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Editor’s Note: All of the Doctors and Surgeons interviewed by The Post Millennial provided their real identities for our review but have had their names changed in this story due to fear of professional repercussions.
Last week, Angus Reid revealed healthcare was the chief concern for Canadians heading to the polls in October. And while Canada’s universal healthcare system has often been identified as an area of national pride, the flaws in the system are undoubtedly beginning to bubble to the surface.
On August 15th, Dallas Mavericks owner and Shark Tank star Mark Cuban entered into a heated discussion about Canadian healthcare on Twitter while expressing criticisms of socialized healthcare. A Canadian tweeter confronted him, insisting that all Canadians, rich and poor, receive the same level of healthcare.
Cuban responded by dismissing the user’s suggestion as “not true,” providing his own experience of being given expedited healthcare access at a Toronto area-hospital when he was recognized in the emergency room, stating “there’s a reason wealthy people in Canada donate to hospitals.”
Within four days of Cuban’s initial twitter exchange, and four hours of his revealing story, Politifact released an article declaring Cuban’s statements of the existence of a two-tiered healthcare system in Canada “Mostly False.” To make this determination, Politifact spoke to one healthcare bureaucrat, and four professors in fields ranging from political science to health policy. No physicians or surgeons were consulted.
Had Politifact spoken to frontline staff, their article may have turned out differently.
“We have many hierarchies of access.” Says Dr. Smith, “There are allowances made for certain individuals.”
“Say, for example, a politician needs an MRI, [he] has some sort of injury…” she continues, noting she was drawing from a real example, “they would contact the CEO at that hospital, and that CEO would arrange for the expedition of their imaging and expedite their surgery.”
Dr. Smith’s statements were echoed by Dr. Shelly, another physician from a Toronto-area Hospital.
“Donors, or other people of influence … at my last hospital … they would not infrequently get fast-tracked. They’d get brought through the clinic with a representative.” Shelly says, “[It wasn’t uncommon] to get phone calls with people asking if certain individuals could be seen directly rather than have to go through different levels of care.”
All of the Doctors and Surgeons The Post Millennial spoke to provided their real identities for our review but asked to have their names changed due to fear of professional repercussions. Dr. Smith underlined this by sharing tweets with The Post Millennial belonging to one surgeon who, after publicly decrying the expedited care politicians were receiving, suddenly deleted all of their tweets and went totally silent across his social media.
“He put out this message saying he was hacked and hasn’t posted at all since.” She laughed pessimistically. Dr. Smith stated she knew of many physicians and surgeons forced to delete public posts about the existence of the “VIP healthcare program” under threat from the Ontario Medical Association, though some still exist.
Some Doctors and Patient advocates in non-urban centres even report seeing “VIP” checkboxes on intake registration forms.
All of the Doctors interviewed for this piece expressed the same concern: The displacement of non-expedited patients by a priority triage for the elite.
Drawing on the Mark Cuban example, Dr. Blanchard noted that Cuban’s expedition would have displaced a non-VIP patient. “He occupied ER physician time, maybe specialist time, when there might have been more urgent problems in ER.”
“And in jumping the queue they make patients already waiting months to years wait even longer.” Dr. Smith says, “If an average Ontarian needed surgery … Wait times for orthopedic surgery can be two to three years.” Dr. Smith notes that the wait times posted on Hospital and Ontario Government websites are generally deflated. “Hospitals get more funding from the [provincial] government if they have lower wait times. So they actually lower their reported wait times.”
Smith explains that it isn’t a lack of surgeons or even operating rooms that are causing lengthy wait times, but an underfunding of the public healthcare system. “Surgeons are actually unemployed or underemployed.” She says.
“The previous Wynne government … permanently shut down operating rooms. There are operating rooms across Ontario, including in the GTA, where the lights are just turned off.”
While thousands of operating rooms are not in use by the public healthcare system, it does not mean they are not being used at all. As one orthopedic surgeon we spoke to revealed, these rooms are often purchased at a premium by the Worker’s Safety and Insurance Board (WSIB)—Ontario’s public worker’s compensation system—to expedite the access to specialists and surgeries of injured workers. This surgeon was affiliated with the WSIB.
“The goal at WSIB [for workers to receive surgery] is three weeks.” Dr. Clark says, noting that if not being expedited by WSIB, the average Ontarian would be waiting “six to 12 months” for the same surgery after waiting for their initial consultation with a surgeon. According to Dr. Clark, the goal of such a program is to reduce the amount of time WSIB has to pay out benefits to the worker.
“The WSIB pays extra to have nursing there and to rent the operating room.” The surgeon revealed that, at his hospital, WSIB utilized an otherwise closed-to-the-public operating room two to three days per week. “When WSIB is not using the room, the room is closed. If those rooms were running, [we] could do 20 to 25 more surgeries per day.”
Surgeons apparently receive an attractive financial bonus for completing a WSIB surgery. Doctor Shelly, when asked if surgeons were incentivized to do a WSIB surgery, clarified that only certain surgeons affiliated with WSIB-cooperative hospitals had the choice. But for those that did, “If a surgeon has a choice between working one day at a regular hospital, and one-day working WSIB cases—there is a financial incentive obviously.”
The result? One less surgeon available to complete surgeries for regular Ontarians.
“It is a revenue generator for the hospital.” Dr. Clark says, noting that the rates WSIB pays are at “a profit” to the hospital.
“The government and politicians demand adherence to the failed Canada Health Act that only guarantees access to a waitlist, but they break their own rules when their own health is on the line,” Dr. Smith tells us. “All lives are not equal. Harsh reality.”
The Post Millennial reached out to Michael Legros, who was identified as the administrator for the VIP Program in 2016 in an article by Canadaland, but Legros refused to answer any questions and referred us to the Ministry of Health’s media team which did not respond to our request for comment. Legros’ official title—Senior Manager of Strategy, Communications, and Performance Management—has not changed since 2012, according to the Sunshine List.
The Post Millennial also reached out to WSIB to clarify unpublished statistics relating to claimants accessing surgery, and the average amount of time WSIB pays out a claim, but a communications specialist claimed it would be “impossible” to determine that.