When will they finally pay attention to fact instead of fable and conclude, as Dr. Jane Philpott said in 2016 while she was the country’s health minister, that, “It’s a myth that Canada has the best health-care system in the world”?

These are the essential questions that author Martinuk raises in her new book, Patients at Risk: Exposing Canada’s Health-care Crisis.

Martinuk, a Port Coquitlam, B.C., media commentator, researcher and analyst, does not pretend to be able to peer into the minds of Canadians to discover why so many cherish what is a demonstrably dysfunctional system.  But she does provide more than enough heartbreaking anecdotes, insightful analyses and alarming facts and figures to persuade even the most dewy-eyed admirers of Tommy Douglas, the revered grandfather of the country’s socialist medical system, to give their heads a shake and re-evaluate their beliefs.

The book is especially timely given the medical system’s lurching response to the COVID-pandemic crisis. Remember: the primary reason that health authorities across the country gave for imposing lockdowns and other restrictions was to prevent hospitals from being overwhelmed. In other words, it was to protect an already fragile system.

But in the two-plus years since the pandemic arrived on our shores, precious little has been done to make that system more robust.

Martinuk, who is currently a Research Fellow in Health with the Frontier Centre for Public Policy, does not directly address moral issues in her book, but the incontrovertible evidence she presents makes it impossible not to conclude that rationing of health care can lead directly to intolerable pain and suffering, and sometimes to death.

And if that’s not a moral question, then nothing is.

Take the example of an unnamed man from Nanaimo, B.C.,  as recounted by his wife, Julie.

Julie’s husband developed some troubling symptoms one October several years ago, and so visited a doctor who ordered a test for the following March 19.

“He didn’t make it,” Julie said. “He landed in an emergency department on March 1 and was admitted.”

He was soon diagnosed with Stage 4 metastatic cancer and began radiation and chemotherapy but died shortly after treatment ended.

“If he had gotten the test within days or weeks of it being ordered rather than months, the cancer may not have had an opportunity to grow so large and he may still be here with me and our teenagers,” said Julie. “I will never know, and he will never see his children finish growing up or meet his future grandchildren.”

Martinuk points out there is no guarantee of timely treatment or timely access to specialty care in Canadian health care. No wonder, then, that Canadians had the worst access to specialist care of 11 wealthy, developed countries as shown in a 2016 survey.

Waiting lists equal denial of care, and denial of care leads to pain, suffering and death; it’s that simple, Martinuk says. As evidence, she points to a headline in the April 23, 2019, edition of the Halifax Chronicle Herald: “39 cancer patients died while still on wait-list for Halifax gastroenterologist study.”

Such waits don’t always lead directly to premature death, of course, but they often lead to increased pain and suffering. And this, in turn, can precipitate thoughts of suicide, Martinuk points out, which in turn is especially problematic given the legalization of Medical Assistance in Dying (MAiD).

“Whether you agree with MAiD or not,” Martinuk writes, “the point is that Canadian governments are willing to grant autonomy to those who want to die yet continue to restrict the autonomy of those who want to live by preventing them from accessing the medical care that they need to get on with their lives.”

She writes about a Vancouver woman who in 2020 said that she was prepared to kill herself because she could not get the medical care she needed to get through the day.

“Question: If we really believe that health care based on socialism is morally superior, why do we not have a moral obligation to provide healing and medical care to those in need?” Martinuk asks.

The conclusion is inescapable: our country’s health-care system is based on a flawed ideology that “equality” of access is paramount, even if that access is severely limited for most and even if some people, such as federal prisoners and injured workers, are given special access to treatment.

So, what should be done? No responsible Canadian is arguing that Canada should completely jettison its health-care system and embrace the United States’ costly, cumbersome and inequitable system.

Rather, as Martinuk’s book makes clear, this country has a duty to its citizens — a moral duty — to allow alternatives to flourish, alternatives such as a parallel private system, supported by private insurance.

It works for most European countries, and it can work here, too.