A long-standing problem needs a Plan B

Hey there, time traveller!
This article was published 09/08/2025 (239 days ago), so information in it may no longer be current.

In his column Public patience wearing thin waiting for NDP health fix of Aug. 1, Tom Brodbeck outlines the NDP failure to address the health care “disaster” the Conservatives left behind. His criticism is unfair to both parties.

There were significant problems in Manitoba’s health care system for years before Brian Pallister was elected in 2016 and before Gary Doer in 1999 and so on. Serious problems in surgical capacity, emergency room wait times and primary care access, among others, continue to this day — just like they do in every other province, no matter which party is in power.

David Foot’s 1996 book “Boom, Bust and Echo” outlined the impact the baby boom generation has had at various life stages on education, housing, employment and health care and how Canada has largely been reactive rather than proactive in dealing with it.

The median baby boomer turns 70 this year and with a 15 year life expectancy, aging Boomers’ extensive, and expensive health care needs will continue to be a major challenge until at least 2040. Waiting for the Boomers to die off isn’t much of a plan.

Tossing money at the health care problems hasn’t worked — there hasn’t been enough money and won’t be in the future, given deteriorating economic conditions and government debt at the national and provincial levels. Mr. Brodbeck’s Aug. 6, 2025 column NDP, living in fiscal fantasy world, must face reality accurately describes the dilemma we face.

Restructuring the health care system and bureaucracy hasn’t worked either. The seemingly never-ending reorganizations give the appearance of taking action but in the end, most have produced marginal net improvements, or worse.

A shortage of doctors in Canada has been part of the problem since the 1990s when all governments in Canada agreed to restrict medical school enrolments as part of a deliberate strategy to reduce the number of doctors (which was intended to reduce health care costs). We have never fully recovered from that mistake.

However, positive changes are being implemented to make better use of doctors’ time, including the introduction of virtual appointments, increased use of technology (e.g. AI note-taking during patient visits) and initiatives to reduce the administrative work required of doctors (e.g. eliminating most “doctor’s notes”). The creation of Minor Illness and Injury Clinics has diverted some patients from doctors’ offices and ERs. The clinics are excellent and more are needed.

But it will take years to obtain and, as importantly, retain more doctors especially in the areas of practice and locations where they are needed most.

Fortunately, pharmacists, nurses, paraprofessionals, technologists, clinical assistants, physician assistants and others have extensive training, plus an interest in and aptitude for health care.

Expanding the medical work these groups do can free up doctors for work that cannot be downloaded to others.

While voters are clear that they want the problems in the health care system resolved, they reject any solutions that involve privatization and in doing so, work against their own interests.

The question is not whether there will be private health care. It already exists — 30 per cent of health care costs in Canada are paid by patients or private insurance companies. Private health care has evolved differently in each province in the absence of a coherent national policy with for example, some types of surgeries provided in private clinics in various provinces but not others.

In Manitoba, it can take over a year to get joint replacement surgery leaving patients in pain and with limited mobility for a lengthy period of time. The delay can cause or exacerbate clinical depression, chemical dependency and musculoskeletal issues arising from prolonged periods of restricted movement. We should not allow that to become the standard of treatment that a patient just has to accept.

Mr. Brodbeck is correct when he suggests a need for benchmarks of service. But for benchmarks to be meaningful, there must be a Plan B.

So the question really should be this: “If the delay in providing service in the public system is serious enough, will we use private health care to alleviate patient pain and suffering?”

A Plan B that involves a commitment to use out of province and even out of country medical services at government expense is required — regardless of whether those services are provided by the public or private sector in that jurisdiction. To be clear, this is not a slippery slope on the way to privatization. We can have it both ways.

A public system with a stop-gap measure that may involve the private sector if required is part of humane treatment of patients. It does not undermine Canadians commitments to public health care.

Robert Pruden writes from Winnipeg.