Vancouver, Canada - Canada's healthcare system has been both praised and criticized.. It is also a source of national pride in providing free healthcare and is receiving worldwide attention, but at the same time, it has several serious flaws. Canada is one of the most livable countries in the world and is considered an advanced welfare state. The healthcare system is a state-run free public service that allows all citizens to purchase public health insurance. Currently, healthcare spending in Canada accounts for 10.8% of the country's gross domestic product (GDP). However, the Canadian healthcare system is not perfect and has some problems.
Medical services in Canada are initially provided by family physicians. Most family doctors are general practitioners, and to get medical care you must first see a family doctor and then get a referral to see a specialist. However, this process is not easy when there is a shortage of family doctors. Especially in places like Vancouver, every family doctor has more patients than they can handle. This leads to longer time for patients to find a family doctor, and longer wait for a specialist even if they do. During the COVID-19 pandemic, these problems have worsened, resulting in millions of Canadians being unable to find a family doctor, record-long waiting lists for specialists, restricted access to diagnostic equipment, and hospital emergency rooms occasionally closed, demonstrating the limitations of the national healthcare infrastructure for patients.
It takes an average of 27.4 weeks for patients in Canada to see a specialist after seeing a family doctor, according to the Fraser Institute. This is the longest wait recorded longer than the 25.6 weeks recorded in the same report last year. And a 195% increase from the 9.3 weeks Canadians waited for health care in 1993, the report explains. These wait times are driven by a system that prioritizes patients based on the severity and urgency of their symptoms, and the disparity between the severity of symptoms as perceived by individuals and the severity as perceived by healthcare providers often results in hours of waiting in emergency rooms and months of waiting to see specialists. This is due to the limited number of publicly funded hospitals and healthcare providers in the Canadian healthcare system.
This has resulted in patients with serious illnesses deteriorating or dying for lack of timely treatment. Faced with these serious healthcare realities, Koreans living in Canada are turning to South Korea's advanced healthcare system as an alternative. Most South Koreans travel to Korea regularly for medical checkups, and it's common for patients diagnosed with serious illnesses to return to Korea for prompt treatment.
Immigration Policy for Foreign Medical Graduates
Recently, Canada's immigration policy has been strengthened in favor of foreign medical graduates. In January, the Minister of Employment, Workforce Development and Official Languages announced that up to $86 million would be provided to 15 organizations across Canada to strengthen their capacity to recognize foreign credentials for approximately 6,600 foreign trainees. The investment will help highly educated and skilled immigrants get their international credentials properly recognized, meaning that the Government of Canada is beginning to lower the barriers for internationally trained health professionals to get their credentials recognized. The 15 funded projects across Canada aim to streamline the recognition process, provide IEHPs with Canadian work experience, and facilitate labor mobility in the health sector. This builds on the government's commitment to address workforce challenges identified at the October 2023 Health Ministers' meeting. By funding key occupations such as nursing, pharmacy and dentistry, the program aims to quickly integrate skilled newcomers into the healthcare workforce, ultimately improving Canada's healthcare system and supporting economic growth.
Most recently, the province of British Columbia (BC) announced an expansion of the IEHP this month. The centerpiece of BC's program is the expansion of the Practice Readiness Assessment Program (PRAP), which aims to triple the number of IEHPs over the next two years. The program serves as an important pathway for foreign physicians seeking licensure in BC, and the provincial government is implementing it to streamline the integration of foreign-trained physicians into the local healthcare workforce by increasing the number of slots.
Physician Assistant Program
In keeping with its policy of supporting foreign-trained physicians, the BC government is providing an alternative pathway for physicians who are not eligible to sit for the Practice Readiness Assessment Program by establishing a Physician Assistant licensure class. These physicians will work under the supervision of attending physicians in the health authority's acute care facilities and will play an important role in relieving pressure on existing resources. This approach recognizes the expertise of foreign-trained physicians who may not be able to immediately meet the requirements of the program. They will be deployed in both rural and urban areas for a minimum of three years, ensuring continuity and stability of care for patients.
These measures are seen as a ray of hope. But the question remains, will these optimistic steps solve the problems of a serious health care system? "It is time to stop throwing money at a broken healthcare system and start investing in a new one," says Dr. Kathleen Ross, president of the Canadian Medical Association (CMA). This is taken to mean a technological innovation and prevention-focused approach.
Technological innovation and a preventive approach
Technological innovations include healthcare diagnostics and treatments that use artificial intelligence. One example is Watson, developed by IBM. Watson is a cloud-based artificial intelligence platform that allows you to enter your symptoms and it will search through decades of clinical cases and hundreds of thousands of pages of peer-reviewed literature to provide you with the most appropriate treatment.
A prevention-focused approach can reduce costs and improve patient health by strengthening disease prevention and health promotion. This can be seen in South Korea's healthcare system. South Korea's National Health Insurance Service provides free, mandatory annual or biannual health check-ups for all citizens to identify all health conditions and provide preventive care. Health screening also requires the strengthening of community-based health facilities and services. It is important to have a transparent and accountable policy to ensure that health screening services are easily accessible to the local population. This raises concerns about the current state and future direction of Canada's healthcare system and points to new directions for improvement.
Particularly since the COVID-19 pandemic, Canada has moved quickly to establish a telemedicine system that allows patients easy access to healthcare providers. However, telemedicine in Canada is currently limited to very basic, non-face-to-face consultations, such as getting a prescription for medication, ordering a blood test, or getting a referral from a family doctor to see a specialist. When it comes to actual care, patients still face long waits for tests and specialists.
Reimbursement gap for physicians
Experts point to the compensation gap for Canadian physicians as an important issue. By 2021, the average annual salary for Canadian physicians will be C$388,000 (approximately $380.54 million). This is the average salary for all physicians. Canadian physicians are paid differently by specialty, and their actual earnings can vary depending on a variety of factors, including years of experience, location, and specialty.
B.C.'s International Recruitment Policy is a strategy to ensure fair compensation for physicians by strengthening domestic medical education and training programs. This can be done by expanding medical school admissions and offering incentives, such as debt forgiveness, to graduates who choose to practice in underserved areas to foster a sustainable pipeline of Canadian-born physicians. This will help maintain a stable supply of health professionals and improve the quality of health care.
However, Canada's healthcare system is currently at a critical crossroads. Experts argue that while Canada's policy of attracting foreign-trained physicians is a step in the right direction, these improvements require long-term, comprehensive solutions to address structural deficiencies that have built up over time. The federal government must respond with aggressive policy changes and strengthen the healthcare infrastructure and workforce to build a stronger, more resilient healthcare system that benefits patients and healthcare professionals alike. This is recognized as a critical challenge to ensure that Canada's health system is future-ready and successful.
