LETTERS TO THE EDITOR May 21

LETTERS TO THE EDITOR
May 21: ‘The sacred cow of medicare is defended even when the system is collapsing around us.’ How would you fix Canadian health care? Plus other letters to the editor

Re There’s A Problem With Social Media, But It’s Not Donald Trump (Opinion, May 14): As with much that humankind initially invents for the good of all, social media is now hijacked. Once a highway, it has become a potholed-distorted avenue paved with distrust, disinformation and disavowal.
From homegrown conspiracy theorists and foreign malevolence to bots and propaganda factories, platforms such as Twitter and Facebook have assigned virtual soapboxes to these once nameless, frequently faceless entities now emerging triumphantly from the fringes of society. Alas, we cannot seem to look away even when that “free speech” is highly suspect, loaded with hate and untruths.
Never mind the chicken and the egg: The horse has left the barn and we should all be guilty of holding the doors open.
Marian Kingsmill Hamilton
Fixer-upper
Re How To Fix Health Care (Opinion, May 14): The contributors write that “we have a limited number of health care professionals,” and therefore any gain by the private sector is a loss for the public sector. That would be the “lump of labour” fallacy.
I believe that no labour supply is fixed. The question should be why labour in the public sector grows too slowly to meet demand, while labour in the private sector frequently responds better to public demand. Think dentists, opticians, optometrists and physiotherapists.
According to the Commonwealth Fund, Canada ranked last in 2010 and 2021 compared with other public systems. We should gain inspiration from others such as Australia, Britain and the Netherlands. Last place isn’t good enough any more.
Mark Wolfgram Ottawa
Governments have historically cut health care spending to save money on the backs of patients and health care workers. It is possible to have new models that are properly funded, support work-life balance and reduce administrative burden while providing excellent care.
Most patients prefer to consult with family physicians when dealing with serious health issues. Primary care physicians are associated with lower overall mortality, fewer hospital visits and reduced hospital admissions and surgeries. Recent analysis shows that primary care delivered by health care professionals without the involvement of a family physician is less cost-effective.
We call on governments to support family physicians now through better pay, increased attention to team-based models of care and greater capacity throughout the system, as advocated by our Patient’s Medical Home vision.
Francine Lemire CM; Executive Director and CEO, College of Family Physicians of Canada Mississauga
A feature of every high-performing health care system in the world is strong primary care, but today too many Canadians do not have fast enough access to it.
It is due to a host of issues, including an older and more complex patient population, outdated payment models and heavy administrative work. It is also a result of not doing enough to recruit and retain more family doctors in Canada.
But there are solutions. If Canada focused on supporting family physicians leading teams that include nurse practitioners, registered nurses, physiotherapists, social workers and pharmacists, we could ensure that patients receive comprehensive and timely care.
A stronger health care system in Canada should focus on leveraging every health professional and their skillsets, including family doctors who trained to provide the level of complex and comprehensive care that so many Canadians need today.
Kimberly Moran CEO, Ontario College of Family Physicians Toronto
Re Around 15% Of Canadians Don’t Have A Family Doctor, But The Solution Isn’t Hiring More (Opinion, May 14): Robert Bell and his colleagues suggest a solution to replace family doctors with nurse practitioners. This would amount to deskilling the health work force at its most critical point. I suppose that if we are short of pilots, the solution is to give flight attendants a six-month course and let them fly planes.
Why don’t we examine health care systems in the world that work well and model ours on success? Australia, Singapore and Britain have functioning, cost-effective health care. Here is the problem: They all have parallel public-private systems.
The sacred cow of medicare is defended even when the system is collapsing around us.
Derryck Smith MD Vancouver
While the number of family doctors in Ontario rose by 31 per cent from 2006 to 2016, the wait time to see a family doctor actually increased.
Ontario’s auditor-general found that in 2014-15, 60 per cent of family health organizations and 36 per cent of family health groups did not provide the number of weeknight or weekend hours mandated by the Ministry of Health. It is a requirement meant to improve patient access to a physician and reduce unnecessary visits to the emergency room.
The contributors recommend hiring more nurse practitioners to improve access to health care. But should one expect more nurse practitioners to boost access if there is no change in the enforcement of FHO and FHG hours?
Constance Smith Victoria
I have read little discussion about the demand side of the health care equation.
If every resident abstained from smoking, drank less alcohol, went for a daily walk, kept vaccinations up to date, nurtured social connections and practised active ways to manage stress, the demands on our health care system would drop dramatically.
I think my mother was right: Eat your fruits and vegetables.
Jamie Alley Saanich, B.C.
Not forgotten
Re Why Are We Ignoring The War On Afghanistan’s Women? (Opinion, May 14): War in Ukraine has focused the public, and apparently Immigration, Refugees and Citizenship Canada, on providing safe haven for Ukrainians. The abysmal treatment of women under the Taliban should also remind us of Afghans, without whose assistance the Canadian military effort in Afghanistan would have been impossible.
The identities of many of these people are known to the Taliban. In 2021, the government committed to admitting 40,000 Afghans to Canada. The current success rate of about 10 per cent is surely underwhelming.
The increased Canadian immigration target of 450,000 suggests that vulnerable Afghans would be a great place to start, and to demonstrate that government trustworthiness, fairness and responsibility are still alive.
Margaret Vandenbroucke Toronto
Canadian history
Re Lewis And Clark Expedition Begins (Moment in Time, May 14): The explorer Alexander Mackenzie, along with his band of French-Canadian voyageurs and Indigenous guides, reached the Pacific Ocean 12 years earlier than the Lewis and Clark Expedition, and over a tougher route with minimal financial support.
As usual, Canada made much less fuss about it.
R.B. Matthews Toronto
Letters to the Editor should be exclusive to The Globe and Mail. Include your name, address and daytime phone number. Try to keep letters to fewer than 150 words. Letters may be edited for length and clarity. To submit a letter by e-mail, click here: letters@globeandmail.com
THEGLOBEANDMAIL.COM