Friday, April 3, 2020

Canada’s hospital system ill-prepared for COVID-19 crisis


Gwyn Morgan
Canada’s hopelessly dysfunctional and dangerous government-monopoly health-care system one of the least prepared in the world to deal with the crisis

By Gwyn Morgan
Contributor
Troy Media
The Liberal government’s plan to use Canada’s “fiscal firepower” to help Canadian families and businesses weather the COVID-19 pandemic has been appropriately termed “a measured well-targeted response” by the Fraser Institute. But no amount of cash can change the terrible reality that Canada’s health-care system is one of the least prepared to deal with the crisis.

Decades before COVID-19 struck, Canadians in every province and territory were suffering, and some dying, on ever-lengthening wait lists.

In an already overloaded system with virtually zero spare capacity, treating burgeoning numbers of COVID-19 patients will necessitate further delay for other patients with time-critical afflictions such as cancer.

And that’s already happening. Over the past few days, two Ontario women had their cancer surgeries cancelled so hospitals can free up capacity for COVID-19 patients.

Canada’s hospital capacity has been in steady decline. The latest available statistics comparing 24 developed countries show that in 2017, Canada ranked dead last in hospital beds per capita at just 2.5 per thousand. Germany, Austria, Hungary, Czech Republic, Lithuania, France, Slovakia, Belgium and Latvia all had more than twice that number.

The U.S. was only marginally better at 2.8 but that’s where the similarity ends.

The occupancy level of Canada’s hospital beds was 92 per cent. That effectively means zero unused capacity since logistics and staffing issues make 100 per cent utilization impossible.

By contrast, hospital bed occupancy in the U.S. was 64 per cent. And for ICU critical care beds, crucial for COVID-19 treatment, the U.S. ranked first of the 24 countries with 35 per 100,000 population. Canada has only 12 per 100,000, the same number as overwhelmed Italy.

With infections rising each day, Canadian doctors face the daunting prospect of deciding who will be treated and who won’t. Those life-and-death decisions must be made not only for patients with COVID-19 but for other seriously ill patients who are displaced.

An October 2019 Fraser Institute report on health care in 28 countries found that Canada ranks second highest in per-capita spending but last in access to treatment. How could this have been allowed to happen?

When the crisis ends, that’s a question Canadians grieving for their lost loved ones will want answered.

But the answer is already clear. Canada is the only country in the world that outlaws private health care. Prime ministers, premiers and health-care administrators have known for years that our government-run monopoly system was suffering from the dual afflictions of unsustainable cost growth and ever-lengthening wait lists.

Meanwhile, anti-private sector unions and other entrenched interests vigorously perpetuated the myth that Canada has world’s best health system and engendered based fear of ‘for-profit’ health care.

Hearkening back to world wars, Canadian industry is being asked to retool to produce the ventilators and other equipment needed to treat COVID-19 victims, along with equipment to protect health-care workers valiantly risking their health to save others.

I’m sure industry will do everything possible to respond. But why, two weeks after Canada’s first COVID-19 case was identified on Jan. 25, did the government sent 16 tonnes of that same personal protective equipment to China? And isn’t it ironic that the private sector is being asked to make up for the failure of a government monopoly ideologically opposed to its involvement?

Dr. Andy Thompson, a respected rheumatologist with Ontario’s Arva Clinic and an associate professor of Medicine at Western University in London, Ont., publishes a daily blog sourcing data from national health authorities that compares the spread of COVID-19 in Italy, Spain, Germany, France, U.K., U.S. and Canada. The comparisons are alarming for Canadians.

Because countries are at various stages of the pandemic, the comparison standard is from the date that 150 cases are detected. For Canada, that day was March 12. By March 30, Canada had 7,708 confirmed and probable cases, making our cases per million population about the same as the U.S. and Italy at their 150-case mark. As of March 30, cases were doubling every four days. If that rate continues, our cases will become 92,496 in just two weeks.

And here’s where our lack of available treatment capacity comes into stark perspective. At the 150-case mark, Canada ranked second highest in cases per hospital bed behind overwhelmed Spain.

Canada’s doctors, nurses and other health-care workers are world class and highly dedicated. We know they will risk their health doing everything possible even as they face an egregious lack of facilities and equipment.

They deserve our support, consideration and admiration.

But once this crisis is behind us, Canadians must demand that Canada’s hopelessly dysfunctional and dangerous government-monopoly health-care system be opened to private sector competition, like every other country in the world.

Gwyn Morgan is a retired Canadian business leader who has been a director of five global corporations.

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