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The health care systems in the United States and Canada are failing

Tomi Mitchell, MD
Health Policy
April 26, 2022
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There are no two ways about it: The health care system in the United States and Canada is failing. Few want to talk about a dirty little secret, but the facts are clear. Health care costs are rising at an unsustainable rate, and millions of Americans are uninsured or underinsured. The system is not accountable to the people it is supposed to serve.

Having experienced both the Canadian and United States health care systems, they have lots to learn from each other. There is no perfect health care system, but that doesn’t mean we can’t learn from each other. The Canadian and United States health care systems both have their strengths and weaknesses. By studying each other’s systems, we can learn from our mistakes and improve the quality of care for everyone.

Each country has its unique challenges when it comes to health care. In Canada, we face long wait times for services and a lack of access to certain specialists. In the United States, there is a high cost of care, and many people are uninsured. However, both countries share some common problems, such as an aging population and a growing prevalence of chronic diseases. Despite our differences, each system has significant room for improvement.

I will make my main point now, focusing on the elephants in the room. The fact is that the books do not balance in either health care system. Laws of economics help shed light on this issue. The health care system is a perfect example of what happens when the laws of supply and demand are broken. When there’s an increase in demand for a product or service but no corresponding increase in supply, prices go up. This is what has happened with health care. The system is failing because the demand for health care services has increased dramatically, but the supply has not kept pace.

There are several reasons for this. One is that health care is a labor-intensive industry. It takes a lot of people to provide health care services – doctors, nurses, aides, support staff, etc. The health care industry is facing a daunting challenge. The demand for health care services is increasing at an unprecedented rate, while the supply of health care workers fails to keep pace. This imbalance is that it takes many years to train a health care provider. It’s not possible to increase the number of medical schools or the number of students enrolled in them overnight.

Similarly, it takes significant time and resources to train nurses, surgeons, and other medical professionals. As a result, the health care industry must find ways to increase the efficiency of training programs and make better use of existing health care workers. In addition, the industry must find ways to attract more people to careers in health care.

So, the question is, how can we control the variables of supply and demand as it pertains to health care. One of the great success stories of modern medicine is the ability to prolong life even in the face of severe chronic illness. Conditions that in the past would have meant a significantly shortened life span can now be managed with a variety of treatments and therapies, allowing people to live long and productive lives. This is particularly true for heart disease, cancer, and diabetes. While there is still much work to be done to cure these illnesses, the fact that people are living longer with them is a sign of progress. In addition to the obvious personal benefits of prolonged life, this trend also has several positive consequences for society as a whole.

In the perfect, utopian world, we decrease the incidence of chronic, preventable illness by maintaining sound health practices. I often laugh when researchers are still conducting new studies on the importance of exercise, diet, and reducing or eliminating alcohol use. Knowing and society, as a whole, not following through with this knowledge is part of the problem.

When I was in full-time primary practice, I saw the impact of poor health choices and patients’ clinical responses. Lack of compliance to healthy life choices is multifactorial; however, the issue wasn’t lack of access to health care or exercise opportunities in my practice. Instead, the main problem was the unwillingness to make a healthy lifestyle a priority. As a practitioner, I wanted my patients to make consistent, healthy choices so I could wean them off certain medications and, frankly, increase their overall wellbeing. I naively used to think that I could help more patients if the majority made significant efforts to prevent illness.

The health care system is falling partly because people are not held accountable for their health. It’s easier to make an appointment with the doctor, get a prescription, and continue with an unhealthy lifestyle rather than make long-term changes to improve overall health. In addition, it’s much cheaper for people to be unhealthy since they can keep going back to the doctor for more medications instead of taking proactive steps to improve their health. I practiced in the Canadian health care system for over ten years, a system that is often touted as the gold standard–universal health care for all, and there is significant room for improvement.

Unfortunately, universal health care, without personal responsibility to make the right choice and accountability is a disaster waiting to happen. The Canadian health care system is one where demand far outstretched supply and where personal responsibility isn’t fitting into the equation.

The United States health care system is also failing because of the high cost of health care. Health care is so expensive that many people cannot afford to go to the doctor, even with insurance. This means that people are putting off preventive care and only going to the doctor when they are sick, which is much more expensive and can lead to increased mortality and mobility. This system is also failing because it is becoming increasingly unaffordable. As health care costs continue to rise, more and more people are being priced out. With an ever-increasing older population, the demand for health care services will continue to grow. Unfortunately, our health care system is not able to deal with this effectively.

One of the issues is that we don’t have enough health care providers to meet the demand. This is partly due to the current workforce nearing retirement age – soon they’ll be leaving the health care system at a time when we need them most. Additionally, there’s a limited pipeline of new health care workers coming into the workforce.

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So, let us talk about something radical. Encourage, or dare I say, in this post-COVID world, mandate healthy lifestyle choices. Create a culture that encourages and nurtures healthy lifestyles. Create a society where it’s cheaper to eat more nutritious foods than junk. Create communities designed so that it’s possible to walk places and public transport is readily accessible. Create tax benefits for families that choose to incorporate healthy choices. Reinforce these healthy choices in schools that make physical activity mandatory in all grades. I remember that school field trips would often include nature walks and outdoor adventures as a child.

Perhaps my ideas are a little unrealistic or radical, but I know that we will see the improvement in our world over time if we make these changes. Let us live in a world where preventable, chronic health conditions are rare and not the norm as it is now. So let us make changes for the sake of our future generations.

Until then, I will continue in my utopian world, that if enough of us lead by example and lead with impact, we can make a difference in this world. Once these changes happen, we will be able to balance the books, and demand will stop outstripping supply. Then, in my simple way of thinking, when needs have been reduced, the price of health care would become more affordable, at least that is what my university economics classes taught me.

What will you do to create change in your life and the life of others?

Tomi Mitchell, a family physician and founder of Dr. Tomi Mitchell Holistic Wellness Strategies, is not only a distinguished international keynote speaker but also a passionate advocate for mental health and physician’s well-being, hosting her podcast, The Mental Health & Wellness Show. With over a decade of experience in presenting, public speaking, and training, she excels in creating meaningful connections with her audience. Connect with her on Facebook, Instagram, and LinkedIn and book a discovery call.

Image credit: Shutterstock.com

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