Livio Di Matteo, a well-known economics professor in Thunder Bay, said Ontario's health-care system is in a crisis marked by waiting lists, ER (emergency room) shutdowns and shortages of critical health professionals including doctors and nurses.
"Unfortunately, it was never designed for an extended pandemic that coincides with staff burnout, a surgical backlog, and a wave of retirements on top of everything else," said Di Matteo.
Di Matteo's comments were included this week in The Hub, a non-profit newsletter oriented toward civic engagement, analysis and debate about public policy in Canada.
His essay argues that Ontario's health crisis is an issue of design and not one of having enough resources.
Di Matteo said anyone calling for more money to be spent should consider the findings of the Romanow Report:Building on values:The Future of Health Care in Canada, published in 2002.
Di Matteo said this resulted in a six-per-cent Canada Health Transfer Escalator that was supposed to buy transformative change in the health-care system.
"Yet, two decades later here we are facing a lot of similar issues — overcrowded ERs, lack of after-hours access to family physicians, waiting lists."
Di Matteo said there are other factors that come into play when the real statistics of Ontario's health care system are compared with health statistics in other countries, based on the premise that Ontario was its own country.
Di Matteo said he used Ontario statistics because there are too many discrepancies when comparing health care stats with all the provinces and territories.
He compared Ontario with several OECD countries (Organization for Economic Cooperation and Development).
For example, when looking at the number of physicians per 1,000 population, Greece was first with 6.2 physicians per 1,000 people. The OECD average was 3.6 physicians per 1,000. Ontario was second last at 2.3 physicians per 1,000 population.
For the numbers of nurses, Switzerland was first with 18.4 practising nurses per 1,000 population. The OECD average was nine nurses per 1,000 people. The Ontario numbers were split, showing 11 nurses per 1,000 people if you included all RNs, nurse practitioners and licenced practical nurses. If you define practising nurses as those giving direct care to patients, the Ontario number is 7.1 per 1,000 population.
Another table he presented was the number of hospital beds per 1,000 people. Korea and Japan were both at more than 12 beds per 1,000. The OECD average was 4.3 per 1,000 and Ontario reported 2.2 hospital beds per 1,000 population.
The final table Di Matteo presented showed the ratio of health care spending compared to GDP (gross domestic product). The United States topped the list with 18.8 per cent. Ontario was in second place with 13.2 per cent and just ahead of Canada's national health spending to GDP ratio, which was listed as third at 12.9 per cent.
Di Matteo said this takes a bite out of the argument that Ontario and Canada need to be spending more money. He said some countries commit a lot of their GDP to health and rank high. Some countries spend little and rank poorly, while other countries spend a lot and still do not rank well in the quantity of resources (doctors, nurses, beds).
"We seem to be in the third category. It does not mean you have a bad health care system, but it does represent a choice of how we have chosen to structure and run our health systems," Di Matteo wrote.
He also said Ontario and Canada "pour a lot of money" into health care, but with fewer resources such as doctors, nurses and hospital beds.
"We generally also pay our health system workers and professionals more than in many other countries and part of the trade-off is that they are run off their feet in return for the compensation they get," Di Matteo wrote.
"The problem now is that after two years of pandemic burnout and a backlog of surgeries combined with COVID-19 resurgences, it is not possible to wring blood from a stone," he continued.
Another issue he said is that over the years doctors have been burdened with more paperwork and administrative processes that takes up more time than it used to take and it translates into less time with patients.
De Matteo's full essay is published on The Hub and can be found here.
Len Gillis covers health care and mining for Sudbury.com.
