Canada's Health Care System Reeks of Corruption

October 25, 2014
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By Lea Z. Singh |

There are few things as sacred to Canadian identity as a universal and free health care system. Most Canadians would probably agree that it is socially mandatory to sing the praises of our socialized health care. Criticism of this system is not just an awkward faux pas, it is downright treachery. It ranks right up there with deserting from the front line in time of war.

And yet, the truth is that our health care system is terribly messed up. We can't do anything about it either, because we refuse to see, or at least to admit, what is wrong with it. Anyone who opens their mouth in a naive effort to improve the system by acknowledging its faults is usually shunned within about 5 seconds flat.

So let's look at the sacred cow. Just how messed up is our system? Let me give you a very poignant example. My husband and I recently met up with a lovely couple who happen to be family friends. They are both Canadian doctors but work in the U.S. (by the way, that is not at all uncommon, which should tell us something). 

One of the doctors was describing the flaws of the American health care system, so I brought up the point that the Canadian health care system is not so hot either. I mentioned that my husband and I have both been waiting for months now for phone calls from different specialists to schedule first appointments. It is sadly true that Canadian citizens often wait for many months before they are seen by specialists.

And it's not just adults. Children too have to wait ridiculously long times. One of my daughters had to wait for one whole year for her first appointment with a specialist doctor at the Children's Hospital. When she was unable to make that appointment due to illness, the appointment was rescheduled again for a full year later. She will be two years older before her problem is finally assessed and addressed!

So here is what happened next. As soon as I mentioned that we were waiting for specialists, the doctor replied "What kind of specialist do you need to see? If you can go to Toronto, I can have you seen even tomorrow." The doctor proceeded to explain that she could bump us to the front of the line due to the contacts that she and her husband have with other doctors, including specialists.  

Although the doctor was very nice and was certainly trying to be helpful, I was shocked. I was also very upset. Not at her, but at the health care system. At what this kind of quick response says about the state of our health care. 

Despite all the propaganda about how progressive our system is, it now resembles those of third world countries and dictatorial regimes. In the Communist system that I remember as a child, doctors used to be bribed under the table with lavish gifts. Canada is not far from that now. Our health care has gotten so bad that people survive through corruption.

The doctor didn't even bother to deny that such cronyism is commonplace. In fact, she openly admitted it. She told me that she regularly takes care of her extended family, who reside in Canada, by getting them fast care this way. She apparently sees this kind of corruption as natural, as an unavoidable part of the system. "Anyone who says this hasn't always happened is lying," she told me.

And she is right that it is commonplace. We have had other experiences with this kind of cronyism in the health care system. Although we have gotten benefits from it (we have gotten services from doctors because we knew other doctors who were their friends), I still feel angry about the injustice of a system where this kind of corrupt behaviour is now almost necessary. That is certainly NOT the "Canadian way", and it flies in the face of all the sweet lies that we have been spoon-fed from infancy.

The doctor might also be right about the other thing, that cronyism is natural and universal. Perhaps everyone prefers to provide services for their friends and family, and will bump such people to the front of the line whenever possible. But here's the problem with Canada: in a country where there is no private health care, we have no other line to stand in. We are all forced to stand in the same public line, so when some people get bumped ahead due to connections, everyone else gets bumped down.

If I lived in the U.S., I wouldn't care so much that some doctor prefers to service his or her family. So what? I would just go to another doctor who was more available, because I can shop for doctors there. Actually, fee-paying clients might speak more loudly than even family connections in the end - I wonder how many doctors would be so quick to prioritize their family and friends if they were depending on income from their patients, rather than from the state?

But here, I can't buy faster service on the market. The only way to speed up service (or sometimes, to get it at all) is through connections. People die while waiting for specialists here. People also die because they were seen by specialists far too late, when their illnesses had progressed beyond curable. Who wants to take that chance?

This is the real way that we have a multi-tiered health care system here in Canada. New immigrants and lower income persons are mostly out of luck because they lack the right connections. I used to be one of those people, and I feel their outrage. The middle class gets lucky some of the time, as has happened to us. But the upper crust (and that includes many doctors themselves) lives in a different world of fast and friendly service by friends and friends of friends. No wonder there is so little will among our leaders to change this system.

Margaret Wente has written about this problem in relation to her hip replacement. She is a well-known columnist for a national newspaper, and she herself got to jump the queue when getting treatment. In fact, she managed to get access to a novel treatment that was not even being offered at the time to most Canadians. Here is how she described it:
What I got was first-tier medicine in a multi-tier system. Access to first-tier medicine isn't about money. It's about knowing people who are willing to help you get in to see a specialist in days or weeks instead of months or years. I found shortcuts. I asked for favours. I used courtesy and charm, which seemed to help, and also tears. (Believe me, the tears were real.)
At first, I felt guilty. But I was in pain, and the pain was destroying my life. If I had relied on the system to take its languid course, I would probably be in a wheelchair right now, still waiting for a consultation with a specialist who would probably recommend a type of surgery that is not as good for me as what I got.

So for all those Canadians who are wondering how to get faster service, here is the secret: being friends with a doctor, or having a doctor in the family, can literally save your life. Not because of what they can do, but because of whom they might know.

What will I do about it in my personal life? I am undecided. We have taken advantage of connections in the past, and frankly, we might do so again in the future. Although I strongly prefer a just system, in Canada playing fair might mean ending up dead. That is the sad truth. How is that for an ethical Catch 22?

Photo: salimfadhley via photopin cc

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