Opinion: To fix Canada’s crumbling health care system, we need better tools than duct tape

There’s a new symbol for what ails Canada’s collapsing health care system: The duct-tape ribbon.

Dr. David Keegan, a professor of family medicine at the University of Calgary’s Cumming School of Medicine, came up with the idea after seeing media reports of staff at hospitals in Red Deer and Calgary using tarps and duct tape to create makeshift consultation spaces in their bursting-at-the-seams facilities.

The duct-tape ribbon symbolizes how the health system is barely being held together, literally and figuratively.

But the more important message in the ribbon is: Fix it.

The constant MacGyvering, like creating new spaces with duct tape and tarp, will get us through in a pinch, but it’s not sufficient, nor sustainable. Nor is the expectation that health professionals should toil to the point of burnout. A healthy system requires healthy employees, not martyrs who set themselves on fire to keep others warm.

We need more permanent solutions, whether it be to staffing shortages or infrastructure deficiencies. We need a solid foundation, not a crumbling shell held together by duct tape.

Wearing a ribbon won’t magically improve the state of health care. But it sends an important, twofold message: Let’s talk frankly about the state of care, and let’s commit to improve it.

Coloured awareness ribbons – pink for breast cancer, red for AIDS, and so on – have a fascinating history.

The concept dates back to the U.S. Civil War, when women tied a yellow ribbon in their hair, or on a tree, to symbolize the hope that a soldier-husband would return home safe. The tradition was revived in 1979, when the wife of a hostage who had been taken in Iran signalled her desire to see her husband home again with a yellow ribbon, a gesture copied by millions.

In 1990, at the height of the AIDS pandemic, a group of New York artists fashioned the red ribbon to show support for people living with HIV, and to push governments to act. The next year, 1991, the pink ribbon symbolizing breast cancer awareness made its debut thanks to Estée Lauder, and soon became a sensation of cause-related marketing.

The duct-tape ribbon is a welcome addition to the pantheon, if for no other reason than it’s so darn Canadian, eh.

You can’t mention duct tape without at least a passing nod to The Red Green Show. The title character is a middle-aged, not-so-handy handyman who mangles most everything he sets out to fix. He routinely relies on the “handyman’s secret weapon”: duct tape.

The similarities between Red Green and all-too-many health “leaders” – with their frustrating mixture of hubris, incompetence, and patchwork solutions – are as striking as they are disconcerting.

Still, like the ribbons that came before it, the duct-tape ribbon should be a symbol of hope, not despair.

While the health system has many challenges – a disturbing lack of primary care, overflowing emergency departments, disturbingly long surgical waits, chronic staffing shortages, out-of-date infrastructure, money woes, and more – we can’t lose sight of the fact that it’s all fixable.

It may seem that hallway medicine is giving way to duct-tape medicine, but we can’t allow ourselves to surrender to cynicism and hopelessness.

Every health system on the planet has challenges right now: aging populations, new technologies, changing expectations, economic challenges, and political upheaval. There is no utopian model.

Yet, the fact remains that if you’re in the right place at the right time, you get excellent care in Canada’s health system – as good as anywhere in the world.

And you get that care for “free” – meaning we have a political and philosophical commitment to ensuring that no one is denied essential care because of an inability to pay. That principle is a precious one that we should not abandon because times are tough.

Rather, we should redouble our commitment to medicare’s fundamental principle by improving both access to and prompt delivery of essential care. But we also have to decide what’s essential, by establishing what is covered by medicare and what isn’t.

That requires some tough public discussion and debate. Simultaneously, we need to undertake some serious modernization and restructuring on both the funding and delivery sides of the equation.

The good news is that we know what to do, because we have countless reports and commissions that have provided blueprints.

We just need to commit to implementation and reconstruction – and not simply patching up what we have with duct tape.

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