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Over the past year, Canadians have doubtless seen headlines about how dysfunctional the American healthcare system is, or how bad it could become. You may have heard of the family who paid over $600 for a Band-Aid at a hospital, or the wildly fluctuating prices of MRIs, which often end up costing patients much more than they would in other countries.

What we don’t hear about as often, however, are the failings of our own system.

In many cases, Canada’s healthcare system is held up as great, or at least greater than most of the alternatives, especially in comparison with that of our neighbours down south. But the fact is, there are some very specific problems that we need to address to ensure our healthcare really is as effective and “universal” as we want it to be.

One thing Canadians like to say about our healthcare is that, as just mentioned, it’s universal. You don’t hear stories about people who can’t get the medical attention they require. But is this really the case?

As some papers in a recent Lancet series point out, the Canadian healthcare system can at times be a jumble of jurisdictions and practices leading to confusion, inefficiency, and inequality in levels of care.

This point on inefficiency has also been raised many times in Canada in response to the long wait times that Canadians experience while trying to receive care, and these wait times show no signs of slowing down.

Whatever the solution may be, we can’t accept the way things are going now—more efficiency in terms of how healthcare is allocated and consumed needs to be part of the public discussion.

Another piece in the Lancet series talks about “profound health inequities” experienced by Indigenous peoples in Canada, as well as other marginalized and minority groups. The paper explains that we need to pay more attention to the social determinants of health in Canada to begin to correct these problems.

A third piece talks broadly about issues in Canadian healthcare on both a national and international stage, citing issues such as “limited funding, and the unaddressed legacy of Canada’s colonisation of Indigenous peoples.” More than just organization, Canada needs to develop its social policies, along with supply money to support those policies.

There’s also the issue of prescription drugs. While many developed nations in the world have universal healthcare systems, Canada is the only one that doesn’t cover essential medications.

As such, the Parliamentary Budget Office found that, as you might expect, cost is a limiting factor for many Canadians who need necessary prescription drugs. It found that between seven and 17 per cent of Canadians don’t adhere to prescriptions because of the cost. Obviously, this affects low-income Canadians the most, only adding to issues of inequality in healthcare.

While Ontario is now covering prescription drugs for people up to age 25, and Quebec has its own public prescription drug insurance, we don’t have a comprehensive national strategy.

If so many other developed countries with universal health care systems have managed to cover prescription drugs comprehensively, why can’t Canada?

Public opinion both within Canada and outside the country may be that we have a strong healthcare system, which is a good thing. However, comparing our system to that of the United States, for example, isn’t enough.

We need to be honest about and address the problems and inequalities that exist in our system right now, like how social status affects health, and the effects of high prescription drug costs, and work harder to fix them. While our system may not face the same issues as the American one, it should still be a continued part of the national discussion as we move forward to find solutions.