An Article By Meaghan Craig From Global News

A visit to the emergency department (ED) is usually associated with negative thoughts by most people. It creates preconceived images of overcrowded waiting rooms and routine long waits for treatment (Jarousse, 2011). From 1996 to 2006, ED visits increased annually from 90.3 million to 119.2 million (32% increase). During this same time period, the number of EDs has declined by 186 facilities creating the age old lower supply and greater demand concept (Crane & Noon, 2011). There are many contributing factors that have led to an increase in ED visits. A few of these key drivers include lack of primary care access, rising of the uninsured population, dwindling mental health services, and the growing elderly

Starla, I agree with your statement that the older adult is a part of the vulnerable population. I also agree that more resources need to be available to them with education and that this could aid in the reduction of hospital readmissions. One of the articles I summarized, Risk Assessment and Intervention for Older Adults (Culo, 2011), also said the older person may have ‘red flags’ such as repeat emergency room visits or admissions, putting off medical problems, and not taking prescriptions as directed. Frequent assessments for risks and home visits could curb their health care costs. There should also be more involvement from family if available.

Canada’s health care system assures universality, portability, and accessibility; disappointingly, not all Canadians have access to specialists and facilities. Many patients face long wait times or do not have access to anesthetic and surgical care because the inadequate supply of anaesthesiologists for demand of Canada’s aging population. For instance, a woman experiencing severe pain in her right lower abdomen may endure excessive wait time to receive pain relief and life-saving care. However, surgical or other medical procedures can only be performed if patients have access to an anaesthesiologist. Despite government promises, and the billions of dollars funnelled into the Canadian healthcare system, the average wait time for surgeries in Ontario is approximately 14.3 weeks (Barua, Rovere & Skinner, 2011).

The waiting time for medical services is long in both countries. The waiting time is mostly determined by the number of medical doctors and facilities available in relation to the population. According to the report done by the American Medical Student Association (2011), it was discovered that the doctor-to-patient ratio in the U.S. is more than in Canada. As a result, the survey discovered that about 42% of patients in Canada had to wait for about two hours compared to the U.S. whereby 29% had to wait for two hours. Also, 43% of Canadians compared to 10% of Americans are forced to wait for about four weeks to see a specialist. In addition, the same study discovered that 37% of Canadians compared to 34% of Americans found it difficult to access medical services during weekends and holidays. As a result, 47% of Canadians compared to 50% of Americans felt that it would have been possible for them to be treated on a regular basis than on an emergency basis if medical personnel were available (American Medical Student Association, 2011).

Public Policies strive to protect all citizens across the nation, includes low-income citizens who often go unrecognized in society. To make sure this happens, legislature has put forth the “The Canada Health Act”, which requires the provincial government to meet certain expectations regarding public-health care and insurance plans. Though this act states that health services are free and accessible facilities, issues arise when citizens need urgent medical attention but appointment are unavailable until weeks later. Many of these poor individuals cannot afford to pay the extra amount to receive faster care as oppose to their rich counterparts.

In Ontario, on average patients wait for 158 to a high of 311 days for surgeries (Health Council of Canada, 2007). To further exacerbate the situation, since 2001 the wait-times for surgery has increased by approximately 50%. Furthermore, on average cancer patients who are suffering with chronic pain wait one to two years for an appointment to see an anesthesiologist for specialized pain treatments (BCAA, 2006). Explain the connection between wait times for surgery and the shortage of anesthesiologists more clearly. The government is not taking enough action to eliminate the issue of long wait times for surgeries; the Supreme Court of Canada says: “access to a waiting list is not access to health care” (CBC, 2006).

Accessibility and quality are being threatened due to cutbacks coupled with a lack of funding. There is a consensus now between medical professionals, the public, and the government that the health care system is deteriorating. It is failing to provide the quality of care promised in the CHA and prided by so many Canadians.

One of the most talked about subjects regarding health care in Canada is the time it takes to be seen by a physician. For acute illnesses, an

It is expected that with the baby boomers significantly using the health care dollars, the provinces and territories will end up spending 60% of their GDP on health care services which accounts to $530 billion dollars of debt ( Robson, 2001). This discrepancy will put pressure on the federal government and encourage provincial policy makers to rely more on the federal government for funding instead of finding their own way to manage their health care systems better. Population aging affects the demand for and costs of health care services, given that seniors account for about 45% of provincial/ government health care dollars (Ng,Sanmartin,Tu, Manuel, 2014, pg 15). Seniors are not only the largest user group of health care, but their hospital visits and admissions are higher than any other age group. This is merely because seniors tend to have more chronic conditions which derive them to use the health care services. Due to the health care problems that many seniors face, it is important to address the future directions in which the sustainability of the universal health care resides.

According to the Government of Canada, they are making improvements in acute care wait times: hiring more health professionals, and expanding ambulatory and community care programs (just naming a

Avoidable emergency department (ED) encounters places a significant burden on the health care system. Seniors 65 years or older have the highest rate of hospital encounters of any other age group (Bulut, Yazici, Demircan, Keles & Demir, 2015). The Center for Medicare and Medicaid (CMS) have placed stiff penalties on hospitals that are not able to reduce repeat encounters (“Coordinating better care & lowering costs”, 2017). These penalties result in the loss of guaranteed funding if the hospitals are not able to reduce readmission rates. Therefore, hospitals are seeking solutions to solving this challenge (“Coordinating better care & lowering costs”, 2017). Care transition teams are in place to help mitigate repeat encounters,

When asked to describe what makes Canada unique compared to other countries, many outsiders might yell out “Hockey!” “Cold Weather!” or “Free Health Care!.” Health care is definitely one of Canada’s most noticeable trademarks when compared to the United States, but the reality is that our health care services are not what they are made out to be. Canadians tend to take pride in the fact that they have a Government funded health care system, but the system is failing at a rapid pace. One can gage the quality of health care in our country while at the emergency ward in any hospital, where most Canadians realize its downsides. The Government spends most of its budget towards health care but Canadians are not feeling an improvement. Waiting

In 1992 a three month guarantee was issued, meaning if you couldn’t receive treatment within three months you were offered treatment at a hospital in another county or with a private facility. Currently, many clinics have armed security guards to keep tempers from flaring when patients get unruly in waiting rooms. (Larson, pg.21) Depression and hopelessness appear to be common

The emergency room has become the new primary care facility for the millions of uninsured in the United States. Thanks to an “unfunded mandate passed into law in 1986,” hospitals that participate in the Medicare program must “screen and treat anyone with an emergency medical condition” (Stephens & Ledlow, 2010). This unfortunately leads to emergency rooms full of people who may have something as simple as a sinus infection which then makes it really difficult for someone with a real emergency that did not require ambulatory transport to be seen in a timely manner. Another unfortunate result of this is that “over 1,100 emergency departments closed over the past decade” (Stephens & Ledlow, 2010).

I will argue that, long wait times are a root of reoccurring and on-going health problems among many Canadians, that waste money and time of the government and public. Long wait times in Canada are very common especially in sub-urban and urban areas around the country. Pro longing waiting times in hospitals and/or treatment centres do not help at all, to make patients better, instead these wait times add into making a patients health status lower. The problem with long waiting times for patients is that it is a huge waste of time. Also, patients that wait for a longer period of time are at a higher risk or being admitted into a hospital and/or at a higher risk of dying within the next seven days, compared to the patients who just get up and leave without being seen by a doctor, nurse or any other health care professional. (Guttman, Schull, Vermeulen & Stukel, 2011) They also face negative effects the more they are asked to wait for their treatments and appointments to see a doctor, including their family doctor. Negative effects including things such as more pain, mentally and physically and sometimes even the spread of cancer to other parts of the human body. The long wait times cost the Canadian government and many healthcare organizations a substantial amount of money and time.