In 2014, 11.2 per cent of Canadians over the age of 12 reported not being able to receive the health care they needed.
That works out to about about 3.4 million people going without physical, emotional or mental health care.
A third (33.4 per cent) said this was due to wait times being too long, 13.7 per cent said health care services were not available at the time, and cost was a barrier for 11.4 per cent of respondents.
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The information comes from 2014’s Canadian Community Health Survey, released by Statistics Canada Tuesday.
While that might sound alarming, it’s better than it used to be, says Michael W. Carter, University of Toronto professor of mechanical and industrial engineering, who has spent the last 25 years working to streamline health care systems.
“Just in terms of wait lists, we’re doing a lot better than we were,” Carter says.
In 2004, a first ministers’ meeting produced a 10-year plan to strengthen healthcare, with a focus on reducing wait times. Carter says there has been progress since then in reaching certain targeted goals.
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However, Carter suggests a perhaps unexpected result: He says, “supply-generated demand” has bogged down the system, with more doctors recommending procedures because they know the wait lists are short.
“If your GP knows it’s going to take six months to get an MRI for you, he’s not going to bother. But if he can get it done in a month, he’ll order one. So as the wait lists in MRI and CT scans dropped, the demand for them skyrocketed.”
Tests being ordered when not appropriate needs to be a part of the system’s assessment process, Carter says.
He said there is an urgent need for coordination of care and support services.
“I really think that cleaning up the process needs a lot of work,” says Carter, pointing to a tangle of systemic issues.
“How do you design a system? Those are the kinds of issues I deal with,” Carter says. “There is no health care system, it was never designed.”
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Independent patient advocate Connie Jorsvik, who worked as a registered nurse for 25 years, says health care system inefficiencies cause financial and emotional stress to those already dealing with often complex care issues.
“A lot of these people are very sick and for them to go back to the doctor time and time again because the doctor can only listen to one concern is not helpful to anybody,” Jorsvik says.
She says doctors need to be able to bill for longer appointments, instead of patients going back time and again for multiple issues, filling up additional appointment slots.
Age is also a factor in health care access: People between the ages 20 and 54 were the most likely to not receive the care they need, according to Stats Canada.
“I think that most people don’t understand that people in their 30s and 40s are not getting the access to care that somebody in their 70s has,” Jorsvik says.
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She says Canada has a system focused on geriatric care; at the same time it’s people in those mid-age groups who will take the hardest financial hit at times of illness.
“They simply have not had the time to accumulate assets, and to be able to take on the expenses of a serious illness. And it’s very expensive to be sick.”
Across the 10 provinces, lower-income Canadians (12.8 per cent) reported higher rates of unmet care than middle- or high-income people (10.2 per cent).
Costs of illness add up quickly, even with Canada’s free health care system.
“It’s all the silent costs of health care that are financially devastating to people,” Jorsvik says.
Both Jorsvik and Carter point to the need for a shift to greater community health care access, and care teams with a combination of expertise working together to provide a more well-rounded approach.
But don’t expect a rapid transformation.
“It’s a difficult system to change,” Carter says.