Healthcare in Ontario has been in the news quite a bit lately. Some of the news makes us question whether it is still truly "universal." The Ministry of Health touts a utopian slogan of "the right care, at the right place, at the right time," but seems unable to deliver on this promise at any level.
For several months a number of CCACs have been under fire for cutting services for home care. Demand has risen (and will continue to rise as more baby boomers reach senior citizen age with its attendant health issues) while funding has remained static. Many people are having their services reduced or denied altogether. Look at almost any newspaper or health care blog in the province and you'll find dozens of sad stories of seniors and disabled who cannot get the care they need to remain in their homes.
It's an issue of our neediest citizens, too. Those who can afford it can hire private home care and nursing services such as Qualicare to fill the gap. Pensioners on a fixed income, who barely can afford food and medication, cannot afford to hire professional help and must rely on whatever their CCAC will give them.
If they cannot manage on their allotted few hours of care a week, many end up going into long term care, but that's a problem, too. It costs the province considerably more for a long term bed than for home care, even at full service. From the client's point of view, it's hard emotionally and physically to have to move at all, much less to wait weeks or perhaps even months for a bed to become available. Compounding the problem is that frequently that bed is nowhere near their family and community. It's a lose-lose scenario.
Hospitals are not immune either. As more home care services are cut, emergency rooms will begin to see patients in crises that could have been prevented had they received the right care - enough services, at the right place - home, at the right time - when they needed it. Some of those emergency patients will need to be admitted, but the beds upstairs are being occupied by those waiting for a long term care bed or home services, so the emergency room will have to house them until a bed becomes available. Meanwhile, the ambulance that arrives with the next patient cannot offload because the beds in the emergency room are full, so they wait as well, and are then unavailable to the next person in the community who needs an ambulance NOW.
To balance a budget that cannot accommodate all clients at full needs service, the CCAC must either cut services to some and give full service to some, cut service back so that everyone only gets partial rations, or give services to those who get there first and deny service to those who come late to the party. Every one of these scenarios is rationed healthcare, in one way or another.
The solution will be neither easy nor inexpensive (see our article on improving Canada's healthcare system), and cannot possibly please everyone; but find a solution we must, because leaving it the way it is will create more chaos, will serve fewer people and none of them well. This is unacceptable in a first world country with the economic resources we have.