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Bed shortage

Gwyn Morgan: Canada’s healthcare system entered the COVID-19 crisis already short on hospital and ICU capacity.
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Not enough of these (Elena Berd / Shutterstock.com)

The Liberal government’s plan to use Canada’s “fiscal firepower” to help Canadian families and businesses weather the COVID-19 pandemic has been appropriately termed “a measured well-targeted response” by no less than the Fraser Institute. But no amount of cash can change the terrible reality that Canada’s healthcare system is one of the least prepared to deal with the crisis.

Decades before COVID-19 struck, Canadians in every province and territory were suffering, and some dying, on ever-lengthening waitlists. In an already overloaded system with virtually zero spare capacity, treating burgeoning numbers of COVID-19 patients will necessitate further delay for other patients with time-critical afflictions such as cancer.

That’s already happening. Over the past few days, two Ontario women had cancer surgery operations cancelled to free up capacity for COVID-19 patients.

Canada’s hospital capacity has been in steady decline. The latest available statistics comparing 24 developed countries show that in 2017, Canada ranked dead last in hospital beds per capita at just 2.5 per thousand. Germany, Austria, Hungary, Czech Republic, Lithuania, France, Slovakia, Belgium and Latvia all had more than twice that number.

The US was only marginally better at 2.8, but that’s where the similarity ends. The occupancy level of Canada’s hospital beds was 92%. That effectively means zero unused capacity; logistics and staffing issues make 100% utilization impossible. By contrast, hospital bed occupancy in the US was 64%.

For ICU Critical Care beds, crucial for COVID-19 treatment, the US ranked first of the 24 countries, with 35 per hundred thousand population. Canada has only 12, the same as overwhelmed Italy. With infections rising each day, Canadian doctors face the daunting prospect of deciding who will be treated and who will not. Those life and death decisions must be made not only for patients with COVID-19, but for other seriously ill patients who are displaced.

An October 2019 Fraser Institute report on health care in 28 countries found that Canada ranks second highest in per-capita spending, but last in access to treatment. How could this have been allowed to happen? The answer is already clear. Canada is the only country in the world that outlaws private health care. Prime Ministers, Premiers and health care administrators have known for years that our government-run monopoly system was suffering from the dual afflictions of unsustainable cost growth and ever-lengthening waitlists.

Dr. Andy Thompson, a respected Rheumatologist with Ontario’s Arva Clinic and Associate Professor of Medicine at The University of Western Ontario publishes a daily blog sourcing data from national health authorities that compares the spread of COVID-19 in Italy, Spain, Germany, France, UK, US and Canada.

The comparisons are alarming.

Because countries are at various stages of the pandemic, the comparison standard is from the date that 150 cases are detected. For Canada, that day was March 12th. By March 30, Canada had 7,708 confirmed and probable cases, making our cases per million population about the same as the US and Italy at their 150-case mark. As of March 30, cases were doubling every four days. If that rate continues, our cases will become 92,496 in just two weeks.

And here’s where our lack of available treatment capacity comes into stark perspective: at the 150-case mark, Canada ranked second highest in cases per hospital bed, behind overwhelmed Spain.

Canada’s doctors, nurses and other healthcare workers are world class and highly dedicated. They deserve our support, consideration and admiration. But once this crisis is behind us, Canadians might demand that Canada’s healthcare system be opened to private sector competition, like every other country in the world.

Gwyn Morgan is a retired Canadian business leader and a Member of The Order of Canada

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