Canada’s health-care crisis: Problems, solutions and privatization

Summary

The video script discusses the urgent need for improvements in healthcare systems, emphasizing the importance of recognizing and supporting caregivers. Participants, including a nursing school representative, a nurse who transitioned to the private sector, a patient, and a doctor, highlight the necessity for long-term solutions, reinvestment in healthcare professionals, and the prevention of health issues. They critique the reliance on private clinics, the lack of universal coverage for services like pharmacare and mental health, and the inefficiencies in data sharing and administration. The conversation underscores the need for a functional public system and the value of every healthcare worker.

Takeaways

• 💰 The healthcare system is receiving more funding than ever, yet it is still insufficient to meet the growing needs.
• 🏫 Enrollment in nursing schools is increasing, but there is a shortage of caregivers and healthcare professionals.
• 👀 Caregivers need to be more visible, heard, respected, and included as vital parts of the healthcare team.
• 🔄 There is a call to reinvest in nursing and healthcare professionals, including better pay and collaboration within healthcare teams.
• 🚑 The solution to healthcare crises requires long-term planning that may not align with short-term election goals.
• 🏥 There is a strong emphasis on the need for more focus on preventive care to reduce hospital admissions.
• 🤯 The lack of free and fair distribution of services, especially mental health services, is a concern post-pandemic.
• 🌐 Canada's reliance on the private sector for healthcare is unusual among advanced countries and contributes to inefficiencies.
• 🏥 The public healthcare system is deteriorating due to underfunding and lack of support for healthcare providers.
• 💉 There is a proposal to leverage the skills of personal support workers to alleviate the workload of nurses and improve patient care.
• 💼 The undervaluation of healthcare workers' work, especially in the public system, is leading to labor shortages and burnout.
• 📈 There is a need for better data sharing, standardized waiting lists, and efficient healthcare administration to improve the system.

Q & A

What is the main concern expressed by Sarah about the current healthcare system?

Sarah emphasizes the need for caregivers to be seen, heard, respected, and included as a vital part of the healthcare team.

Why did Lynn Tran leave the public healthcare system to work in the private sector?

Lynn Tran left the public system due to a lack of opportunities for training and growth, and she seeks a career that values flexibility, work-life balance, and fair compensation.

What decision did Max Johnson make that was influenced by the healthcare system's shortcomings?

Max Johnson decided to travel to Lithuania for a knee replacement surgery because of a two-year waiting list in Winnipeg, highlighting the issue of long wait times in the public system.

What does Dr. Germantang suggest as a solution to the healthcare crisis?

Dr. Germantang suggests putting more emphasis on prevention and investing in areas that will have higher needs in the future, such as mental health services.

What is the issue with mental health services according to the transcript?

The issue is that mental health services are not universally covered and people are still required to pay out of pocket, which is not a fair distribution of services.

What is the problem with the current reliance on the private sector in healthcare as discussed in the transcript?

The reliance on the private sector is problematic because it leads to underfunding of public services like pharmacare, dental care, and mental health care, and it neglects the caregivers who are essential to the system.

Why does the Ontario government's approach to offering more money to private clinics for certain procedures raise concerns?

The approach is concerning because it costs the public system more money, as private clinics are for-profit and receive a 30% incentive, which could be better spent improving the public system.

What is the impact of individuals paying for private healthcare on the public system?

When individuals pay for private healthcare, it drains resources from the public system, leading to a decline in the quality of care for those who cannot afford private options.

What does Lynn suggest as a way to improve the healthcare system?

Lynn suggests leveraging the expertise and knowledge of all healthcare professionals, including personal support workers, to operate at their highest capacity and improve patient care.

What inefficiencies in the healthcare system are highlighted in the transcript?

Inefficiencies highlighted include excessive administration costs, lack of collaboration between health authorities, and absence of standardized waiting lists or data sharing.

What is the role of a medical scribe as discussed in the transcript?

The role of a medical scribe is not explicitly defined in the transcript, but it is implied that they could be part of the solution to support healthcare professionals by handling some of the administrative tasks.

Outlines

00:00

🚑 Health Care System's Challenges and Solutions

The first paragraph discusses the pressing issues within the health care system, highlighting the increased spending yet insufficient resources. It emphasizes the need for caregivers to be recognized and included as vital members of the health care team. The conversation includes various perspectives from a nursing school, a nurse who transitioned to the private sector, a patient affected by policy decisions, and an ICU doctor advocating for preventive measures. The discussion points to the lack of universal coverage for services like pharmacare and mental health care, as well as the reliance on private sector solutions that may exacerbate public system deficiencies.

05:00

🤔 The Impact of Undervaluing Health Care Professionals

The second paragraph delves into the consequences of undervaluing health care professionals, particularly nurses, and the loss of talent to the private sector. It explores the idea of leveraging the skills of various health care workers to improve efficiency and patient care. The narrative includes personal accounts from a nurse who left the public system due to lack of opportunities and growth, and the challenges faced by caregivers in the public system. The discussion also touches on the inefficiencies in administration and the need for a more collaborative approach between health authorities.

10:02

📊 Inefficiencies and the Need for Data-Driven Health Care

The third paragraph focuses on the inefficiencies in the health care system, such as the lack of standardized waiting lists and data sharing between jurisdictions. It underscores the importance of having accessible patient data for efficient care and the absence of a centralized system to manage surgical backlogs. The conversation also highlights the need for investment in preventive measures and support at home to reduce the strain on emergency rooms. The participants express their concerns about the future of health care and the importance of a robust public system that can adapt to an aging population.

Keywords

💡Health care

Health care refers to the organized provision of medical services to individuals or communities through various health professionals and allied health fields. In the video, the theme revolves around the challenges and necessary improvements in the health care system, with discussions on increased spending, nursing shortages, and the impact of private sector involvement on public health care services.

💡Nursing school enrollment

Nursing school enrollment refers to the number of students who have registered to study nursing in educational institutions. The script mentions that despite an increase in enrollment, there is still a shortage of nurses, indicating a growing demand for health care professionals that the current education system is struggling to meet.

💡Caregivers

Caregivers are individuals who provide care and support to those in need, such as the elderly, chronically ill, or disabled. In the video, the importance of recognizing and respecting the role of caregivers is highlighted, emphasizing their visibility, inclusion, and integral part in the health care team.

💡Private system

The private system refers to health care services provided outside of the public or government-funded sector. The script discusses the experiences of a nurse who transitioned from the public to the private system, noting the benefits and drawbacks, and the impact this shift has on the quality and accessibility of health care.

💡Prevention

Prevention in health care involves measures taken to avoid the onset or progression of diseases. The script calls for a greater emphasis on preventive measures, such as mental health services, to reduce the strain on hospitals and improve overall public health.

💡Mental health services

Mental health services are specialized health care services that address mental health conditions. The video points out the inadequacy of mental health services, particularly the financial burden on individuals who must pay out-of-pocket, which is a concern in the context of universal health care.

💡Primary care

Primary care is the first point of contact for patients within the health care system, typically provided by general practitioners or family doctors. The script discusses the need for robust primary care to reduce hospital admissions and improve community health outcomes.

💡For-profit clinics

For-profit clinics are medical facilities that operate with the intention of generating profit. The script criticizes the higher costs associated with for-profit clinics, which receive more funding from the government compared to public clinics, questioning the efficiency and fairness of this approach.

💡Universal Health Care

Universal Health Care is a system where all residents of a country have access to health care services, regardless of their ability to pay. The video discusses the perceived benefits and actual shortcomings of universal health care, particularly in terms of accessibility and quality of services.

💡Staffing agencies

Staffing agencies provide temporary or permanent employees to organizations that require additional workforce. The script mentions the reliance on staffing agencies in the health care sector, which can be more expensive, as a result of undervaluing and underpaying public health care workers.

💡Medical scribes

Medical scribes are professionals who assist healthcare providers by documenting patient information, allowing doctors and nurses to spend more time with patients. The video suggests that incorporating roles like medical scribes could improve efficiency and patient care within the health care system.

💡Health authorities

Health authorities are governmental or quasi-governmental organizations responsible for the administration of health services within a particular region. The script points out the inefficiencies and lack of collaboration between different health authorities, which affects the overall effectiveness of the health care system.

Highlights

The need for more visibility and recognition for caregivers in the healthcare system.

The increasing enrollment in nursing schools, yet still facing a shortage of healthcare professionals.

The call for reinvestment in nursing and healthcare professionals to improve patient care.

The importance of including healthcare professionals in decision-making processes as key stakeholders.

The long-term solution to healthcare crises, which may not align with short-term election benefits.

The lack of a free and fair distribution of services in mental health post-pandemic.

The issue of patients paying out of pocket for mental health services not covered by universal healthcare.

The need to emphasize prevention and predict areas of higher healthcare needs in the future.

The reliance on the private sector for healthcare in Canada, which is unusual among advanced countries.

The absence of coverage for pharmacare, dental care, and mental health care in the public system.

The impact of not having access to primary care and the subsequent strain on hospitals.

The proposal to improve primary care to reduce hospital admissions and focus on community care.

The inefficiency of paying more for-profit clinics for services that could be provided in the public system.

The patient's perspective on the challenges of accessing timely healthcare and the decision to seek treatment abroad.

The negative impact of individuals seeking private healthcare on the public system's quality.

The undervaluing of healthcare professionals' work in the public system, leading to staff shortages.

The need for better leveraging of healthcare professionals' expertise and knowledge within the system.

The potential of training personal support workers to assist with tasks and reduce nurses' workload.

The desire for a reinvigorated nursing profession with opportunities for training and growth.

The importance of work-life balance and fair compensation for healthcare professionals.

The inefficiencies in healthcare administration and the high costs of maintaining multiple health authorities.

The lack of collaboration and data sharing between health ministries leading to inefficiencies.

The absence of standardized waiting lists and the need for a centralized system to improve patient care.

The call for a focus on prevention and investment in services to reduce the strain on emergency rooms.

Transcripts

so this is a moment to talk about health

care more money is being spent on health

care than ever before it's not enough

we're in a nursing school right now

where enrollment is up it's still not

enough if you had one thing that you

wanted the politicians to understand

about what has to happen in health care

right now what would it be Sarah well

Adrian I would say this I need to have a

visibility cloak caregivers need to be

seen they need to be heard they need to

be respected and they need to be a vital

part of the health care team included

Lynn Tran you're a nurse who left to go

into the private system Adrian I think

we really need to reinvest in our

nursing and our Healthcare professionals

bring back all those benefits of pay

patient care collaboration with our

health care teams we need them at the

table because they are key stakeholders

and we need the government to listen to

what their needs and wants are Max

Johnson you are a patient who made a

very difficult decision that's very

simple leaving tens of thousands of

people in pain is not a very sound

Health policy I think from our

perspective we need politicians to

realize that the solution to these

crises is going to be long-term and not

necessarily beneficial in the next

election

Dr germantang you're an ICU doctor

honestly I think we need to put more

emphasis on prevention we can predict

areas that are going to be of higher

needs over the next few years or and

what would what would that look like if

we started to put more resources into

areas that are going to be concerned

mental health like this the fact that

Mental Health Services

especially exiting the pandemic the

people are still paying out of pocket to

me baffles me it's not free and fair

distribution of services the way

Universal Health Care we think it is

yeah and by definition it's not and and

from my perspective as a nice u-doc we

see the repercussions of not having that

access I mean can you can you start off

helping us understand though we talk

about this as if this is Canada's

problem but it's not unique to this

country it's absolutely not unique to

this country but we are we have a very

strange profile in the advanced World in

terms of how much we rely on the private

sector to begin with we don't cover

pharmacare which is very unusual we

don't cover the things that keep people

out of Hospital like Dental Care Mental

Health Care all the rehab and we don't

pay attention to the people that are

actually providing the care and I

couldn't agree more with Dr tremontan

which is to say we need to keep people

out of the hospital we're turning to the

hospital because we don't have primary

care we're turning to hospitals because

people are don't have the care they need

at home with people like Sarah we need

to get people out of the hospital into

the community with good primary care so

the conversation that we need Solutions

here's a province Ontario that's

offering it we have problems with sort

of hernia and cataracts you know what if

you need them you can go to this private

Clinic you're still not out of pocket

and it will take you away from the

public system on paper it seems like it

might ease some of the pressure well

they're not out of the public system

we're paying 30 more for those Services

because they happen to be for-profit

clinics we could be running more of

these cataract factories in the public

system off-site of hospitals or even

underutilized spaces in hospitals so how

so how does it cost more money to make

that happen to do those cataract

surgeries in private club because this

province in Ontario has offered

for-profit clinics 30 percent more to

incentivize them opening up

talk about baffling it's interesting

listening to to the conversation because

as a patient we get very worried you

know we hear all sorts of people talking

about all sorts of problems all sorts of

solutions but they don't seem to appear

anywhere

and

the the principle of a funded Universal

Health Care Program I think is one that

almost everybody in the country would

agree with but let me tell you that

abject pain trumps ideology every day of

the week I ended up going to Lithuania

to have a knee replacement and

I did it because it was a two-year

waiting list in Winnipeg it was painful

to walk painful to sit I couldn't work

six weeks later I'm back from Lithuania

nine weeks later I'm economically active

again I probably paid more in income

taxes in the two years that I otherwise

would have been sitting in a wheelchair

I fully understand why for an individual

the idea that there is a

a solution I can pay for is extremely

attractive the problem is they pay for

this care with the people that are

leaving the public system the public

system keeps getting worse so the people

that don't have the money are getting

continually inferior care and it's like

so many things in the economy what's

good for the individual is suicide for

the system we know that there is no

country in the world that has relied

heavily on a for-profit system that

delivers faster better cheaper care so

we need to make the public system work

better as we're talking about

you know different clinics and private

clinics they're not just buildings

they're staffed with people they're

staffed with people like Lynn because

you you left the public system

absolutely that is a huge loss yeah I'm

thinking you're not that long out of a

nursing school just like this one you

know trained here went to school here

started in the public system absolutely

like this all looks so familiar it's

like it was yesterday that I was back in

school

um it was a tough decision and don't get

me wrong I I love being a nurse I just

don't think it was the career that I

expected it to be and I absolutely agree

with this discussion like I'm a prime

example like I feel as though there were

lacking opportunities for training and

growth and we need to leverage

everyone's expertise and knowledge

within the healthcare system and have

them operating at their highest capacity

that's one of the main Solutions is

leveraging

like personal support workers you could

train personal support workers within a

year and they have abilities to put in

Foley catheters to put in IVs to do ECGs

offload a lot of the work that our

nurses are having to tackle yeah and why

aren't we leveraging that what would

make you go back I

it's hard to say Adrian

um I think we really need to re

reinvigorate what it means to be a nurse

and I think that's something that I lost

passion for and do you feel that now in

the private system I do I think there

are things that I really value in a

career and I value that flexibility that

work life balance and actually being

compensated for the work that I'm doing

that doesn't seem like an unreasonable

ask it's completely reasonable and it is

insane that we have undervalued the work

of people like Lynn in the public system

by holding their wages in a province

like Ontario at a one percent increase

in the middle of a pandemic in the

middle of a massive labor shortage

preventing these people from taking

vacations when they're burnt out and

then wondering why do we need to turn to

staffing agencies and pay 30 40 50 more

but you know you can have a for-profit

system for the people that can afford to

pay if it's on top of a functional

public system

we already have that Executives don't go

to public hospitals unless they're

really sick and if they're really sick

where do they go they go to emerge they

go and get care in an ICU which is

publicly funded and we are letting the

public system Decline and you need to

support

these doctors and these nurses with

nursing assistants medical scribes all

the things that these people that have

got the most public training to do their

job properly we're not doing any of it

and and honestly the

I I'll speak personally I could see way

more patience if it wasn't for some of

the

some the paperwork I can see wait I

would honestly subscribe

I love the idea of a medical script add

the caregiver in that Circle 100 because

we are of equal value we're treated like

we're an inconvenience I come to say oh

my God my husband's you know he's he's

having a seizure I think and and they're

like unless it's a doctor who sees it or

a nurse who sees it it's like it didn't

happen and your story is is a double

whammy of a story because you left the

public system as a social worker to

become a caregiver

it was unbearable I couldn't do it I'm

very lucky I have three hours of care

right now and I do the rest and is the

three hours care public or do you have

to pay for that yourself I do not have

to pay for it there are supports that I

would love to have and I actually would

even pay for some of them because I'm so

desperate to have them but they don't

even exist

so this is a great example of where

investment in prevention could have so

much impact

you can think of several examples of

things happening at home where you're

going to need a support that can't be

offered at home and now you get into a

merge and if you're admitted you're in

you're in the emergency room for two or

three days potentially like the this is

where it falls apart I don't think

people fully

comprehend what kind of level of cost

we're we're talking about I look at

what's a fundamentally and apparently

astonishing amounts of money spent on

the administration

I look at the four Atlantic provinces

Manitoba Saskatchewan and the three

territories we maintain nine Health

authorities for under five million

people

one out of every 500 000 people is a

health Minister it's absolutely

astonishing there seems to be virtually

no collaboration no cooperation between

various health ministries the amount of

inefficiencies in their Healthcare

System is yeah is it because of the

staffing issues you I don't get me

started so like patients coming from a

different jurisdiction that doesn't have

we don't have access to their chart or

their Diagnostic Imaging we don't have

that CT let's just order another one

like you want to provide the most

efficient most reliable care to a

patient you want to have that data in

front of you not only that we don't even

do some of the most basic system design

issues like standardized waiting lists

right so you've got actually a

Clearinghouse of where the surgeries are

where the backlogs are that you as a

patient can choose to travel a little

bit further and get that that that

surgery in a place that is not quite as

busy are you talking about a centralized

waiting list within a province or across

provinces anywhere thank you we don't

have it in Ontario we don't have it

across we don't even we don't even

measure how many nurses are working in

hospitals across the country we don't do

the basic data sharing that we need to

do it I wish the health ministers were

sitting in this room right now I think

we'd have to lock the doors actually

but they aren't but they are listening I

mean it's not so much about private and

public it's about

sitting there and thinking in 10 years

time when I will be 10 years older and

presumably disintegrate a little bit

will there be a health system to a point

I don't really care who delivers it I

mean Max Lynn Dr Turman tank Sarah thank

you very very much we appreciate your

time everybody

thank you thank you