What’s Happening to Healthcare? - Granite Grok

What’s Happening to Healthcare?

Affordable Quality Healthcare

Last week the Los Angeles Times declared it conventional wisdom thatCOVID-19 proves Bernie Sanders was right about “Medicare for All.” The Times said with universal health coverage, the government wouldn’t have to send emergency aid to “hospitals and state health programs.” But is that actually true?

Funny as it may be, writing something, even in a big paper does not make it true. The LA Time assertion is completely false. We know because billions in emergency aid from the federal government is precisely what’s happening in Canada. Canada is Bernie’s exemplar for single payer healthcare.

What is single payer showing us in Canada today?

Canada is experiencing a surge in serious COVID-19 cases. It is seeing eight new deaths per million. Total deaths in Canada were up to 435 per day. Canadian society essentially is on lockdown. Schools and public events are closing, police fining house parties, and provinces are closing all nonessential businesses.

Any of that sound familiar? Like the U.S., Canada began to see widespread shortages in health-related supplies. From masks to personal protective equipment, from testing reagents to vaccine manufacturing capacity, they are short. How could that be in a single payer system?

Like the U.S., the overarching concern in Canada has been “bending the curve” of infections. They are using compulsory social distancing mandates that raise constitutional questions. Like the U.S. and contrary to the Los Angeles Times, Canada’s federal government is committing to billions for cash strapped health agencies and hospitals across the country.  There is intense pressure for more.

The fight is about MONEY … because everyone knows there isn’t enough healthcare

The spending sparked a bitter showdown in Parliament. The opposition balked at the government’s request to spend “all money required to do anything.” What gives Canada such urgency to keep the infection curve down is that, going on decades now, the single dominating feature of Canadian health care is shortages.

As early as March 20, Reuters news service quoted the chief of staff of one of Ontario’s newest hospitals. He said, “You’ve got people in broom closets and auditoriums and conference rooms across the country.” Even in normal times, the average wait in Canada from referral to treatment by a specialist is 20 weeks. That compares with less than four weeks in the U.S. Long before COVID-19, an estimated 1 million Canadians languished on waiting lists, waiting in pain or flying abroad for faster treatment.

Canadians long have faced shortages and lengthy waits for MRIs and ultrasounds. It is common for them to be forced to use outdated and cheaper drugs. Canadian emergency rooms have been packed for years. Canadian average four-hour waits are running three times the U.S. level in good times.  This is all in normal times, before COVID-19, the disease caused by the new coronavirus.

These shortages mean there is very little spare capacity in Canada. The spike from coronavirus has made it difficult to handle the surge in emergency treatment. The concern is most acute for beds in intensive care units, the kind needed to treat critical COVID-19 cases.

Bureaucracy may be efficient but it fails to plan for the inevitable

Per capita, Canada has one-third as many ICU beds as the U.S.  It has about the same capacity Italy. In some provinces, including Alberta and British Columbia, ICU beds number fewer per capita than Iran. That’s government running your hospitals. The budget gets tight what gets cut?

Given these problems, “bending the curve” of coronavirus infections becomes an existential priority for Canada. Few are talking of reopening the Canadian economy anytime soon. That’s because the spare critical care infrastructure is not there. Already in early April, over 3 million Canadians had applied for unemployment benefits, equivalent to 27 million Americans.

Unfortunately, at this point, there is little Canada can do. The private health care sector for critical care is atrophied. That’s what happens when a monopoly public sector largely bans private sector competition. Then the government cuts corners to save money. Thousands of retired doctors and nurses have volunteered heroically to return to work. But understand, there essentially is no private sector to ramp up capacity quickly or otherwise. Canadians are left to hope for the best as the slow machinery of government which is the public health system grinds on.

Canada is trying… coping… waiting for inadequate healthcare…

Too little too late, Canada is doing what it can to bring in the private sector. Emergency deregulations are spreading across health care. From scope of practice to product licensing change is coming. Private operators finally are getting limited permission to operate in telemedicine. But Canada has 50 years of government management of essential health care. This has left Canada with far less capacity and far fewer resources than it needs in this crisis.

The Canadians are going to pay for their cheap, not very accessible care, probably with lives. As for Medicare for All, the COVID-19 crisis in Canada has shown the brutal consequences of government-run health care. It gives you shortages just when you need care the most. Government cannot and will not respond to demand like a functioning private sector. Do you want your ability to access healthcare dependent on governmental budget debates?