Acclaimed columnist and author André Picard reflects on 40 years of health journalism, from how health care has changed over the decades, and where he believes it’s headed. Picard delivered the 2023 Dalton Camp Lecture in Journalism, at St. Thomas University in New Brunswick.
Doctors are burning out and closing their practices. Nurses are leaving in droves. Care aides are jumping at the opportunity for better work at Tim Hortons — it pays better and has better benefits. We're kicking people out of hospitals and sending them to nursing homes against their will. Long-term care homes have become killing fields. Of the 50,000 COVID deaths in Canada, 25,000 have been in nursing homes, home to one per cent of the population. It's been a massacre of neglect.
Medicare began just after the Second World War, a heady time when nations were rebuilding and investing in public services like hospitals and social programs like pensions and medicare. People were also making babies — lots of babies. It was the beginning of the baby boom, which is now coming home to roost.
Saskatchewan created the first publicly funded hospital insurance program in 1947. Other provinces followed suit in 1957. The federal government offered to pay half of the province's escalating hospital bills, but they had a couple of conditions: access had to be universal and free. In other words, no user fees. That funding model was extended to physician care about a decade later in 1966.
We built a health system for the needs of the population at that time and that was totally appropriate. Today, the median age in our country is 47. Life expectancy is 82. The vast majority of care is chronic care for older people. The baby boomers have come of age, but the health system has not. In Canada, only hospital care and physician services are 100-per-cent covered by medicare. They're the only services considered, quote, medically necessary, unquote.
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