OTTAWA, ON (February 11, 2021): As lockdown restrictions gradually lift in parts of Canada, we are hearing the same message from politicians: these measure are required to keep our health system from collapsing due to an influx of COVID-19 patients.
But, as MLI senior fellow Dr. Shawn Whatley asks, why, 11 months into the pandemic and amid a predictable second wave, are we faced with a choice of locking down or having our hospitals overrun?
In a new MLI commentary titled, “COVID-19: Masking a Failed System,” Whatley argues that the pandemic gave medicare the stress test Canada had long hoped to avoid. According to Whatley, medicare was already beleaguered with problems like overcrowding, hallway medicine, shortages in long-term care, world-famous wait times, technology shortages, and spiralling costs. COVID-19 has unmasked a health care system that is failing Canadians.
Faced with locking down or overrunning our hospitals, Whatley argues that Canada’s lack of capacity is a core issue. Prior to the pandemic, Canada had only 2.5 hospital beds per 1000 population compared to the OECD average of 4.7. It is clear, given the low number of beds, Canada’s hospitals often overflow. Notably, Ontario has far fewer beds than other jurisdictions around the developed world.
Closing the bed gap might cost more than Canadians are willing to pay, however. “Canada spent $264 billion on healthcare in 2019 with 26 percent of it going to hospitals ($70.2 billion). Given that Canada currently sits at 53 percent of the OECD average [of available beds], we might expect to spend almost double what we spend now on hospitals,” concludes Whatley.
What could we have done in the face of the pandemic in the short term? Whatley notes that Canada could have been setting up staff bubbles around long-term care homes, similar to the NBA and NHL bubbles for players, implementing point of care testing which delivers results in minutes, and decanting all patients waiting to leave acute-care hospital using patient hotels.
Yet, worst-case pandemic scenarios continue to grip pundits and lockdowns have remained the primary strategy in mitigating COVID-19. According to Whatley, we have had months to prepare for subsequent waves of COVID-19 and years to realize that the medicare system was failing, yet there have been few meaningful steps taken to address this.
“[W]e have squandered the time we had, with no plan to make sure it does not evolve the same way for the rest of wave two or any subsequent waves,” explains Whatley. “We need to stop talking about lockdowns and start talking about greatly increasing health care capacity and pursuing meaningful system change.”
To learn more about why medicare is failing, read the full commentary here.
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Dr. Shawn Whatley is a Munk Senior Fellow at the Macdonald-Laurier Institute and author of “When Politics Comes Before Patients: Why and How Canadian Medicare is Failing.”
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