Yes, About That ...

According to Dr. Rachlis:

But one of Canada's leading health care experts says the solution isn't hiring more doctors.

"The number of family physicians in Nova Scotia is about 15 to 20 per cent higher than the Canadian average ... so it's not just a case of not having enough of something. It's how you're using it," Michael Rachlis told CBC Radio's Information Morning on Wednesday.

 

 According to what is happening now:

At the core of Canada’s health-care system is the promise of accessibility. For all those without a family doctor, that’s a broken promise. Statistics Canada found in 2019 that 4.6 million Canadians — about 14.5 per cent of those 12 and older at the time — did not have a regular health-care provider.

It’s not a new problem. But evidence suggests that solutions remain elusive. According to the Canadian Medical Association, 2,400 family physician positions were advertised on recruitment websites in 2021; the previous year, just over 1,400 family physicians entered practice. In 2021, 32 per cent of medical graduates chose family medicine, down from 39 per cent in 2015.

**

An inter-provincial scramble has led to a many leaving Ontario for Alberta — and even the United States — as exhausted nurses seek better conditions, pay, and work-life balance.

The loss of some to other provinces – combined with staff shortages from pandemic fatigue – is fuelling a teetering of the health-care system as hospitals close or restrict intensive care units and emergency room capacity.

“They’re closing beds now because they have no staff,” said Kathy Howe, executive director of the  Alberta Association of Nurses.

That province – according to the Ontario Nurses’ Association (ONA) and some of its members – has been a big draw.

Alberta Health Services, Howe said Wednesday, has at least 200 positions to fill right now with contract nurses and nursing attendants.

She said travel nurses can earn up to double their salary – if they are willing to relocate and contend with shifting work conditions.

“There’s a world-wide shortage of nurses and Canada is feeling it. I think every single province is feeling the crunch,” said Howe.

But, she said, the competition to attract from a shrinking pool of nurses is not a long-term solution.

“It seems like we’re just robbing nurses from each province, and I’m not sure we’re getting ahead. It doesn’t make more nurses in Canada.”

Howe said provinces need to train more, try to retain those close to retirement or have retired, and approve more internationally-trained nurses.

**

Patients in Canada are currently fully covered for the costs of insured medical services; that is, patients are not directly billed for any portion of their care. Economic theory suggests that the distorting effects of such first-dollar insurance coverage can lead to excess demand for medical care accompanied by loss of social welfare. In Canada, the rationing of services through long wait times is one such by-product of excess demand. Economic theory also offers a set of tools to mitigate the magnitude of this social-welfare loss through cost-sharing mechanisms. These include deductibles—an amount up to which individuals are exposed to the full cost of treatment, after which insurance covers expenses; co-insurance payments—a certain percentage of the cost of each unit of treatment that is to be borne by the individual; and co-payments—a fixed amount paid by the patient per unit of treatment.

**

The waiting time in this segment increased from 12.1 weeks in 2020 to 14.5 weeks this year. This wait time is 159% longer than in 1993 when it was 5.6 weeks, and 6.1 weeks longer than what physicians consider to be clinically “reasonable” (8.3 weeks). The shortest specialist-to-treatment waits are found in Ontario (10.3 weeks), while the longest are in Nova Scotia (34.1 weeks).

It is estimated that, across the 10 provinces, the total number of procedures for which people are waiting in 2021 is 1,425,517. This means that, assuming that each person waits for only one procedure, 3.7% of Canadians are waiting for treatment in 2021. The proportion of the population waiting for treatment varies from a low of 2.96% in Ontario to a high of 10.76% in Nova Scotia. It is important to note that physicians report that only about 14.4% of their patients are on a waiting list because they requested a delay or postponement.

Patients also experience significant waiting times for various diagnostic technologies across the provinces. This year, Canadians could expect to wait 5.2 weeks for a computed tomography (CT) scan, 10.2 weeks for a magnetic resonance imaging (MRI) scan, and 3.6 weeks for an ultrasound.

 

Strange.

If the answer is not more doctors and nurses, then we don't need foreign nurses, do we? 

Of course, we could train people here. but that's just nutty.