Time, money needed for trip to Moose Jaw clinic gets to heart of crumbling, unequal health system

Hey there, time traveller!
This article was published 19/03/2024 (601 days ago), so information in it may no longer be current.

You know your health-care system is in tatters when people are driving 650 kilometres from Winnipeg to Moose Jaw to get a heart scan.

Manitoba’s health-care system is so broken, it can’t even provide people with a simple diagnostic service — an echocardiogram — in a timely fashion. Not even close, actually.

The recommended wait time for an elective echocardiogram is 30 days. In Manitoba, the median wait time is an astounding 30 weeks. That means half of patients are waiting longer than 30 weeks for a scan that could reveal a serious heart condition in need of immediate attention. Every week and month that passes where someone is deprived of that basic service could be a week or month closer to a heart attack or death.

The saddest part about the story of people travelling to Saskatchewan for heart scans at a private clinic — which appeared in Tuesday’s Free Press — is that only people with money get to do it. Those who can’t afford to pay have to wait seven months, a year — maybe longer. They might be dead by the time their number is finally called.

In some cases, patients don’t even know when their echocardiogram will be scheduled, such as Max Johnson, one of the people featured in the newspaper story who has been waiting for a heart scan, but has not been told when it might take place. The fact his name appeared in a media report might help him get an appointment.

Our health-care system is so broken, that’s frequently what it takes to get medical service these days: the squeaky wheel gets the grease. Or, if you have the time and money, you drive to Moose Jaw.

Leaving the province to get medical attention is not new. It’s been going on for decades. Whether it’s worse today than it was 30 years ago is anybody’s guess because no one tracks it. Those who have the money regularly travel to Alberta for cataract surgery or to Quebec for knee or hip replacement. They pay out of pocket because waiting two years or longer in agony is unfathomable. Those who can’t afford it are forced to suffer in silence.

Canada pretends it doesn’t have “two-tier” health care when, in fact, it’s set up to promote that very thing. Those who can afford to leave the province for care do just that; those who can’t face interminable waits, or receive no treatment at all. Well-heeled Canadians can buy private medical services that are “allowed” under the antiquated Canada Health Act — such as private nursing, home care or even physician services, if a doctor decides to opt out of the public system. Those who can’t afford it are deprived of that option.

Under the Canada Health Act, Canadians are not permitted to buy “medically necessary” services in their own province. The act defines that as services that are covered by their province’s health insurance plan. However, they can buy those medically necessary services in another province because they are not residents of that province and therefore are not “insured” there. It’s a perverse system that’s so mired in ideology and politics, it’s a miracle it functions at all.

The upshot is people with money can get the health care they need. Those without the means often cannot, or have to wait so long it has a negative impact on their well-being. Canadians regularly get health care “based on the size of their wallet,” the very thing the country’s beloved medicare system is supposed to eliminate.

The worst part is that it’s about to deteriorate further as the baby boom population ages. The strain on Canada’s government-monopoly, politically micromanaged health-care system will only intensify. The division between the have and have-nots when it comes to medical care will become even more pronounced. There will be more people driving to Moose Jaw for echocardiograms in the future, not less. If it’s not echocardiograms, it will be something else.

That is, of course, unless Canada decides to have a real conversation about the state of its health-care system and starts looking at models in other parts of the world (no, not the United States, sigh) that get far better outcomes than we do, including in continental Europe, and still ensure people have universal coverage.

Unfortunately, having that conversation in Canada has been virtually impossible because it gets immediately bogged down, and eventually shut down, by those who benefit from the status quo — those who have the money to get the care they need out of province.

Until that changes, Manitobans will keep driving to Moose Jaw.

tom.brodbeck@freepress.mb.ca