A lack of debate minimizes important healthcare issues in Ontario

Photo by Mico Mazza

It has long been an underlying assumption of Canadian political campaigns that healthcare is untouchable. Mention it and you will regret it at the polls.

A discomfort across the population exists when anything departing from our current model is suggested, even though said model is poorly understood by most and leaves much to be desired from a value for cost perspective.

Since the signing of the writs of Ontario’s 41st general election, the health policy platforms of the three major parties have not garnered much attention, despite healthcare costing $51 billion — or about 42 per cent — of our provincial budget in 2012–13. The economy has apparently been at the centre of this election, yet none of the six questions posed to the major party leaders during the only televised debate on June 3 even remotely touched on healthcare, the most expensive item on the public budget.

A number of healthcare organizations and journalists have been particularly scathing toward different party leaders for not making their plan for healthcare a prominent point of discussion, but the fact of the matter is they are not to blame.

We, the voters of Ontario, are to blame. Political parties, and even more so their respective leaders, are driven by constant opinion polling. Parties find and target their base voters and then do everything to get them out to vote on Election Day — this is how elections are won. So, if no party is giving healthcare any attention, it is because their research tells them we would prefer to hear about something else.

Thus, there are currently two principal flaws with the Ontario healthcare system. The first is a mixture of structural inadequacies and unsustainable economic demands caused by a fragmented system which was originally designed to treat acute disease, but is now required to provide care for an ageing population. The second, and most essential in this case, is our revulsion for any serious political debate of the first flaw.

Healthcare policies affect us all, so it would seem completely irresponsible for our political leaders to just ignore it altogether, particularly when close to three quarters of a million Ontarians are without a family physician. Emergency room wait times are too long due to an array of factors, but primarily because of an astounding shortage of acute care beds. The long-term and home care that this province requires continues to grow as the population ages and the numbers of seniors with complex, multi-system needs increases. Health human resource management is a nightmare with high rates of unemployed specialists sprinkled through major centres, yet many rural communities are without a primary care physician. The list goes on as many complex and expensive issues are void of clear solutions or debate.

Nonetheless, we have been conditioned to believe that our national identity is tied to a single-payer, one-tier healthcare system. Any mention of change to the current model is swiftly assumed to mean an end to the apparently universally equal treatment in our system and a replacement by a two-tier system — or dare I say it — a US-style system.

The truth is that most international comparison studies have put Canada at the middle of the pack in terms of accepted outcomes, and generally at the top of the pack in terms of cost. Furthermore, the supposed duality of only having two options — the status quo or a US-style system — is a fallacy; a plurality of healthcare systems with a public backbone and mixtures of public and private delivery of care exist across the globe.

All three major party platforms include clear commitments in healthcare. Some are quite shallow and near-sighted, but some are very bold. So, again, why the lack of political debate? Because the people of Ontario remain enigmatic or even apathetic to these issues.

Any pollster will tell you the majority of us believe healthcare is an important election issue, but at the same time we don’t want to hear about it. We value our system, but deep down inside we know that it is not great and yet we are not willing to pay higher taxes or reduce other services to support the necessary costs of change.

For far too long, healthcare has been the third rail of Canadian politics. Innovative public policy, derived from open public and political debate, is necessary and inevitably soon to come, as necessity is the mother of invention. Until then, it’s still our fault.