Lessons learned from the pandemic about health care

When we pull together, we can quickly achieve results that have escaped us in the past.

image: Hartford Healthcare

Some liken to being at war but I prefer to compare the pandemic response to what happened when we created universal health care.

Governments have been reluctant to implement the universal coverage of drugs in the past, but in short order we have vaccines freely available for all Canadians.

It’s that easy. A universal pharmacare program could happen, too. All it takes is the will to carry it out.

Canada has the dubious distinction of being the only country in the world with universal health care that doesn’t include prescription drugs.

Canada has been stuck in a time warp since the inception of health care. When Tommy Douglas envisioned a healthcare system in 1947, it included hospitals and then later, doctor’s services.

Other countries have moved on. New Zealand’s publicly funded system goes beyond hospital and physician care to include long-term care, mental health, physical therapy and prescription drugs.

While we like to boast of our healthcare system compared to our neighbours to the south, in reality ours is just good enough. Canada is stuck in “paradigm freeze” — good enough to prevent any major change or improvement.

The pandemic can shake us from our stupor and awaken us to the fact that a universal pharmacy program is cheaper for all, not just in the bargaining power of negotiating drug prices but in reduced healthcare costs resulting from a healthier population.

Another lesson learned was how rapid we can achieve, essentially, a basic universal wage. The Canada Emergency Response Benefit (CERB) was distributed virtually overnight.

CERB has been replaced with other programs but with the political will to make it happen, Canada could have a basic universal wage.

A reduction in poverty through a basic income could improve health. The connection is deep, say Drs. Nadine Caron and Danielle Martin:

“But, perhaps surprisingly, the experiment [CERB] that may have had the biggest impact on health during COVID-19 didn’t take place in the healthcare system at all.” (The Walrus, Jan/Feb, 2021)

The connection between finances and health is well studied. Between 1993 and 2014 in Ontario, for example, residents of the poorest areas were more than twice as likely to die from a preventable cause as those living in the wealthier neighbourhoods.

Another lesson learned was from the fewer diagnostics done during the pandemic.

On the negative side, cancelled tests meant that diseases went undetected. The B.C. Cancer agency estimates that 250 British Columbians unknowingly had silent cancers go undiagnosed as their screening mammograms, colonoscopies, and pap smears were cancelled in just the first six weeks of the pandemic.

On the positive side, many tests routinely done may be unnecessary. If all those tests are so important, why aren’t they done uniformly across Canada? Chris Simpson, a cardiologist and former president of the Canadian Medical Association, wonders:

“Why do patients in one region get these tests and procedures at higher rates than other regions?”

The simple answer may be that, like prescriptions, doctors like to order tests so as to be seen to be doing something towards patient care. All those tests may not be the best use of resources.

Canadians can be proud for pulling together during this crisis. Let’s not forget what we can accomplish.

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