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Randall Denley: Lack of a family doctor is the real two-tier health care system

Ontario is a long way from providing everyone with the most fundamental connection to care

Imagine every Ontario adult having a family doctor. It would seem like the most basic expectation of our public-health system, but the province is well short of the mark.


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Just how short is unclear. About 2.2 million Ontarians don’t have a family doctor according to the latest data from Inspire-PHC, a health-care research group. That’s up 400,000 from 2020, the last time the number was measured. A new report this week from the Public Policy Forum puts the number of doctorless people at 6.5 million nationally. The Ontario government’s own number is a little over a million adults without a doctor.


No matter which number you believe, Ontario is a long way from providing everyone with the most fundamental connection to care.


People certainly expect better. A poll of 9,000 people conducted for the policy forum found that 97 per cent of Canadians believe that having a primary care doctor is a right and 72 per cent think that doctors should have to accept any patient who lives near their office.

In Ontario, that would be what former premier Kathleen Wynne liked to call “a stretch goal.”


Everyone pays for health care through their taxes but up to 2.2 million don’t get a family doctor. In a world obsessed with equity, this goes surprisingly unremarked. Lack of access to a family physician is the real two-tier medicine in Ontario.


All the opposition party and media fussing about a few doctors in Ottawa performing hip and knee surgeries on weekends misses the main point. That kind of care is accessible to anyone. Family health care, by contrast, is available only to those fortunate enough to be on a doctor’s list. Doctors can choose how many patients they take. This is truly private health care, in the sense that valid OHIP card holders are excluded.


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Even if one is lucky enough to have a doctor now, there is no guarantee for the future. According to the Ontario College of Family Physicians, in 2019 1.7 million Ontarians had a family doctor who was about to retire. In that same year, 4.9 million Ontarians had a family doctor older than 55. Add in population expansion and an aging population and you’ve got a significant problem.


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