Canada’s Healthcare – Past, Present and Future

Fifty-five years ago, Saskatchewan NDP leader Tommy Douglas introduced the first government-controlled, universal single-payer medical insurance plan in North America. This was followed by a national initiative a decade later. At the time, many were apprehensive about this major change to the health system, including physicians.

Decades later, our healthcare system is one of our most precious assets, but it has to be modernized. When the current system was developed, our population was younger. Our healthcare system was designed for acute care – meaning short-term treatment for illness or injury. What we see today is a gridlock of hospital beds, unacceptably long wait times, unsustainable costs, dangerous rates of declining population and physician health, and unsatisfactory indigenous healthcare. Our population’s healthcare needs are far different in 2018, and will continue to strain the system if we do not change.

As a society, we need to place a greater emphasis on healthy living, diet and exercise, to remain healthy as we age. We must also work harder as a province to address the underlying economic and environmental factors which impact the health status of individuals. Public awareness campaigns such as Choosing Wisely Canada – which also has a New Brunswick-specific campaign - are leading the charge in engaging patients in a dialogue to help reduce unnecessary medical tests and treatments. Support for similar campaigns can help raise awareness, promote healthy living, and help reduce the burden on our healthcare system. 

As a urologist, I see many older New Brunswickers in my day-to-day practice. Seniors are often wrongly blamed for the lack of available hospital beds in New Brunswick. Our lifespan has increased, not just in number, but also in our ability to lead a richer, fuller life. However, this means that seniors sometime live with illness and chronic conditions longer. We need better chronic disease management to care for our seniors and for the sustainability of our healthcare system. This will not, and simply cannot, happen under a system built for short-term care.

Necessary modernization in healthcare also needs to happen using something that most of us use every day – technology. The healthcare sector has seen incredible technology advancements which have saved many lives, for which doctors, patients, and loved ones are immensely thankful. Electronic medical records are increasing in popularity and soon it will become the standard of care. This is the future of healthcare – it adds efficiency to everyday family doctor visits, increases our ability to offer preventative care, and is essential for the recruitment of young doctors.

We also need to launch the discussion on many other issues such as the need for a national seniors’ strategy, pharmaceutical coverage for all Canadians, and better care for indigenous people. Change cannot take decades. It needs to happen now. I choose these three issues because all require federal leadership and provincial collaboration.

Historically, our system fails Canadians when jurisdiction over policy matters is unclear. Canada has several good examples of work that was led by a federal vision and supported by provinces, such as Canada Health Infoway, a federal organisation which has worked with provinces to develop health technology. Even last year’s federal effort to legalise medical aid in dying, a charged and emotional topic for many, showed a degree of federal and provincial cooperation. It can be done.

I am not underestimating the challenges that come with changing our healthcare system. However, I am also not underestimating the determination of my colleagues nationwide, and their desire for a stronger system. Healthcare reform is a discussion that is inherently political, but like the inception of the system we have today, major change requires collaboration. This collaboration must involve all key partners - government, health professionals, health administrators, universities and the public.

We must work collectively to cherish our health system and modernize it so that our future generations can benefit. Fifty-five years after the inception of the system we know today as Medicare, it is time to be innovative once more. I have two young daughters, and like other parents, I hope that the next generation is supported by a strong healthcare system when they will need it throughout the course of their life.

Dr. Dharm Singh
President, New Brunswick Medical Society