Canada's population is booming – access to family doctors hasn't kept pace

https://www.cbc.ca/news/politics/canada-popuation-booming-family-doctor-access-1.7087794

by voisin • 2 years ago

61 115 2 years ago

The Canadian government's plan is import people by the boatload and hope everything from housing to public services just sort of works itself out.

fidotron• 2 years ago

"The Century Initiative (originally the Laurier Project Foundation)[2] is a Canadian lobby group and charity that aims to increase Canada's population to 100 million by 2100."

https://en.wikipedia.org/wiki/Century_Initiative

NoMoreNicksLeft5• 2 years ago

Why would they want the population to grow so large?

AlexandrB• 2 years ago

Multiple founders and affiliates of the organization have been employed by McKinsey & Company, a multinational consulting firm. Due to this, the Century Initiative has been connected to a scandal over McKinsey consulting expenses by Justin Trudeau's government, in which whistleblowers have highlighted McKinsey's large and growing influence over Canadian immigration policy.

McKinsey's influence on government policy around the world seems unhealthy.

calf4• 2 years ago

I'm Canadian, immigrated as a child from Taiwan.

It's pretty scary that the powers that be want more immigration yet don't actually have a real implementation for it. This goes against everything engineers value, obviously for many of us here. The likely consequence is a lot of harm and disruption to people in the future.

I mean, I guess the real plan is the Canadian 1% exploiting a booming immigrant society.

JohnMakin2• 2 years ago

Most western countries are seeing severely declining birth rates right now. What is different about canada? Is this driven by immigration?

verisimi2• 2 years ago

Yes. Opening paragraph:

Canada is going through an unprecedented growth spurt, having added well over a million people last year after a similarly historic intake in 2022.

JohnMakin2• 2 years ago

“added 1 million people” is not super clear language as to the contributing factor

bryanlarsen4• 2 years ago

AFAICT, "adding a million people" is double counting by adding the number of people who arrive and the number of people who obtain residency.

crowcroft• 2 years ago

I can't find the article now so someone might want to fact check me, but I believe the figure is that 98% of Canada's population increase in 2023 was from immigration.

bushbaba• 2 years ago

There’s 1 million international students in Canadian university right now. There’s just 38Miion people in Canada.

Canada took immigration on steroids under their current government. Many think it’s not sustainable with housing, medical, education, and social services unable to absorb such large growth short term.

myth_drannon• 2 years ago

Just to compare, US also has 1 million international students while having x10 population.

TMWNN2• 2 years ago

Context: Like the US, Canada allows international students to work. Unlike the US, Canada allows those students to work off campus, up to 40 hours a week. This has caused the rise of an entire industry, in which so-called institutions of higher learning (Conestoga, Lambton, Confederation) have 99% Indian "students" that work off campus, destroying the local job and housing markets.

screye• 2 years ago

It is sustainable, just not with the current polices.

At its current first world standards, Canada should be able to attract top talent from any developing country. It has practically infinite space & resources. They can selectively import a mix of medicine, education and construction professionals to make sure that services keep in touch with the rising population. Sadly, their polices are all over the place. While the US skims from the top of the Indian talent pool, Canada seems hell bent on importing the most mediocre of Indian talent.

This article does a good job of elaborating on the needles and massive hurdles faced by a foreign health-care professional, if they want to immigrate to Canada. You can complain about the shortcomings all you want, but the unwillingness to expand slots is a purely political decision. Similarly, despite having a massive housing shortage, housing remains firmly in the grasp of Canadian NIMBYs.

All social-welfarist countries will need to find ways to replace their aging workforces. Some will try to promote fertility (Hungary, Poland?) and others will try immigration. There isn't much else you can do. For once, the US had had a mature and well thought out legal immigration system. It pretty much selects for only those who can productively contribute to the economy, and that's after drawing ~$200k in tuition and ~5-10 years of uncompensated social security taxes.

theironhammer2• 2 years ago

Over 2 Million a year are coming in. Canada does not have infinite space. Most of the country is uninhabitable. It has a harsh climate. Most of the influx goes to two cities and their environs. Housing costs are the most expensive in the developed world.

dukeyukey• 2 years ago

Entirely by immigration - Canada's fertility rate is low even by developed Western standards. Around 1.4 children per woman, compared to the US at 1.64, the UK at 1.56, and not far from Japan at 1.34

ttul2• 2 years ago

Yes, because why would anyone have a child when they can’t be sure of finding housing or childcare?

jj999• 2 years ago

Yes. Birth rate is 1.4 by woman but immigration is 470k/y.

theironhammer2• 2 years ago

Don't forget the visa immigrants. Students, special work permits like IT, refugees and illegals. It's 2+ Million a year.

rayiner• 2 years ago

I was just in Toronto. It’s basically Indian Chicago.

jeffbee3• 2 years ago

That sounds dope.

gaudat• 2 years ago

Wait until you see Brampton

jeffbee3• 2 years ago

People tend to ignore or underestimate the contribution of longevity to population growth even while birth rates decline.

shwoopdiwoop• 2 years ago

Would that not make the situation worse? I would think that having more older people as part of the population means less productivity and a much bigger strain on the health care system.

folkrav• 2 years ago

Last I checked, in Quebec specifically, 25%+ of the population is 65 and up, and it's trending upward. Immigration rates definitely have to do with the shorter-term issues, but this has been going on for decades at this point.

skissane• 2 years ago

Canada has a “points-based” immigration system - you get points for various factors (university degrees, in-demand skills, etc), and anyone who gets over the cutoff can immigrate permanently. A lot easier to navigate and understand than the US rules. Hence, on a per capita basis, its immigration rate is 2-3 times that of the US.

Australia and New Zealand are other countries with a points-based system. Australia likewise has much higher immigration than US, although currently not quite as high as Canada. New Zealand’s immigration levels have historically been higher than the US too, although the last few years have been a COVID-induced anomaly. (Again, when I say higher, I mean per capita - in absolute terms the US comes first globally, but per capita it is only about average.)

verisimi2• 2 years ago

On the plus side, iatrogenic causes of death will drop.

TMWNN2• 2 years ago

Context: An amazingly high portion of Canadians don't have a family doctor <https://www.ctvnews.ca/health/despite-more-doctors-many-cana...>. In Atlantic Canada (the four easternmost provinces) it is impossible, repeat impossible, to get a family doctor if you don't have one <https://web.archive.org/web/20190226051406/https://www.thete...>. It's one thing to have shortages in rural areas—that happens in the US too—but Halifax?!? I've heard the same occurs in Vancouver too.

SleepilyLimping• 2 years ago

I've had two family doctors over the last four years, and they've both closed their practice to become specialists; much better paying, much easier work. I've been going to walk-in clinics who technically have "consistent" doctors I see every time I go in, but those people vanish without a trace, too.

swader999• 2 years ago

Feels like a ponzi scheme that even immigrants are starting to see.

cybercity2• 2 years ago

Work 70 hours. Always on. At Google they would give you stock options for that and you'd retire at 45.

The medical field runs on empathy. Imagine if the medical profession followed market capitalism. Cyberpunk 2077 Trauma Team.

goodSteveramos6• 2 years ago

Clearly you need to read more Ann Rand novels you hippy freak /s. It’s amazing to me how greedy people can not comprehend the idea that other people are motivated by things other than money.

soperj2• 2 years ago

This is just a prioritization problem. We have more doctors per capita than we did 20 years ago, they just don't pay them properly to be family doctors.

hesdeadjim• 2 years ago

My father was a GP who ran and taught a residency program for the speciality. In the 80s and 90s the program was extremely competitive, but by the 00’s they struggled to fill a class.

Med students caught on, why work your ass off in the most thankless field of medicine to make 200-300k when you could be a cardiologist and make $1mm reading X-rays?

ActionHank2• 2 years ago

It also takes ages to see any specialists, so it's not like there is a glut of cardiologists running around.

cybercity2• 2 years ago

Every few weeks they do a walk-in (or crawl-in) for those who are not insured. It's not a thankless job but it sure as hell doesn't pay the bills.

beaeglebeached4• 2 years ago

'Market' failure. Something is interfering with supply and demand.

ActionHank2• 2 years ago

Another side effect is that when you do get one they are so packed with patients that you have to wait months for a low priority appointment or see the doctor after hours.

stewx• 2 years ago

From 2000-2022, Canada's average age increased from 36.8 to 41. Older population consumes more health services.

https://www.statista.com/statistics/444844/canada-median-age...

ttul2• 2 years ago

BC changed its primary care billing model dramatically in 2023 to address the problem. The new model pays doctors based on a combination of their patient load and the complexity of their cases. The typical family doctor pay rises as a result from C$250K to C$385K - in line with what many specialists earn.

As a result, doctors are moving to BC from other provinces and countries and, as an anecdote, my small community now has 3x as many doctors as it had before. Money works.

loceng2• 2 years ago

You may be right that this is a prioritization problem, in that the priority is allowing incompetent/bad bureaucrats and unelected administrators as a central-single point of failure to make decisions - rather than allowing the free market decide, allowing the general population decide - so then the most efficient providers while providing an acceptable quality of care gain momentum, can hire more staff, etc.

But this is not a "just don't pay them properly" issue because in Canada free market competitive forces don't economically suffocate out the bad-incompetent doctors and administrators, and also then don't fuel-reward the good-best doctors and administrators.

How do I know this? 10+ years of hell trying to navigate the Ontario medical system, the prior 10+ years being harmed by that Ontario system - where I have had to spend $600k+ getting medical treatment outside of Canada, with the next surgery coming in in Europe to add another 60k EUR to medical expenses - of which I would have to find a lawyer who specializes in suing OHIP, spend another $200k+ and years of time, to try to get compensated for any of the expenses; stress, time, and money that isn't available to initiate that.

Anyone defending the current system has no leg to stand on: there's absolutely zero oversight and accountability. Example? I recently actually became a "rostered" patient with a general-family physician, rostered meaning that instead of going to a walk-in clinic and waiting many many hours to briefly discuss 1 thing - I can book an appointment instead. Of the 3 phone calls I had with this "family" physician so far, of which I had a file with them for years and recently had see multiple of his assistants (PAs: physician assistants), he hadn't even for a moment reviewed my file, nor on the 2nd and 3rd call did he even review the previous call notes with me - to even know what page he should be on; and no, not a new physician, he's been practicing for 25+ years.

This also is part of a planned destruction-erasure of Canadian culture and weakening of the population strategy.

In part via weaponized immigration + weaponized international student visas + irrational-illogical highly harmful "carbon tax" on all Canadian products and services - rather than say specifically on products coming from China - which arguably the majority are but Trudeau is toeing the CCP line, our intelligence agency CSIS having multiple whistle blowers [one who even came publicly forward to add credibility] stated that Trudeau and 11+ MPs had help of CCP to get elected for at least the last 2 elections; and more tactics they deployed.

Chart showing the West reducing its CO2 emissions vs. China's skyrocketing: https://ourworldindata.org/explorers/co2?facet=none&Gas+or+W...

Ignorance is bliss, and if the depths of your understanding is only what's discussed as acceptable to pop culture - which is heavily crafted by what narratives state-funded media like CBC floods the landscape with - then you'll miss the foundational points, because they don't want you to know the fundamentals, don't want you critically thinking through - they want you regurgitating-parroting.

aprdm5• 2 years ago

You might want to take off your foil hat. I am also very curious on you breaking down your claims as they don't make any sense on money spent and what happened. Regardless it seems like you had a bad experience (like others do - all around the world in every medical system) and that sucks. We can definitely do better

alephnerd2• 2 years ago

Canadian Medicare is also largely based on the NHS system back in the UK, which is also buckling for similar reasons.

Both the Canadian and British Single Payer system are holdovers from the post-war Old Labour era, specifically, the vision of Clement Attlee in the UK and Tommy Douglas in Canada.

I think a lot of people forget that Canada was basically Britain-lite until the 70s and 80s (hell, Newfoundland was under direct British rule until 1945), when Americanization became more prominent in the younger post-war generation.

Most of the Canadian leadership until the 1980s studied in the UK, were born in the UK, or were the children of immigrants from the UK. And specifically blue collar Labour Party leaning parts of Scotland. As such, a lot of the policies and legislation passed in Canada before the 80s or 90s tends to have a significant amount of British influence in it.

Australia's is similar as well, but they moved towards a public-private model in the late 1990s after their economy almost collapsed in the early 1990s.

kaycebasques• 2 years ago

Is it fair to assume that access to doctors is even worse for immigrants than it is for citizens? Assuming that citizens are the country's top priority, like they usually are in most countries.

(I know some Canadian immigrants on the path to citizenship who are planning to have their first baby but have not been able to see a doctor for a year plus. Just curious if they're situation is worse than citizens, the same, or better.)

ivraatiems• 2 years ago

Depends on what kind of immigrant they are. For people who are permanent residents or otherwise have a legal work visa, I don't think it's much different.

stackedinserter4• 2 years ago

In Canada, the whole so called "free" healthcare system is collapsing, not just access to family doctors. If you get sick and you're not visibly dying right now – good luck to get any help. The best you can hope for is $60 10 min appointment via zoom with a doctor that can't even refer you to a specialist. Also, you can spend 6-10 hours in your local ER to get help, or be told to come tomorrow because we don't have radiologist or something.

Oh there's an option to subscribe to "case management" plan at your local doctor office for $2000/year per person, then you can magically have ad-hoc slots, phone consultations, referrals to specialists etc.

calf4• 2 years ago

I live in BC, personally went through this ordeal this year involving two medical issues. One was during the holidays so access to specialists was even worse.

I did not know about "case management plans". That's a lot of money but for the price of a nice Apple laptop, a more personalized assessment of my chronic digestive issues? I might resort to that.

stackedinserter4• 2 years ago

They can be called something else, it's just an example from the nearest clinic that offers that.

thedangler• 2 years ago

You also have people that go to the ER for nothing plugging up the system. I was in the ER waiting to get stitches and someone had a blister. Why are you at the ER for a blister on your finger.

bryanlarsen4• 2 years ago

Because they don't have a family doctor.

aprdm5• 2 years ago

Why do you lie and spread fud ? I have been in Vancouver/BC for close to 10y and have never heard of anyone paying for care in any form. The virtual ones are all covered by MSP, access to doctors via the virtual calls and walk ins isn't perfect but isn't what you're describing

stackedinserter4• 2 years ago

"Lie"? You can go fuck yourself, bud.

Maybe in BC it's much better (I doubt it), but in Ontario, wherever you go to get online appointment, it's $50-70. There are places that still accept OHIP, but it's harder and harder to find. Last time we just bit the bullet and paid $60 because of urgency.

calf4• 2 years ago

I paid $60 to see a shopping mall optometrist in Richmond to diagnose my sudden vision problem. It was a co-pay for the service. I went home without having to go to the ER that day.

It was a wise suggestion by my mother, in that going to the hospital ER could've been a multi-hour long wait.

mthoms• 2 years ago

Relevant: A cap on international students has been announced today.

https://web.archive.org/web/20240122144208/https://www.thegl...

weberer• 2 years ago

Don't worry, the Canadian government came up with a solution for that as well.

https://apnews.com/article/covid-science-health-toronto-7c63...

debacle• 2 years ago

The role of the family doctor (in the US) has changed drastically in the last ~8 years. They are a heuristic wearing a lab coat doing mostly data entry.

The healthcare industry (in the US) needs sweeping reform to embrace technological and sociological realities for the 2020s. The AMA is a brake on progress, and not crazy progress or "disruption," but basic things like providing more direct access to care. Insurance companies are changing some aspects, but mostly in ways that benefit them, not the individual.

jacknews• 2 years ago

Some of these institutions and services have been built up over, and by, generations. I think it's unfair to expect them to suddenly cater for a mass of new arrivals.

tharmas3• 2 years ago

This high Immigration policy reminds me of China's campaign against the sparrow (https://journals.sagepub.com/doi/full/10.1177/03064220188002...) and its one child policy. Total disasters. The bureaucrats tried to solve one problem but ended up creating new problems that were far worse.

aaomidi• 2 years ago

I feel like comparing this to the systemic killing of sparrows is not...correct.

tharmas3• 2 years ago

The similarity is in not thinking about unintended consequences of govt policy. Solve one problem but create another (or more), which might even be worse. The cure being worse than the disease, as it were.

The Canadian govt sought to solve a demographics problem but have created a massive housing affordability problem. What with the climate in Canada, proper housing is a serious necessity.

Canada's population is booming – access to family doctors hasn't kept pace

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