals on the job in the short term. When the money runs out, waiting lines will be as long, if not longer. These quick fixes will not remedy fundamental problems in Canadian healthcare.

Universal healthcare is a celebrated Canadian treasure, but we can’t ignore the program’s fiscal unsustainability. If young Canadians want to reap the benefits of our national healthcare system in the future, they must reassess their complacent attitude toward Medicare and enact serious structural changes now. One mustn’t fix what’s not broken, but we should fix what is.

Morgan Fergenbaum is a U3 History and Political Science student. He can reached at