Poll reveals Canadians’ confusion about health-care system

Opinion

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This article was published 25/09/2024 (351 days ago), so information in it may no longer be current.

Another poll on health care has produced more curious and conflicting opinions about what’s wrong and how we can get better care.

A poll by Navigator Research on health-care reform, published in the the Globe and Mail, is an excellent case in point.

The polls authors claimed they were looking for the opinions of Canadians as “consumers” of health care, rather than as taxpayers or citizens. The results they got were quite fascinating, although not because they were insightful.

Instead, this was merely the latest evidence that reveals how little average Canadians know about their health-care system.

The poll found that nearly three-quarters of respondents want health care to be “reformed,” possibly with an increased role for the private sector. However, at the same time, two-thirds of respondents said they did not want to allow people with financial means to buy health services and jump the queue past others who cannot afford to do so.

The poll did show that just over half of Canadians think the system is working well. However, even with that one bright spot, the results confirm how little we know about how health care is delivered in this country.

First, Canadians seem chronically ignorant about the fact that our health-care system is already enormously dependent on the private sector.

The spine of the primary-care system is formed by clinics that are privately owned by physicians, who bill government on a fee-for-service basis to pay operating costs. As well, most of our hospitals are operated by private, not-for-profit organizations. And an increasing number of publicly financed surgeries, blood tests and non-hospital X-rays are performed in privately owned clinics and labs.

Second, pollsters who ask questions about increasing private-sector options are not capturing public opinion, they are actually misleading it. A vague question about whether someone wants “more private-sector involvement” in health care is pretty useless when people have only vague details of how the private sector is already involved.

Finally, although we really want someone to do something about the woeful state of health care, these poll results prove we don’t know what to do and even worse, we can’t acknowledge the biggest problem we face: a shortage of health-care professionals.

Canadians may love to blame politicians for not providing enough money, or bureaucracies for consuming too much of the health-care pie. But the more pressing concern is that we don’t have enough people to deliver the services we need.

One need only look at the front pages from this week’s Free Press to see how staff shortages have become an eclipsing issue in health care.

In Wednesday’s edition, we published a story detailing a toxic work environment at CancerCare Manitoba, the province’s primary cancer diagnosis and treatment centre. Doctors Manitoba said it had been contacted by physicians raising concerns about a poor workplace culture driven, in large part, by burnout from increasing workloads and staff shortages.

CancerCare is scrambling to replace physicians who are leaving Manitoba or retiring. Although the agency had been able to hire 19 doctors over the last five years, it also lost 16 to retirement.

Those recruitment efforts demonstrate CancerCare is attempting to address the staffing shortages. However, a net increase of three physicians is unlikely to help it deal with a steady increase in the number of Manitobans requiring treatment.

That was not the only red flag on staffing shortages to be raised this week.

A day earlier, we published a story about a new report from the Montreal Economic Institute on nurse retention. On average, 40 per cent of trained nurses across Canada quit the profession before they are 35. Manitoba has a slightly better record, but still loses nearly 30 per cent of its younger nurses before they reach their mid-30s.

In case you didn’t know, the chronic loss of younger nurses is a problem that has the potential to bring the health-care system to its knees.

Currently, the number of older nurses who are retiring, or retreating to the private sector for a more reasonable work schedule, is growing. Although this is not a brand-new trend, the trauma of providing care through the worst parts of the global pandemic has dramatically increased the number of nurses who no longer want to nurse.

Without enough nurses, wait times in ERs will grow. And even with enough surgeons to remove all of the cataracts and replace hips and knees, the total number of surgeries cannot grow without nurses to staff the operating rooms.

Staffing shortages mean the question of where health care is delivered — in a privately owned surgical clinic or a publicly owned and operated hospital — is irrelevant. There aren’t enough doctors and nurses to deliver the services we want, when we want them, regardless of where they are being provided.

If we really want to expand private health-care options, or just add to the capacity of the existing system, we have to develop a concerted plan to train, recruit and retain more doctors and nurses.

Any other solution offered or implied by politicians or pollsters is largely noise that serves no purpose.

dan.lett@freepress.mb.ca