Canada's population is booming – access to family doctors hasn't kept pace
cbc.ca
cbc.ca
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.
https://www.statista.com/statistics/444844/canada-median-age...
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?
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.
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.
You can't brainstorm any scenario where the money spent makes sense? And indeed, I didn't give much detail at all for the costs, except for the upcoming surgery.
And then you jump to actual whataboutism.
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.
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.
It was a wise suggestion by my mother, in that going to the hospital ER could've been a multi-hour long wait.
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.
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.
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.
Not true for most of Canada on the Shield, the vast majority of land is close to barren rock, very hard rock at that, and way too cold & remote for economically viable anything (without huge subsidies from Ottawa), any mining/farming/etc. only happens in unusual pockets, like Sudbury where a big asteroid hit relatively recently in the geological past.
Our banks are publishing papers that for every 1% our population increases, home prices appreciate 3% above the target CPI of 2%; AFTER accounting for interest rates.
It's flat out a Ponzi Scheme. Our real wages are absolute CRAP.
Canada: 40.8 million (https://www150.statcan.gc.ca/n1/pub/71-607-x/71-607-x2018005...)
US: 336 million (https://www.census.gov/popclock/)
--Wikipedia
The ethnic 'whites' are about 50%, ethnic Chinese is now ~25%, it was quite a bit lower when I was still living in Canada so it was definitely on the rise but the increase seems to have leveled off.
Some externally sourced data that more or less confirms this:
https://worldpopulationreview.com/canadian-cities/vancouver-...
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.)
> Canada is going through an unprecedented growth spurt, having added well over a million people last year after a similarly historic intake in 2022.
https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=171000...
https://web.archive.org/web/20240122144208/https://www.thegl...
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.
McKinsey's influence on government policy around the world seems unhealthy.
https://www.centuryinitiative.ca/our-work#focus-4-early-chil...
And all governments of the last 30 years have been spending money on children: Harper had sports credits, and the Universal Canada Child Benefit. Trudeau replaced it with Canada Child Benefit and has added daycare subsidies, dental and drug cover for minors.
The bigger problem is that nobody in the world has figured out what effective "pro-natal" policies look like. You can't push on a string.
Given how old our demographics are, even if our 20-year-olds all started having 3 kids each, TFR wouldn't even climb much. Demographic decline is baked in the cake without immigration.
I would say it in reverse: BECAUSE 40 years of trying to raise TFR has absolutely failed in every advanced nation on the planet, Canada has chosen immigration as the only practical path.
Or you tell me - is there somewhere you think we should copy? Or are you just blaming 40 years of Canadian government for a global phenomenon?
The ex-Soviet states have had some recent gains, but those look more like a rebound from the total collapse of the 80s. And they are all stabilizing around the new-normal 1.8. I don't think there are any lessons there. Hungary has struggled to recover from the post-Soviet low of 1.3, and has almost reached the might peak of 1.6!
https://ifstudies.org/blog/a-new-normal-an-updated-look-at-f...
Dead cat bounce. Will be below 1.0 within a decade or two.
Little girls who grow up watching all the adult women around them have few or no children don't suddenly get it in their heads that they want a large family. The rate of decline will only accelerate.
Almost nobody except really poor people get this credit and its only $6000 in an entire year. Do you expect that to increase birth rates across the whole population?
On 4chan, they have some laughably bad conspiracy theories about it, and while I don't subscribe to those, we clearly have some very effective (accidental) propaganda that discourages people from procreating. But banning that propaganda isn't compatible with free speech, and so I think that it's virtually impossible for anyone to do anything about this in the West. What surprises me is that even China and North Korea apparently can't handle it either.
It's not even easy to talk about. Any attempt is seen as (at best) thinly veiled racism. I think that even if you didn't care about natalism, that you still might not want your population to triple. Isn't the housing crisis already absurd in the Toronto region as it is? This can't be in the interest of any Canadian, no matter their skin color.
But I'll push back on one thing: who is this mysterious "you" people keep talking to? There is no single "Canadian" whose interests represent the whole.
There are LOTS of people who are doing well from the current housing crisis -- landlords, real estate agents, homeowners, construction trades, the Family Compact, etc. Landlords have perfected the rennoviction sneak past rent-control. They love the crisis. Our mayor in 2000 was a (small-time crooked) furniture dealer. Immigrants buy furniture. Our last mayor worked for a monopoly cable company - every new immigrant needs a phone/tv/internet package. The Westons (grocery barons) basically make money from every new body in Canada. All of them know that more immigration = more money in their pocket.
It's been hell on young people, but you might notice they aren't running the show.
I think in this case there is. Whether your ancestors have been there for 200 years, or you just naturalized last week... it's not in your interest for Canada to import another 70 million people so they can "be a player on the world stage".
> There are LOTS of people who are doing well from the current housing crisis
There are some who do relatively well in it, but it's doubtful to me that their (self-)perceived wealth is actually higher in these conditions than it would be in a country with a strong economy, low inflation, and an engaged workforce. Their 1%er income might be twice as high, but buys less than half as much. Most of the people you point out are lusting after a larger piece of a smaller pie. And the few that truly to gain advantage from this, they number in the low thousands or even hundreds, not the tens of millions.
I'm not in Canada myself, but the country I am a citizen of is suffering the same exact problem. If mine is too dumb to fix it, it might be nice to at least see you guys succeed. Doesn't look like that's in the cards either.
Canada is currently having a spirited debate about levels. It's pretty obvious that 500k/a is higher than we can currently absorb. But 0 is just a recipe for a different disaster.
I gave you a concrete list of people (real estate agents, furniture sales, monopoly owners, retiring home owners) that make tons of money off mass immigration. Your answer is "no they don't".
If you can point to single country in the world that has defeated the stagnation of an aging population, I'm all ears.
But if you are going to give me unrealistic counterfactuals, I might as well wish for a pony too.
Here's Canada's dependency ratios over time:
https://www150.statcan.gc.ca/n1/pub/82-229-x/2009001/demo/de...
And here's the global context:
https://data.oecd.org/pop/old-age-dependency-ratio.htm
We're in better shape that Italy and Japan. But absent immigration, we're in exactly the same boat. The baby boom has turned to baby bust.
https://en.wikipedia.org/wiki/Demographics_of_Canada#/media/...
https://www.centuryinitiative.ca/why-100m
Not that I agree...
Every country with social security has to make sure there's enough young people to pay for old people.
At this point I'm wondering WHAT IS a sustainable policy? Is there a country this all doesn't apply to that has figured things out somehow?
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.
The medical field runs on empathy. Imagine if the medical profession followed market capitalism. Cyberpunk 2077 Trauma Team.
https://apnews.com/article/covid-science-health-toronto-7c63...
(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.)
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.