FROLITICKS

Satirical commentary on Canadian and American current political issues

Mar 16

Why Are So Many People In North America On Antidepressants?

by bcurry

At no time in our history have so many Americans and Canadians been prescribed antidepressants.  Firstly, one should remember that patients who take the drugs often get them from their regular doctor rather than a so-called mental health professional.  Feeling down or unhappy with your life, go see your doctor and get prescribed some form of antidepressant.

According to a 2011 analysis by the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics, antidepressants were the third-most common drug used by Americans of all ages between 2005 and 2008.  They were the most common drug among people aged 18 to 44.  According to the same survey, U.S. women are 2-1/2 times more likely than men to take antidepressants, and whites are more likely than blacks to take the drugs. Also, fewer than a third of Americans taking one antidepressant drug and fewer than half of those taking more than one have seen a mental health professional in the past year.

Canadians now rank among the highest users of antidepressants in the world.  In 2011, Canadians consumed 86 daily doses of antidepressants for every 1,000 people per day. One of Canada’s top psychiatrists stated that too many Canadians are treating life’s normal spells of misery the way they would handle something they dislike about their bodies: by asking a doctor to make their lives better.  Canadians take twice as many antidepressants as Italians do, and more than Germans or French.  In 2011, Canada reported the third highest level of consumption of antidepressants among 23 member nations surveyed by the Organization for Economic Co-operation and Development (OECD).

What’s even more alarming showed up in a large 2015 American study containing data about the state of children’s mental health in the U.S.  The study found that depression in many children appears to start as early as age 11.  By the time they hit age 17, the analysis found 13.6 percent of boys and a staggering 36.1 percent of girls have been or are considered depressed.  These numbers are significantly higher than previous estimates.  As recently as the 1980s, adolescents were considered too developmentally immature to be able to experience such a grown-up affliction. Today, most scientists recognize that children as young as 4 or 5 years of age can be depressed.

Now, don’t get me wrong.  Diagnosed clinical depression is a very serious mental illness.  Many of us are familiar with persons with such a diagnosis, and who are undergoing treatment which includes antidepressants.  In such cases, antidepressants are essential in treating severe, debilitating and life-threatening depression.  However, the pills including Prozac and its cousins that were held out to be miraculous when they hit the market in the late 1980s, are increasingly being swallowed by millions of Americans and Canadians every day.  However, recent studies suggest that, in cases of mild depression where one is still working and functioning, the drugs often don’t work, or they produce a temporary placebo effect which doesn’t last.

One observer declared that “drugging unhappiness” has far too often become the easy solution, especially one taken by family physicians.  Remember the 1960s and 1970s when someone complaining of some form of anxiety was prescribed Valium.  With its launch in 1963, diazepam, which was patented in 1959 by Hoffmann-La Roche, became one of the most frequently prescribed medications in the world.  In the U.S. it was the best-selling medication between 1968 and 1982, selling more than 2 billion tablets in 1978 alone, prescribed particularly to women.  For some its continuing use became addictive.  In addition, besides dependence, long-term use can result in tolerance and withdrawal symptoms on dose reduction.  Abrupt stopping after long-term use can be potentially dangerous.  For these reasons, the drugs became less prescribed in later years.

Today, our societies must begin to question why people believe that they require medication to deal with their everyday lives and a state of so-called unhappiness.  What’s even more worrisome is the fact that more and more children are being diagnosed with some form of depression at an ever younger age!  Given these facts, one cannot but conclude that something is terribly wrong with our general state of mental health and with our health care systems.

Canada Health Care Health Care Systen US

Leave a comment »
Feb 9

Politicization of Health Issues in North America

by bcurry

The last few decades have seen a greater politicization of a number of issues related to health.  The clear division among pro-vaccine and anti-vaccine proponents during the COVID pandemic was a major indication of such politicization, with even public officials taking up one side or another.  The pandemic raised a number of health issues in both the U.S. and Canada, forcing governments and medical practitioners to support one side or the other.  However, the science was clear and supported the need for a vaccine and the various societal restrictions introduced to protect peoples’ lives.  The high number of COVID-related deaths, particularly in the first year of the pandemic, confirmed the urgency for action in order to minimize the terrible impact of the virus on the population at large.  Results indicated that where individuals were not immunized, the probability of serious health consequences and even death was that much higher.  Many ended up placing an extreme hardship on the health care system and communities.

In the U.S., the recent Supreme Court’s decision which overturned Roe vs. Wade — a 1973 landmark decision establishing a constitutional right to abortion — opened up the door to reviving the whole issue surrounding abortion, another primarily health issue.  Again, pro-life and pro-choice groups became more politically active in many states, with some state governments enacting laws introducing all kinds of restrictions on abortion, sometimes leading in practice to an outright ban.  This placed medical practitioners in a difficult situation, often putting a woman’s health in jeopardy as a result of the loss of the abortion option. 

More recently, governments in Canada and the U.S. have or plan to introduce legislation to support planned policy changes affecting transgender and non-binary youth and adults.  Often under the banner of “parental rights”, the laws aim to restrict health-care options for such youth and inform parents of any name and gender identity changes students request at school.  Age limits are being prescribed for the use by medical practitioners of puberty blockers and hormone therapies for gender affirmation.  As a result, medical experts and patients are weighing in on gender-affirming care and the potential impact of such laws on affected youth.  They believe that limiting their access to care will put some kids at risk of self-harm, especially with respect to their mental health.  Psychiatrists who see gender-diverse youth and adult patients believe that to outlaw access to puberty blockers ignores best practices, guidelines and international standards of care endorsed by major medical associations.  Such laws are an unnecessary and unconstitutional political intrusion into the personal health choices of children, their parents and their doctors.  What is difficult to understand is that it appears to be the policy equivalent to hitting a fly with a hammer, given that the issue affects a very tiny portion of the population, often depicted as representing well less than one percent of children and adolescents.

When it comes to personal health matters, I believe that the majority of people would prefer that the government stay out of the equation.  In Canada, we saw a similar political split during past debates on the issue of medical assistance in dying (referred to as MAiD).  There were those that opposed MAiD primarily on religious beliefs, compared to the medical profession and civil rights groups who argued in favour of assisting those with terminal diseases, living with pain, in anguish, and with no hope for a cure.  In the six years since assisted dying was decriminalized by the Canadian Parliament in 2016, more patients are seeking MAiD year over year as this option becomes more widely known and available.  Since the introduction of this practice into the Canadian healthcare system, over 40,000 Canadians have taken advantage of the option. Decisions for assisted dying are left to the individual, his or her family and their medical practitioners, using several prescribed guidelines developed under the program.

I don’t know about you, but I want to make decisions about my health with the least amount of government interference or that of politically motivated groups.  I want decisions to be based on the best science at the time and the experience and input of medical practitioners.  There has been far too much politicization of health issues, driven by motives that most likely have nothing to do with the freedom to determine what is right for each person.  Our beliefs are our own.  As long as one is not harming anyone else, our health-related choices are our business. 

Canada Civil Rights COVID-19 Health Care Health Care Systen Mandatory Vaccination US US Politics

Leave a comment »
Jan 20

Issues Over Privatization Of Health Care Services in Canada

by bcurry

As you know, Canada has a universal health care system, largely funded by the federal government via the Canada Health Act with services largely provided by each of the provinces under their provincial health acts.  However, in recent years, provincial governments have been considering more delivery of health care services through private outlets.  This occurrence became increasingly an issue in light of the fact that provinces have to be careful not to violate the Canada Health Act by requiring people to pay for medically necessary procedures. Otherwise, they could loose funds that they receive annually from the federal government for health care.  The issue has once again arisen as result of a severe lack of family physicians in many provinces, long wait times for some surgeries and in emergency rooms, and hospital closings because of staff shortages.  Some have described the situation as one reaching crisis levels.

Now, this is not to say that numerous health care services are not now provided through private means.  These include such services as medical testing, drugs, dentistry, physiotherapy, audiology and optometry.  According to one expert, such privately delivered health services already make up about thirty percent of the total health services in most provinces.  They further include the supply of nurses for home care or to cover hospital staff shortages, building of new hospitals in partnerships with governments, and the operation of costly equipment like M.R.I. machines.  Some provinces, such as Ontario, have recently announced that more services will be allowed to be provided through private sources.  These would include a number that initially had been performed only in public hospitals, such as medical imaging, cataract surgeries and hip and knee replacements.  To date, most such clinics have been owned by groups of physicians, and they are relatively small businesses. The primary caveat for this expansion is that patients will continue to be covered by public health plans.  The last thing that they want to see is move to a two-tier health care regime such as exists in the U.S.

Katherine Fierlbeck, a professor of political science at Dalhousie University in Halifax, is the author of a recent report on the issue.  In it, she predicts that as the private clinic business grows, large health care companies based in the U.S. will take a keen interest in the Canadian market.  Professor Fierlbeck also notes that these American companies don’t have that much political clout, and they’re not interested in behaving aggressively.  However, if you open the door and allow these huge corporations to come in from the States, then they are going to act aggressively, the same way that pharmaceutical companies act aggressively.  As a result, you would have to fend off interests who really want to expand the parameters of private business through constant lobbying or lawsuits.

Some observers argue that allowing for more private clinics to operate could lead to more medical practitioners moving from the public hospitals to private clinics, thereby impacting on the services normally provided by public hospitals.  A further loss of staff would only increase the waiting times in emergency wards and operating rooms for patients without access to private clinics, particularly in rural areas.

All in all, the increased use of private clinics is considered as being only one aspect of dealing with the health care crisis in Canada.  It must be accompanied by increases in the number of doctors, nurses and other medical staff through more subsidized training in medical schools and facilitating and speeding up of the licensing of foreign medical practitioners.  As with other occupations, the number of medical practitioners retiring in Canada will only increase in the near future. 

Polls indicate that the vast majority of Canadians continue to support a universal health care system.  There is no doubt that both federal and provincial governments will have to be very cautious in how they deal with this politically-hot issue!

Canada Health Care Systen

Leave a comment »
Jul 26

Why Canada’s Infatuation With Public Inquiries Is Flawed

by bcurry

Recently, opposition parties in the federal legislature have been demanding that the federal government of Prime Minister Justin Trudeau create a public inquiry into the matter of Chinese and other foreign interference in our national security scene.  I touched on this issue in a recent blog: Why would the Canadian government need a public inquiry on national security matters. 

Now, we have several health and medical related bodies asking the federal government to have a public inquiry into the handling by governments of the COVID-19 pandemic in Canada. On July 24th, the British Medical Journal (BMJ) published a letter by more than a dozen Canadian physicians and health advocates shining a spotlight on what they’ve dubbed the country’s “major pandemic failures,” from the devastation in long-term care homes, to vaccine hoarding, to higher death rates among lower-income communities.  Why would one need a public inquiry when there are already a number of federal and provincial bodies, such as Health Canada and the Public Health Agency of Canada (PHAC), which were directly involved in the coordination of policies and actions in response to COVID-19?  Indeed, Health Canada has already indicated that there are a number of audits and studies underway, including the launch of an independent public health review panel and a series of comprehensive audits on the agency’s pandemic response being undertaken by the federal Office of the Auditor General. 

The difficulty in Canada is that the responsibility for health matters is a shared one between the federal government and thirteen provincial/territorial governments.  The implementation of a national COVID-19 strategy had to be coordinated among the provinces which for the most part were responsible for the actual implementation of actions on the ground, including the eventual mass vaccination of Canadians across the country.  In addition, the on-going responsibility for long-term care residences lies with the provinces, and these facilities were known prior to COVID-19 to have major resource issues, including health care personnel shortages.  The unfortunate high level of pandemic-related deaths at the outset was largely due to numerous systemic problems in long-term care residences in several provinces.  As a result, plans are already underway by the provinces to attempt to correct these problems, especially when it comes to health care resources.  The state of our hospitals and emergency services are also the responsibility of each province, and would require a thorough investigation of problems arising during the pandemic with respect to the handling of patients.  There have already been several studies as to why communities with low incomes, immigrants and essential workers were hardest hit by COVID-19.

In addition, this past spring it was reported that there is a citizen-led, cross-Canada inquiry, the National Citizens Inquiry into Canada’s Response to COVID-19, which aims to examine how governments and institutions reacted to the pandemic. This appears to be a unique inquiry in many ways since it is citizen run and citizen funded.

Yes, there is little doubt that there were frustrations and concerns about the impact of existing complexities within the Canadian health care system, with its joint responsibilities between the two levels of government.  Some, like the physicians and health advocates, might conclude that Canada was ‘ill-prepared’ and ‘lacked coordination’ in the COVID-19 pandemic.  However, the same could be said for most Western countries, including the U.S. and Britain.  No one disagrees that it is time to investigate what happened and learn how to prepare for the next pandemic.  Having another full-scale public inquiry is probably not the best way to go.

There are enough expert organizations already out there, both federally and provincially, which need to examine their roles and resources when it comes to meeting the challenges associated with pandemics.  By doing so, each of the necessary blocks can be strengthened and improved so as to develop more coherent and appropriate policies and actions in the future.  In the past, Canada was infatuated with so-called royal commissions related to economic and social matters.  However, they were top-heavy in resources and took a very long time to complete.  In most cases, the resulting reports were simply shelved and forgotten about until the next crisis occurred.  I truly believe that our existing institutions can carry out their post-mortem studies in a lot faster and more efficient matter.  This way, they each will ultimately be accountable for the results, especially when it comes to carrying out any subsequent recommendations in a timely manner.

Canada COVID-19 Health Care Systen

Leave a comment »
Feb 20

Telehealth Raises New Concerns About How Drugs Are Dispensed in North America

by bcurry

Back in 2020, at the height of the pandemic, the Trump administration made it easier to treat patients by telehealth or telemedicine, including remotely prescribing certain controlled substances.  Today, all manner of medical care, from management of chronic diseases like diabetes to substance abuse treatment, have become more accessible and affordable.  While many patients have benefited, the rapid growth of remote prescribing and at-home use of various drugs has outpaced the evidence that doing so is safe and effective.  As the gap between medical treatment and online shopping has narrowed, already-thorny debates over the proper balance between availability and safety have become increasingly urgent.  The introduction of telehealth has created a whole new industry when it comes to providing health care, especially with the provision of drugs used to treat such mental health issues such as depression.

Back in 2017, I read about a new use for the drug ketamine, a long-used anesthetic that was primarily used to sedate patients during surgery but has also been used as a date-rape drug.   Ketamine was undergoing studies by several researchers both in Canada and the U.S. for its ability to rapidly stop suicidal thoughts in a high percentage of patients.  As far back as 2013, one Canadian researcher, Dr. Pierre Blier, director of the mood disorders research unit at the Royal Ottawa Hospital, called ketamine the biggest breakthrough since the introduction of anti-depressants.  For patients resistant to other drug treatments, it is considered an alternative to one of the only remaining treatments — electroconvulsive therapy, which has potential long-lasting side effects and is more invasive and often requires hospitalization.  For anyone suffering from clinical depression, ketamine has been shown to be effective and safe if prescribed and closely monitored by an attending physician.  Needless-to-say, there are known serious side-effects from the use of ketamine, and there is a potential for addiction and abuse.

The access to cheaper sources of ketamine for at-home treatment has been facilitated by the emergence of telehealth.  Marketing to doctors is often done through social media posts and mailers, wherein they extol the benefits of ketamine.  Companies that once served primarily local customers now ship their products across the country.  The ketamine boom has presented an alluring opportunity.  Because ketamine is regulated by the U.S. Drug Enforcement Administration and Health Canada as a controlled substance, provision of the drug still requires a physician’s prescription.  Previously, while prescribing ketamine for depression was allowed, patients needed to first meet in person with a doctor, and treatment was mostly limited to infusions in clinics.  Now, telehealth providers will accommodate patients by providing online access to a physician.  Patients have the option to schedule live telemedicine visits with their providers at any time for no additional cost.  Needless-to-say, this isn’t an ideal situation when it comes to providing medical follow-up for monitoring purposes.  Some at-home providers simply view ketamine as just another medicine to be taken regularly.

Covid-19 exacerbated the nation’s mental health crisis and underscored the inadequacy of many existing treatments, accelerating a reconsideration of once-stigmatized psychedelics.  The sale of ketamine has reportedly grown ten times what it was in 2019.  People who are using telehealth to acquire the drug are desperate, but may also be prone to addiction and abuse.  Some suffer serious health side-effects but are hesitant to report them for fear of loosing their cheaper access to the drug.  One the one hand, the growth of telehealth is yet one more example of reacting to the lack of availability and affordable access to mental health services in many communities.  On the other hand, there are those that worry that this potentially lifesaving treatment could become inaccessible if more rigorous intervention by regulators is implemented.  In addition, more research on the long-term use of such drugs as ketamine is needed to determine if its continuous medical use might be harmful.  Since many online users are reluctant to provide information about its use, such needed research may be more difficult to undertake.  Like access to other controlled substances, regulators need to take a closer look at the growth of telemedicine in both countries.  After all, if there are profits to be made and drug costs are reduced, one can certainly foresee the continuing growth of this sector.

Canada Health Care Health Care Systen US

Leave a comment »
Nov 30

Where Do Provincial Powers Begin and End in Canada?

by bcurry

To better understand the split between provincial and federal powers, given by Canada’s written constitution, one has to understand a little bit of the history.  When Canada became an independent country from Great Britain, the federal government was given a good deal of governance responsibilities.  Canada was formed as a confederation comprised of ten provinces and several territories.  However, the provinces eventually garnered a fair amount of responsibility for certain matters which were not national in scope.  Federally, the government deals primarily with inter-provincial areas such as transportation, banking, and inter-provincial commerce, as well as such international areas dealing with foreign policy, trade, defence and immigration.  So far so good.  However, during World War II, the federal government took control of areas of taxation in order to make war related payments.  These revenue areas were not returned to the provinces after the war. For this reason, the provinces have complained about their heavy reliance on access to federal funding for areas of primary provincial responsibility such as health, education and housing.  In addition, as the years passed, new areas surfaced of great importance such as telecommunications and nuclear energy, something that the federal government determined was in their jurisdiction as part of its constitutional responsibility for the peace, order and good government of Canada.  Over the course of the 20th century, legal interpretations of peace, order and good government more clearly defined the limits of federal authority over the provinces.  Often disputes over who’s responsible for what and to what extent end up in litigation by provinces and the federal government.  Like the old constitution of 1867, the new one of 1982 will remain vague in many areas until time and circumstance permit its interpretation by the courts.

All in all, the provinces continue to have substantial jurisdiction for areas such as education, health and urban affairs.  One area of contention has been the federal introduction of “equalization payments” to the provinces to help ensure that provincial governments across Canada can provide adequate services.  It was expected that the richer provinces would help to subsidize certain areas in the so-called poorer provinces.  For example, Alberta has its oil and gas industry which brings in large revenues to its coffers.  The federal government gets its share of taxes from Alberta’s energy sector and passes most along to the Maritime and other provinces to help provide some of the services that Canadians have come to rely on.  Quebec has also benefited greatly from the equalization arrangement, while Ontario has not.

Now, the current Alberta government is complaining about federal policies and laws that they feel intrude upon their provincial responsibilities or which Albertans are not in agreement with, such as gun control measures and environmental taxes on oil and gas sectors to name a few.  Recently proposed legislation introduced in Alberta would allow its cabinet to direct “provincial entities” — Crown-controlled organizations, municipalities, school boards, post-secondary schools, municipal police forces, regional health authorities and any social agency receiving provincial money — to not use provincial resources to enforce federal rules deemed harmful to Alberta’s interests.  This is a very disturbing development, suggesting even greater polarization between a province and the federal government.  Fortunately, the Alberta government has not gone as far as — like Quebec in the past — to suggest a potential separation from Canada’s confederation.

However, Alberta’s stance appears to be somewhat similar to Quebec’s political moves in the sixties, seventies and eighties where provincial parties promoting Quebec’s independence from Canada had emerged.  Failing to obtain a majority in two referendums on independence, the Quebec movement slowly disappeared over the last decade.  Instead, Quebec has attempted to secure more provincial control over former federal jurisdiction, such in such areas as immigration and public pensions plans.  Indeed, Quebec recently passed several contentious laws dealing with French language rights and secularism in its public sector.  The courts have already begun to examine appeals to such legislation based on possible violations under human and rights laws.

What all this amounts to is the power to govern.  The federal government has to play a fine line between what powers can be shared and what policies best serve all Canadians equally.  There is little doubt that provincial premiers will continue to gang up on the Prime Minister, particularly when to do so is in their interests.  The PM on the other hand has the difficult and delicate task of maintaining a strong national presence in governance in support of the peace, order and good government of Canada.

Canada Charter of Rights and Freedoms Defence Education Fairness in Taxation Federal Government Gun Laws Health Care Systen Immigration Policies

Leave a comment »
Sep 5

Shouldn’t We Pay Health Care and Education Workers More Because of the Valuable Work They Do?

by bcurry

If there’s one thing to take from the pandemic is that workers in the health care sector and in our schools merit more pay than they currently have.  What could be more important than ensuring that our health and the education of our children meet today’s standards as modern industrialized countries?  Yet, the pandemic and an aging population have resulted in tens of thousands of teachers and health care workers to leave or retire from their profession.  The numbers don’t lie.  Take for example in the U.S., where recent statistics highlight that there is a massive teacher shortage, particularly severe in several states and many localities.  In Canada, the Canadian Nurses Association in a 2009 report predicted that Canada could see a shortage of 60,000 full-time nurses by 2022.  The estimate is based on a number of factors, including retirement projections, but of course doesn’t account for the serious impacts of the pandemic.

What is more disconcerting is the fact that within the teacher shortage, there are certain disciplines which are critical to developing a new labour force in the science, technology, engineering and mathematics (STEM) fields.  Up until now, in both Canada and the U.S. immigrants continue to be a major source of STEM labour.  In Canada, adult immigrants accounted for 44% of all individuals aged 25 to 64 with a university degree in a STEM field in 2016, compared with 24% in the United States.  Can we continue to rely on immigrants to fill those job vacancies in high tech industries?  The teaching profession has grappled with a labour supply issue in STEM for years.  For example, according to a March 2022 report by the American Association of Colleges for Teacher Education, over the last decade, the number of teaching degrees and certificates conferred fell 27 percent in science and mathematics education.

On top of which, there are places that serve economically disadvantaged students where they are more likely to have vacant positions.  In lower income communities and in rural areas, school boards have a hard time attracting teachers to their schools.  We know certain types of teachers are also hard to attract, in particular STEM teachers and special education teachers.  As for special education teachers, the demand outpaces the supply.  Parents with autistic children or those with learning disabilities have complained, and rightly so, for a number of years about the lack of special education support in schools.  While something has to be done to encourage students enrolled in teachers’ colleges to become special education teachers, better pay and working conditions need to be promoted and implemented.

One of the things the pandemic has really shown the public is the value that nurses particularly bring to the health system.  As a result, I would hope that people recognize the importance that nurses play in making sure we all have access to care.  Interestingly, the media coverage during the pandemic did highlight the courageous acts by and commitment of nurses.  As a result, nursing colleges have seen a recent increase in applications within both countries.  However, burnout, wage competition with other sectors and early retirement has contributed to the current nursing shortage in the short-term.  When compared to health care workers in general, nurses continue to be underpaid given the extensive degree of training and responsibilities they have.

As a modern society, one needs to take a close look at where our priorities lie.  Everyone is touched by how well our health care and education systems work or don’t work.  Following the consequences of the pandemic for our children and aging population, we need to get our priorities straight.  This takes political and societal will and commitment to resolve these current specific worker shortage issues.  This is not something that technology alone can resolve.  These are people issues, requiring people solutions.  Unfortunately, up until now, most jurisdictions have been unable or unwilling to adequately address these immediate and long-term challenges.  I predict that within the next year, one will see this issue becoming increasingly a concern in both countries.

Canada Education Education in U.S. Health Care Health Care Systen Labor Force US

Leave a comment »
Jul 11

Pandemic Illustrated Serious Concerns About Capacity of Canadian Health Care System

by bcurry

Increasingly, because of the impact of the pandemic, Canadians have been questioning the capacity of its health care system to meet their current and future needs.  Recently, staffing issues and staff absenteeism due to COVID have caused several emergency and operating units to shut down across the country, especially in more rural areas.  In addition, due to burnout and retirements, more and more medical professionals are leaving the profession.  Replacing them has become a greater concern, especially in the field of family physicians.

Nevertheless, Canadians still believe that they have better access to health care, live longer than Americans and rarely go bankrupt because of medical bills.  Canada’s mortality rate from Covid-19 is a third of the U.S. rate, a reflection of Canada’s more widespread use of health restrictions and its collectivist approach to universal health care.  Where it falls down is in what is referred to as ‘surge capacity’ where hospitals are capable of handling a sudden or longer-term surge of patients.  Even in normal times, Canada has fewer hospital beds per person than almost any other developed country, particularly when it comes to the number of available intensive care unit (ICU) beds.  For example, it is reported that on average, the U.S. has one ICU bed for roughly very 4,100 citizens.  In the largest province of Ontario that ratio is one to 6,000.

Then there are the issues surrounding the number of nurses and doctors available to serve Canadian patients.  While Canadian nursing schools are seeing a surge in interest amid the pandemic, experts warn it may not be enough to alleviate the shortage of people working in the profession.  In a 2009 report, the Canadian Nurses Association predicted that Canada could see a shortage of 60,000 full-time nurses by 2022.  The Association wants to see more financial assistance to nursing students and more clinical placements available for students to get hands-on experience in hospitals or other health-care settings.  Better compensation and working conditions are also on the table.  As for doctors, fewer graduates are choosing family medicine as a discipline, despite family-doctor shortages across the country.  This is despite the fact that the total number of medical school graduates applying for residency positions in Canada has risen over the past 10 years.  Access to family doctors and primary care is a problem for a large portion of the country.  According to a 2019 Statistics Canada report, 4.6 million Canadians over the age of 12 did not have a regular family doctor.  With an aging workforce and an increase in the numbers of retiring physicians, the primary care situation has even become worst.

The pandemic exacerbated already serious problems within the Canadian health care system.  Fortunately, the consequences of the pandemic for the system have stimulated a much needed national conversation on inadequate health care capacity, staffing shortages and under funding.  Part of the problem rests with the overseeing associations that regulate and control access to medical licenses across Canada.  For years, there have been systemic barriers to both qualified domestic and foreign trained medical students/practitioners to find residency positions in Canada.  While it is understandable that such bodies as colleges of physicians and surgeons want to ensure the highest of standards within the profession, there have been at times failures to really consider the impact of restrictive practices on the overall health care system.  The pandemic further demonstrated that among the biggest bottlenecks in the system is the staffing required by acute care, particularly in the emergency departments and ICUs.

With an aging population and people living longer due to the marvels of modern medicine and treatments, the discussion about the capacity of our health care system to meet the needs of Canadians has to take place now and not later.  Groups representing all facets of the system, from medical practitioners to patients, have to be allowed to provide their input to governments.  While the pandemic created several serious drawbacks for the overall system, the subsequent reactions of governments and health care providers demonstrated that collectively we can meet these future challenges as a nation.  Despite evident challenges, Canadians generally continue to be proud of their health care system, its workforce and its universal coverage.  However, as always, there is room for improvements.

Canada COVID-19 Health Care Systen

Leave a comment »
Blog at WordPress.com.