Canadian Healthcare M*A*S*H-Up (Part 1)
The wildly popular 1970 movie, M*A*S*H, which was later made into a television sitcom that ran from 1972 to 1983, introduced us to the medical practice defined as “triage”. The term triage was used by French military surgeon, Dominique-Jean Larrey in the late 1700s and was derived from the 12th century old French word “triàre”, meaning “to sort”. Developments enhanced triage procedures through both World War I and World War II, Korea, and beyond to better sort out those soldiers who exhibited the greatest need for immediate treatment, while presenting the best chances of survival. Those who were either too injured to be saved or not injured seriously enough to require immediate action had to wait.
In my opinion, healthcare in Canada has become “sickness” care, structured using the very same practice. Let me share with you two statements that help describe healthcare in Canada today.
First: Canadian healthcare is not free. Our system is operated using public funds raised by federal income and consumption taxes that are transferred to the provinces and territories and augmented by additional taxes levied by those same provincial and territorial governments, among other funding sources.
Second: Private, for-profit healthcare is not entirely forbidden in Canada. It is, however, heavily regulated and restricted.
The Reality: Canadian healthcare is today metered out using the very same triage techniques first imagined on the French battlefield well over 230 years ago. The reasons for this are quite simple in concept, yet complex in application.
There are 10 provincial and 3 territorial governments in Canada, responsible for managing their respective healthcare systems. This means each government body must manage every stakeholder and service provider in the healthcare supply chain. Not only does this mean doctors, nurses, nurse practitioners, anaesthesiologists, but also all the myriad technical staff responsible for medical diagnostics, hospital custodial, maintenance staff and administration teams at hospitals and clinics in each jurisdiction. The list is by no means complete.
It’s a gargantuan task, and there are only so many dollars to go around. There lies the problem.
Canadian healthcare is constrained by the funding provided and the incredibly heavy infrastructure required to operate 13 separate systems. Such is life in Canada.
To me, this means when we lobby for more nurses and doctors, et. al., we might not have enough funds to take full advantage of their skills or even maximize the use of the facilities we have. Once the money runs out through the operating year (through any reporting period, i.e. monthly), things start to creak and groan and operating theatres, ER wards and clinics shut down.
What Does That Look Like Today?
In many cases, it means diagnostics may be made too late and treatment, even later. Once symptoms present themselves, the disease or affliction may have already progressed to the point where necessary care is not nearly so timely and or effective. Additionally, in some cases where surgeries or treatments may be required, triage evaluations might require others to be treated first, because they are in worse condition.
While Hawkeye and Trapper John might support such decision-making, the poor patient just starting their journey through the public system waits and suffers as their condition gets worse. This delay means diseases can progress from an early stage to a more advanced stage, making treatment more invasive, complex, and risky than it would have been if addressed sooner.
The difference between wartime triage and the peacetime civilian variety seems to be the availability of time and resources at the front versus the more constrained and politically defined resources available otherwise.
What Can You Do?
Recalling the point I made near the beginning of this article that private healthcare was available, given restrictions, we can consider the following.
- Recognize that the first step is to develop a plan of action to ensure your access to healthcare. Further, take steps to understand where you stand currently. What is your starting point? Do you suffer from unknown health conditions that require immediate corrective action?
- Research your available options. Several clinics in Canada are privately operated with public funding to provide more timely service. These may include ear, nose and throat care, in addition to cataract corrective surgery and, in some situations, hernia operations and limited access to joint replacement.
- Know that there is help available to navigate the path forward. You might consider using a healthcare concierge or advocate who will help you find unknown capacity within the existing provincial health network or even help you find a path outside Canada, should your condition be dire enough to take matters into your own hands.
Having a healthcare advocate may yield positive results, but that is by no means guaranteed. Should you elect to avoid out-of-pocket expenses and seek treatment inside Canada, you will need to wait through the triage process and the possible wait times inherent to the journey. It may be possible to seek faster access to securing diagnostic testing “inside the system,” but actual treatment and surgery may not be so quickly secured.
Knowing that this story appeals equally to Canadian business owners as well as private citizens, I offer the following.
Illness and accidents are beyond the physical sensations of pain and despair; they are also a drag on Canada’s economy and the fiscal health of your business. This might especially be the case for incorporated individuals, micro-sized and medium-sized companies, as well as the largest of Canadian businesses and conglomerates.
Picture this: You are the founder and principal of a micro-sized company, looking to establish a benefits plan or health spending account for your company, your teammates, if any, and their respective families. In this position, the buck stops with you. You are responsible for paying the bill and working with your benefits advisor to design the healthcare plan that is uniquely and appropriately set up for you and your firm. What happens if you get sick or suffer a serious accident? You are dealing with pain and loss of your productivity at work. This is a drag on your business. Not good.
In this role, you are referred to as the “plan sponsor”, but you are also a plan member, and so you wear two hats.
What happens if your spouse suffers a similar event? I guarantee your head is not fully in the game, as you would do almost anything to find a solution to help get them healthy as quickly as possible.
Now, the nightmare scenario continues: what happens if your child suffers the same fate? I absolutely guarantee you and your spouse will be singularly focused on finding whatever path forward at home or abroad to help heal your child, alleviate their pain and cure their condition.
Your team members and colleagues could face similar life events and impact the productivity of your company. If you are at all motivated to help your team members through their predicaments and return your company to peak productivity, you will need to understand and support them all along the way.
Every business owner says their competitive advantage is their people. Are they?
In upcoming issues of Canadian MoneySaver, we will explore these very strategies, products and services that can help you find a resolution and return to health, seeking treatment either at home or abroad. It starts with knowing where you are and to whom you can turn.
There are options available. These options are designed to provide a range of services at various price points. After all, you can only afford what your bank and income statements will allow. And remember – healthcare in Canada is not free.
Please reach out to me should you have an immediate need or simply want to know your options.
With over 42 years of experience as a sales professional and business owner, Bob works with small business owners, incorporated individuals and their advisors to provide guidance on their investments, insurance and benefit plans. He has developed a specialty helping Canadians navigate the executive and specialty healthcare and individual private medical insurance market.
bob.carter@carterconsultingcorp.ca