WINTER 2019 Page 12 CONTENTS
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C2CC2CJOURNAL JOURNAL | WINTER 2019 page 12 CONTENTS Dying For Timely Health Care PAGE 1 Doug Firby Canadian health care can be world-class – if you can actually get some. If not, you might just die waiting. Other countries innovate, experiment and embrace change to improve their systems. Canada, not so much. Here, inertia, status quo protection and self-satisfaction reign. And don’t ever raise your voice in the waiting room or you’re liable to get kicked out for “abusing” the staff. Veteran journalist Doug Firby conducted a diagnosis of what ails our system – interviewing patients, talking to experts and reading key reports – and, in this exclusively reported feature, presents his prognosis. Tweeting Truth to Power: What’s Behind the Ugly Rise in Social Media Censorship PAGE 7 Josh Dehaas Things happen quickly on social media. And urged on by radical groups, censorship of unpopular ideas is rapidly becoming standard practice across the industry. With a parliamentary committee recently recommending dramatic new rules for controlling online speech, the Trudeau Liberals’ re-election brings politically-motivated restrictions on social media discourse that much closer to reality. By focusing on how one individual experienced the arbitrariness of corporate censorship, Josh Dehaas raises an alarm over the impending calamity of the government-imposed variety. Don’t say you weren’t warned. The Return Of The Alberta Agenda PAGE 11 Tom Flanagan What’s old is new again, and that extends well beyond aviator shades and flat-billed caps into the political realm. New again and, sometimes, even more urgent than the first time. The federal votes had barely been counted last October before calls erupted to dust off the Alberta Agenda, aka, the “Firewall Letter” of 2001. Some see its measures as forming Alberta’s first big step towards independence; others hope the same policies would help douse separatist flames. Just as quickly, opponents confidently pronounced all of the Agenda’s items unworkable. Tom Flanagan, co-author of the original Alberta Agenda, reviews its five policy recommendations and evaluates their merits in the light of current circumstances. C2C Journal on PressReader Each month, C2C Journal prepares a selection of its best articles for publication in this easy-to-read, printer-friendly layout published by PressReader. For our complete lineup of stories, please visit c2cjournal.ca Dying for Timely Health Care By Doug Firby sk any group of Canadians what they member of numerous boards. transform a once-stodgy subsidiary of a Ahate about our health-care system and Before his treatment could begin, U.S. oil company into a highly profitable chances are they’ll give you a one-word Fischer travelled a long road of diagnosis, Canadian independent producer. (Since answer: waits. Waits to find a doctor. Waits referral, assessment and more tests in his departure, Nexen has once again at ER. Long waits for non-urgent tests. Calgary. It was a “linear” path, he says – in become a subsidiary, this time of a giant Endless waits to see a specialist and to which one step had to be completed before Chinese oil company.) Fischer notes that, have procedures. Waits, sometimes, even the next could begin. It seemed to lack the when your chances of recovery depend on urgency he felt. After his diagnosis, he timely treatment. was referred to an ear, nose and throat Charlie Fischer knows all about waiting specialist in Calgary, but again had to wait on Canada’s government-throttled health- because the doctor was only doing intake care system. When he was diagnosed one day per week. That doctor referred with Stage 4 throat cancer in April 2014, Fischer to a medical oncologist and one of the first things he was told was radiation oncologist. “But guess what?” how urgent it was to start treatment within says Fischer. “They only have intake one two weeks. Stage 4 is the most advanced day a week, and they’re busy.” Doctors form of cancer, in which cancer cells have ordered a positron emission tomography spread to other organs in the body, and (PET) scan, but that was also delayed is considered gravely life-threatening. It because Fischer’s oncologist determined a didn’t happen. Instead, Fischer had to wait. broken tooth crown needed to be repaired Emergency room wait clock: A depressingly familiar sight for Canada’s health-care users. Through a shocking series of avoidable before the scan could be done. Why, missteps, it was six weeks before he Fischer wondered, had no one mentioned in business, it’s a given that a business unit started the urgent treatment he needed this weeks earlier? It might have avoided or project team will perform multiple tasks to save his life. The experience turned still more delays. concurrently to avoid delays. This simple Fischer, now 69, from happily retired It was all quite bizarre to one of lesson appears lost on otherwise talented oil patch executive into an outspoken Canada’s senior oil patch veterans. and dedicated health-care professionals in advocate for health-care reform. Charlie’s As head of Nexen Inc. from 2001 until Canada’s public system. “retirement” was unlike those of many 2008 Fischer, who holds an MBA from Fischer reasons that if the health for, as a Calgary-based community icon, the University of Calgary, had applied system had conducted several tests and he remained active as a volunteer and principles of business efficiency to procedures at the same time, he could C2CC2CJOURNAL JOURNAL | WINTER 2019 page 12 be calculated in the case of a person or care system is put up against other OECD group suing a private party for negligence countries, there is no reason to be smug. or other harms). The report found that Of 44 countries assessed and compared after receiving a referral from a general by the OECD in 2018, Canada’s per- practitioner, the typical patient waited capita spending was in the top third, yet more than 21 weeks to initiate treatment its health outcomes were just average. In from a specialist. Alberta, where per-capita spending is the One of the key problems is the highest in the country at $7,552, outcomes system’s siloed approach to treatment, are below average, according to the 2015 says Fischer. Doctors in one specialty Report of the Advisory Panel on Healthcare are out of touch with what other doctors Innovation. Worse, of 11 countries’ health- are doing or planning. “You don’t get the care systems, Canada’s was ranked ninth sense that treatments are coordinated,” he – just two above the U.S. says. “Everybody’s sort of doing their own “We have a relatively high-cost thing.” Hospitals, primary care physicians, system, but we’re getting such mediocre After being diagnosed with Stage 4 throat cancer, specialists, primary care, social care and health care,” Jack Mintz, a member of businessman Charlie Fischer found himself navigating Canada’s maddeningly inefficient health care system. other disciplines function as entities unto the Healthcare Innovation advisory panel themselves. As a result, there is poor and President’s Fellow of the School of have cut the six- or seven-week wait “in information sharing and a general failure Public Policy at the University of Calgary, half.” When Fischer raised his concerns to coordinate treatment. said in an interview. Mintz, who has been about the delays with doctors, they told Curiously, many Canadians remain described as “the premier public policy him a week wouldn’t matter. “I said, ‘What smug about their about a month?’ And they said, ‘A month publicly funded would make a huge difference,’” Fischer health-care system, recalls. “I said, ‘You jerks. Every one of you seeing it as superior thinks you have a week and you all take to the U.S., where it. The week turns into three, four, five... per-capita spending whatever.’” The process was, needless to on health care say, also extremely hard on Fischer’s wife, is double that Joanne Cuthbertson. of Canada’s. In Many Canadians experience similar Canada, that level frustrations with health-care services: was $6,839 per delays, lack of communication, information capita in 2018, gaps, inconsistent care delivery, and while in the U.S., lack of coordination among doctors and it was equivalent specialists. Although Canada’s health to Cdn$13,722 in practitioners are often touted as world- 2017. Critics of class, the system as a whole does not the U.S. system Waits for key diagnostic tools, such as a Positron Emission Tomography (PET) seem to function efficiently. Instead, it contend that while scan, can cause weeks-long delay when time is of the essence. comes across to dissatisfied patients as insured Americans less than the sum of its parts. No wonder can receive outstanding health care, economist in Canada,” was founding that, when their lives or well-being depend others receive little or none at all. Some director of the school from 2008 to 2015, on it, many Canadians who have the U.S. hospitals, however, routinely provide and built it into a prominent academic financial resources head south of the emergency care free of charge, and think-tank for public policy research and border. Fischer, however, stuck it out at hospitals owned by religious or charitable education. Currently, Mintz, a member of home. organizations have various programs the Order of Canada, conducts research, A study published in 2018 by the Fraser to provide primary care for the indigent. builds capacity and provides leadership on Institute estimated that long waiting times In addition, the U.S.’s massive federal tax, financial regulatory and urban policy affected more than 1 million Canadian Medicare and Medicaid programs cover programs.