Geographically, Canada is a big country, the second biggest in the world after Russia, then closely followed in size by the United States, China and Brazil.
However, Canada is not a big country in terms of its population, far from it: on a list of the 50 most populous countries in the world it stands 38th, with a population of 35,362,905. That’s a little more than Morocco, but less than Sudan.
Canada is also widely regarded as one of the most developed and richest countries in the world, a member of the G7 group of the world’s most industrialized countries.
It is also, I think it’s fair to say, regarded as one of the most civilized countries in the world, in the best sense of that word. It has become in the last 50 years especially, one of the most culturally diverse countries where people of virtually every nationality, religion – or none – live together in peace.
Canada is not without it’s problems, that is certainly true. As I’ve often said, it is a work in progress, but it works.
Politically, Canadian voters elected a Liberal federal government in October, 2015, defeating a Conservative government that was increasingly viewed as culturally divisive. The Liberal government, under Prime Minister Justin Trudeau, has celebrated and encouraged diversity. Since taking office it has also welcome 40,000 Syrian and other refugees mainly from the war-torn Middle East to the country. In recent weeks hundreds of people who feel threatended by the immigration policies of the new Administration of U.S. President Donald Trump have risked freezing temperatures to cross the U.S.-Canada border at isolated points to seek Canadian asylum. Canada’s response has been humanitarian, including emergency and ongoing medical treatment, while giving them access to the legal process provided for asylum-seekers. They are not simply sent back to the U.S., nor should they be.
It is indeed sad to say, but I believe, as do many other Canadians, these people looking for asylum in Canada are right to be afraid of what fate might await them now in the U.S.
Canadians are justly proud of their universal medicare system. But it comes at a large cost for a geographically big country with a relatively small population, and a country with many other economic priorities.
Meanwhile, a large proportion of Canada’s population consists of members of the “baby-boom generation,” people who were born in the years after the Second World War when Canadian soldiers who had served overseas in the war came home. During those post-war years Canada had one of the highest birth rates in the world. The birth rate also, of course spiked, as the soldiers went overseas during the war years. I am one of those pre-boom “boomers.”
With the boomer generation now approaching and reaching its senior years, concerns have been raised about health-care costs reaching an essentially unsustainable levels, to the extent of they’re being little funding left for other government programs and priorities.
With all the problems Canada is facing, including the future of the North Atlatic Free Trade Agreement (NAFTA), the real prospect of increased Defence spending, improved living conditions for isolated First Nation communities, to name just a few, I suppose it’s no wonder health-care funding is hard to find on the high-priority Canadian agenda.
And yet there’s good reason to regard it as the most important issue the country is facing. Canada is on a crucial timeline: Do something decisive soon about the prospect of dramatically rising health care costs, or the country’s ability to find money for anything else will be severely limited.
There was an opportunity to bring the issue to the fore, by delving deeper several months ago into the underlying reasons why the provincial and territorial governments were demanding more health-care transfer money from the federal government. The cost of homecare was cited as one of the most urgent needs already, as people live longer than ever before. And that’s before the full impact of the aging boomer generation has hit.
But the funding crisis looming for health care appears to be – to coin a phrase related to climate change – an “inconvenient truth.”
Indeed, that phrase was used in 2012 to describe the approaching crisis, after the Conference Board of Canada, a non-profit organization, organized a Summit on Sustainable Heralth and Health care. The final report was titled, The Inconvenient Truths About Canadian Health Care, and included the following:
“Rising health care costs and public funding for the existing system are limiting public investments in other areas that could make us a more effective, equitable, and successful society—particularly among and between generations. Health care costs are rising toward 50 per cent of provincial budgets and are crowding out spending on other priorities. Interestingly, on the margin, health care services are not a major determinant of the health of a population – social and economic factors and resulting individual behaviours are the primary drivers. As such, an argument can be made that a dollar invested in improving the economic and social factors affecting population health has more impact than an additional dollar invested in our health care system – particularly when the system remains focused on the acute care aspect of health care.”
Taken one step further, the issue regarding health-care funding then, and now even more so, was potentially caught in a vicious cycle: The more invested to improve the social and economic well-being of Canadian residents, the better their health; but rising health-case costs means the ability to do that is becoming increasingly difficult.
I am a senior, and in recent months, the full-time caregiver of an older family member who needs and uses Ontario’s homecare service.
I have also learned homecare has its limits. But already there’s a one to two-year waiting list for the most frail elderly to be accommodated in existine Long Term Care facilities in this part of Ontario, for example. How will the system possibly be able to respond to the needs of many thousands of boomers reaching that level of need? Meanwhile, Canadians are living longer than ever before, often well into their 90s, or more.
On a similar note, life expectancy continues to rise, according to the latest (2016) Statistics Canada analysis. Based on a birth year of 2012, it is 80 years for men and 84 for women. In the early 1950s it was 66 and 71 respectively. Life-expectancy analysis takes into account various statistics, such as the rate of infant and child mortality. The fact that has been in steep decline in Canada and other developed countries for many years is a major reason for the continuing increase in life expectancy, thanks largely to advances in health care.
It’s interesting to note life expectancy is higher in Canada than in the U.S. where it’s 76.3 years for men and 81.2 for women, for people born in 2015, according to the National Center for Health Statistics. That’s actually a slight drop from the year before.
Also in 2012 the Ontario Ministry of Health and Long Term care spoke in its “Action Plan” of the need for changes to the way health care is done. Ontario is a Canadian province, one of the biggest and most populous.
“Even if the province wasn’t facing serious economic pressures, the health care system would still need to transform to address the coming demographic shift. Today, health care consumes 42 cents of every dollar spent on provincial programs,” the Health ministry said five years ago.
“Without a change of course, health spending would eat up 70 per cent of the provincial budget within 12 years, crowding out our ability to pay for many other important priorities.”
That clock continues to tick. Time is running out for the action needed to save Canada’s universal health-care system.
In the long run immigration is an important part of Canada’s economic future, including universal health-care funding: more people prospering and sharing the cost of supporting that and other social programs of this good country, the country that welcomed them in their hour of need.
In the short term the health-care funding crisis needs to become the highest possible priority for public discussion
This post is partly inspired by the Daily Prompt vivid.
A version of this was originally published in The Sun Times in March, 2017