By Olivia Visser, Staff Writer
Canadians like to boast about our country’s exceptional healthcare system. “It’s free!” they’ll exclaim. And while it’s true that you can visit a Canadian emergency room without having to worry about racking up a semester’s worth of debt, there’s still work to be done to ensure equal access to routine and critical healthcare.
The Canada Health Act (CHA) is the federal statute that guides provinces on the quality of health services and coverage. The Act aims to “facilitate reasonable access to health services without financial or other barriers.” It’s not as effective a safety net as you might think.
The problem is that the CHA doesn’t specify what “reasonable access” means, leaving it mostly up to each province’s discretion. One study found Canada’s quality of healthcare services is unfairly distributed to people based on people’s “gender, ethnicity, geographic location, and socioeconomic status.”
Class inequities in healthcare are exacerbated by historical marginalization. Indigenous communities, for instance, face some of the most significant barriers to receiving quality healthcare. 82% of Inuit living in Inuit Nunangat do not have a family doctor. Surely, that should constitute a violation of what most Canadians consider to be “reasonable access.”
The CHA is not only failing to deliver equal access, it’s failing to support home and community care, as well as outpatient prescriptions. As such, delivering quality care lies largely in provincial, territorial, and municipal guidelines. That’s only the beginning of how the CHA is failing to address critical care.
For conditions that don’t present an immediate risk to one’s life, finding support is a lofty task. Canadians with endometriosis experience an average diagnosis delay of more than five years, despite it affecting roughly 1 in 10 people who have a uterus. It’s considered one of the most painful conditions in the world, yet it’s one of many chronic illnesses that aren’t properly cared for under our system.
Those with rare and under-researched chronic illnesses also suffer from substandard care in Canada. A BC woman in her 30s living with the genetic Ehlers-Danlos syndrome was recently approved for medical assistance in dying, despite reportedly wanting to live. She commented that accessing “death care” was easier than navigating our poorly managed healthcare system.
Mental health remains one of the least accessible services in Canada, despite the growing movement to normalize it. Federally, the cost of mental health services is only covered if they are deemed “medically necessary.” This means psychology services provided outside of a hospital will generally cost you out-of-pocket. In BC, outpatient psychology services are only covered by your provincial Medical Services Plan until you reach the age of 18. After that, you’re on your own. An adult autism diagnosis in BC is around $2,500, and the average cost of a single therapy appointment is at least $100. Many extended health plans provide a very limited amount of coverage for such services. The same can be said for dental care and physiotherapy.
The CHA needs to be amended to define what “reasonable access” means, and ensure it actually is reasonable. Denmark offers “free and equal access to healthcare for all citizens,” leaving less room for interpretation. Their system includes a comprehensive list of patient rights, like a time limit on diagnosis and treatment. In hospitals, the limit is 30 days. If it can’t be met, patients are given the option to be treated privately or abroad for free.
We need to stop dismissing people’s suffering by falling into the belief that our healthcare system is efficient enough. It’s not. This is a crisis that not enough people are talking about. Discussion may only be the beginning of real change, but it’s an important piece of the puzzle. Only once we amend the “reasonable access” clause can we start dispensing quality care to all Canadians.
