• Wed. Nov 29th, 2023

Healthcare Definition

Healthcare Definition, You Can't Live Withou It.

Yukonomist: It’s time for an awkward conversation about rationing

Pour a few PBRs into a certain type of Alaskan libertarian around a campfire, and they will start criticizing the Canadian health care system for being “socialist.” Before you know it, they will say, you’ll end up with rationing and government bureaucrats deciding who gets health care.

Yukoners would usually politely explain that we have universal health care and could go to a doctor whenever we wanted. Heck, there are even rumours that Sarah Palin went to the doctor in Whitehorse when her family lived in Skagway.

We had better hope no Republican politicians in Juneau saw that headline in the Yukon News last Friday: “Doctor waitlist swells to 3,341 Yukoners.”

Think about that. About eight per cent of our population is on a waitlist to get a doctor.

And you know the real number is higher. Some without a doctor won’t be on the waiting list, either because they thought it was futile or because they haven’t heard about it.

The definition of the word “universal” in universal health care is getting stretched to the limit.

At what point do we admit it? We are rationing health care. More people want it than our public system is providing.

And the Yukon’s method for rationing is neither rational nor transparent. In practice, those who have been in the territory a long time have a doctor. Newcomers probably don’t.

This is not fair.

Nor is it efficient. People without a doctor have to go to Emergency, which is neither designed nor staffed to provide routine medical care to thousands of Yukoners. And those unable to get medical care now may end up needing more expensive treatments later.

The Yukon government’s attempt to solve the problem is not a poster project for public sector effectiveness.

The government promised a government-supported walk-in clinic. It was supposed to open in May. In October, we heard plans had fallen through.

Then there is the new bilingual health centre, a project which was announced at least as far back as March 2021. When it opens this month it won’t have any doctors — zero — and will only take 150 clients.

Adding bureaucratic insult to health care injury, the 3,341 Yukoners on the doctor waitlist will have to make a special application to join the clinic. These applications will be assessed by officials at the government-funded clinic. The number of openings at the clinic can only accommodate four per cent of the people on the waiting list.

I can hear those Alaskan libertarians laughing.

An MLA from the NDP, which is keeping the current government in office, compared getting selected for the clinic to winning the “health-care lottery.”

There is a shortage across Canada of health care professionals.

There is not much to do about supply in the short term. It takes years to train a nurse or doctor.

Nor is there much we can, or want, to do about demand. Yukoners have a right to health care.

Which leaves the Yukon government at the mercy of the law of supply and demand. Top politicians and officials may not like it, but they are going to have to spend more on health care. This has already happened in British Columbia. The Canadian Press reports that the new pay deal for B.C. doctors will boost the compensation of the typical family doctor from $250,000 to $385,000 per year.

You can expect similar reports about pay for nurses and other health professionals to come out of other provinces in the months ahead.

Here in the Yukon, we already receive a massive transfer payment. Asking Ottawa for more cash is likely to be a non-starter. So this means giving health spending a higher priority in the territorial budget.

You have to wonder why this realization didn’t sink in before the waiting list got to 3,341.

Yukon government spending announcements this year, supported by a majority of the MLAs in the legislature, have included a cruise-ship buffet of things that are not health care. Paving the parking lot outside the legislature for $2.7 million. A new Arts and Heritage Resource Centre budgeted at up to $40 million. Myriad highway upgrades. Up to $3 million for an upgraded tourism website.

Hiring consultants to study a varsity sports program at Yukon University may have only cost $50,000 this year, but how overworked nurses must have shaken their heads when they heard about it.

Meanwhile, as each of those projects was approved and announced, the doctor waitlist was on some hard drive in government; growing and growing, from 2,472 last November to 3,341 now.

That list of non-health spending projects goes on. All very nice projects. But not if more than 3,000 Yukoners are without a doctor.

Keith Halliday is a Yukon economist, author of the Aurore of the Yukon youth adventure novels and co-host of the Klondike Gold Rush History podcast. He is a Ma Murray award-winner for best columnist.


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