What a new health-care funding deal means for Canada

As an anesthesiologist, my mind is trained to perceive the world in a certain way. With a cursory glance, I assess whether a person will be a difficult IV start or challenging intubation. When someone begins sweating and breathing heavily besides me, I go through a mental checklist of whether it’s a medical emergency. These mental models help focus my attention on what’s important to anesthesiologists. Inevitably however, there have been situations where a narrow focus stopped me from seeing the bigger patient picture. In health care, governments have been focused on funding as the quick fix. And while it’s clear we do need more money, that narrow focus has stopped our 13 health systems from seeing the bigger picture to stabilize and rebuild Canadian health care. The Canadian Medical Association (CMA) has been advocating for the federal government to work with the provinces and territories to increase health funding via the Canada Health Transfer. A 2022 report commissioned by the CMA showed that as provinces and territories grapple with more demand, the federal share of health funding is projected to decline. Health-care costs account for 30 to 40 per cent of provincial and territorial budgets, and these costs are expected to increase at an average annual rate of 5.2 per cent over the next decade—a rate that might grow faster than projected revenues. At the time of this publication, I am cautiously optimistic a long-awaited funding agreement is near. But I will repeat a common refrain from the CMA and several other advocacy organizations: further fiscal investment alone isn’t enough. We need targeted funding with pragmatic outcome measurements if we’re to address the multiple health crises that are pushing health systems to their breaking point and beyond. Right now, we spend more than $300-billion annually on health care—about 13 per cent of our GDP, amounting to the second highest among OECD countries. The harsh reality is that, while COVID-19 shone a light on vulnerabilities, our health-care system has increasingly been focused on the wrong solutions. This is evident with staggering wait times, chronic staff shortages, and rampant burnout; the system continues to crumble around us. Dr. Alika Lafontaine is president of the Canadian Medical Association. Photograph courtesy of the CMA One physician in Port Hardy, B.C., is offering to pay for an assistant out of pocket, counting down the days until July 1 when he will be the only doctor in the emergency department to serve nearly 4,000 people. There have been multiple reports of patients coming to harm as a result of wait times, sometimes even within ERs themselves. For physicians, the inability to care for patients is demoralizing. A recent CMA poll found that more than 95 per cent of physicians, residents, and medical students describe Canada’s health-care system as being unable to meet the needs of patients. In fact, more than half of respondents rated health system performance as dangerous or failing. Canadians desperately need action to stabilize the health workforce, improve patient access, and deepen collaboration across our provincial and territorial health systems—which until this point have been operating in siloes. We need concrete action from governments to work more collaboratively together, with a focus on the bigger picture. We need pan-Canadian licensure to make physicians more mobile, so they can work where patients need them the most. We need to expand team-based and virtual care so more Canadians have timely access to family doctors and other practitioners, leaving behind a current siloed approach. We need multi-jurisdictional data sharing so we can better understand and plan for real-time patient needs. We need to reduce physicians’ administrative burden to give them more time for patients. A recent study estimated this to be equivalent to 18.5 million hours per year—that’s 55.6 million patient visits annually. And we need a national health human resource strategy to rebuild our health-care workforce, leaving behind competition between provinces and territories. Any one of these solutions would greatly stabilize our current health system collapse. Together, these solutions would transform Canadian health care. For too long, we’ve been operating under a collective myth that Canada’s 13 health systems continue to be the best in the world, delivering high-quality care to anyone who needs it. We continue to look backwards, clinging to narrowly focused solutions rooted in maladaptive mental models. With the foundation of a new sustainable funding agreement, we must widen our focus to the bigger picture if we truly want to fix Canadian health care. Dr. Alika Lafontaine is president of the Canadian Medical Association. The Hill Times

What a new health-care funding deal means for Canada

While it’s clear we do need more money, that narrow focus has stopped our 13 health systems from seeing the bigger picture to stabilize and rebuild Canadian health care.

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What a new health-care funding deal means for Canada

While it’s clear we do need more money, that narrow focus has stopped our 13 health systems from seeing the bigger picture to stabilize and rebuild Canadian health care.

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