Without mental health and substance use care, Canada’s health care system is not universal
From the days of Tommy Douglas, Canadians have staked a hefty portion of our national identity on universal health care: the promise that no matter who you are or how much money you make, our public system will take care of you. Yet this source of pride is under threat. To make health care truly universal and accessible, we must prioritize investments in the full range of care that keeps us well, including mental health and substance use care.
Prioritize investments in the full range of care that keeps us well, including mental health and substance use care.
DJ Larkin and Steven Staples
Canadians have routinely rejected privatized health care and the inequality it drives, setting us apart from our American neighbours, where health care-driven bankruptcy is routine. Our system is built on the shared value that everyone deserves access to care. But to fulfill that promise, we need to build on recent wins to protect and expand it.
Within the past two years alone, millions of Canadians have benefited from expanded access to care with the new Canadian Dental Care Plan and the passage of the Pharmacare Act. We should celebrate these hard-won victories: they remind us what is missing from our health system, and what is possible when we work close those gaps. Even so, too many Canadians are being let down and left out.
We hear the challenges every day: nurse and doctor shortages, surgical and diagnostic delays, overcrowded hospitals, and lengthy emergency room wait times. These challenges are interconnected: without adequate investments in primary care, we put our acute care systems under immense strain. If someone cannot access a family doctor to diagnose the nagging pain in their side, they eventually find themselves in the emergency room when that pain becomes unbearable. If someone cannot access a supervised consumption site, we rely on overstretched paramedics to respond to 911 call when they experience drug poisoning.
Everyone benefits from robust public investment in universal health care. That’s why it is so galling to witness the federal government’s reckless decisions, diverting funds from solutions we need. Provoked by an American president with zero regard for Canadian sovereignty and even less for the truth, Canada recently committed $1.3 billion in public funding toward a new ‘fentanyl czar’ and ‘Canada-U.S. Joint Strike Force’ and a further $200 million to the RCMP for exorbitantly priced helicopters, drones and mobile surveillance towers. Predictably, these costly attempts to appease President Trump failed. His demands were only ever cover to impose expensive tariffs, driving a multi-trillion dollar trade war. The result? Not only rising food prices, job losses, and escalating conflict, but billions of public dollars diverted from systems proven to keep us well.
[Trump’s] demands were only ever cover to impose expensive tariffs, driving a multi-trillion dollar trade war.
DJ Larkin and Steven Staples
Rather than pour money into theatrics at the whims of America’s president, our leaders could put those funds to work for Canadians, collaborating with the provinces to invest in the full umbrella of primary health care. That includes improving access to quality mental health and substance use treatment, reducing wait times, and supporting workers. We need to invest in our primary care system to support health, not push costs downstream, where everything becomes an emergency.
This is happening while health care workers are increasingly outraged by the lack of meaningful action to address the unregulated drug crisis that has harmed families across the country. Despite the proven success of community-based harm reduction services, alternatives to the toxic supply, and universal access to evidence-informed substance use and mental health services, we are witnessing a worrisome retreat from this vital aspect of primary care.
If we believe in universal health care, we must fully incorporate mental health and substance use services into primary care. In Ontario, the Ford government’s hostility toward and shuttering of supervised consumption sites places unnecessary strain on already-overloaded emergency services. Alberta’s Premier Smith has consistently diverted public funds to private for-profit unregulated treatment providers. These are two sides of a terrible coin: overburden and privatize, not only distancing us from the expanded services we need, but also dangerously undermining existing systems.
Recent expansions of public health care to include dental and pharmacare show we can also expand access to primary care. To live our values and stand behind truly universal health care, we need to bring in those of us who are being let down and left out. We must commit to making health care truly accessible for everyone.
