Once proud public healthcare in the West is not what it used to be
- Decline and fall of social democracy in the UK and Canada has a lot to do with shrinking medical services and worsening outcomes for the people
The octogenarian mother of my wife’s friend recently moved back to Hong Kong after living in Canada for decades. The reason? She couldn’t get a doctor to consult on the periodic return of a very painful condition from a chronic disease.
By the way, unlike my family, she is extremely wealthy. But that doesn’t count in Canada when it comes to seeing a medical specialist.
Less than a week after her return, she was able to see a private specialist.
My wife has not seen a gynaecologist for more than three years, not since her last return to the city. My daughter was hit by a car in downtown Toronto more than two years ago. Our family doctor referred her to a specialist and said their office would call. We are still waiting.
The ambulance ride for my daughter was C$45 (HK$260) for a Canadian resident, but since she didn’t have her health card on her, they ended up charging her C$245.
We are still fighting the charge. But my family are lucky; we all have our GP, or family doctor, and the support of nurses. In Ontario, pharmacists increasingly play a consultative role for minor health issues.
It’s estimated that more than 6.5 million Canadians don’t have access to primary care or have a family doctor. That’s 22 per cent of the adult population, or more than one in five people.
In Canada, you need a referral before a specialist will see you. In the United States, many types of medical insurance policy allow direct access to specialists. However, sky-high medical bills are one of the main causes of personal bankruptcy in the US.
The latest annual survey by the Fraser Institute finds that in 2023, “[Canadian] physicians report a median wait time of 27.7 weeks between a referral from a general practitioner and receipt of [specialist] treatment. This represents the longest delay in the survey’s history and is 198 per cent longer than the 9.3 weeks Canadian patients could expect to wait in 1993.
“Overall, Ontario reports the shortest wait across Canada (21.6 weeks) while Nova Scotia had the longest (56.7 weeks).”
But Canadians are still luckier than people in the United Kingdom. The once famed National Health Service (NHS), which has been described as the country’s civil religion, is crumbling.
People in Canada and the UK used to be very proud of their universal healthcare, unlike in the US. Now, though, maybe the US mixture of private and subsidised healthcare isn’t so bad.
Following his latest delivery of the UK budget on Wednesday, Chancellor of the Exchequer Jeremy Hunt has been roundly ridiculed for saying “the NHS is, rightly, the biggest reason most of us are proud to be British”.
For 25 years, UK residents have been more likely to die after a diagnosis of five out of seven common forms of cancer compared with Australia, Canada, Norway, Denmark, Ireland and New Zealand.
Generally, 10,000 UK residents die each year who would not have done so in an average European country. The UK waiting list for operations has now reached a staggering 7.6 million people. About 400,000 people waited 24 hours or more in emergency wards in 2022-23.
The rise and fall of social democracy in post-war Europe and Canada has a lot to do with their universal healthcare models.
Longest doctors’ strike in NHS history adds to England’s health service woes
Outsiders often admire Western democracy in abstract terms, but when it comes right down to it, the ability or inability of a country to deliver adequate public healthcare is a major determinant of people’s satisfaction with their governments.
Hong Kong people are, of course, free to live wherever they choose, with the UK and Canada being their favourite destinations. But believe me, with its combination of public and private healthcare, and whatever serious flaws and bad features you can find in the local system, it’s really not bad compared to some Western countries.
