Health

What are the true tests of a healthcare system?

Photo Courtesy of Nappy

W. Gifford-Jones MD & Diana Gifford-Jones

September 20, 2026

What are the true tests of a healthcare system? Is it how well it resolves health problems? How it prevents them? How efficiently it operates? One question should be, how does it treat our eldest citizens? The fact is, it’s absurdly difficult for seniors to access care, submit claims, and navigate a plethora of disjointed systems.

People pay taxes for decades. They contribute to insurance plans. They work hard, raise a family and play by the rules. Then, when they finally need help after a stroke, a broken hip, or a heart attack, they are handed another form to complete, another approval to obtain, and one after another, bureaucratic hurdles to clear.

In the United States, headlines have focused on insurance companies denying rehabilitation, long-term care and other medically necessary services to older patients. Many denials are overturned on appeal, but if the care was appropriate, why was it denied in the first place? How defeated are people in the process? How much illness is created, not cured?

Canada likes to congratulate itself for having a different system, but Canada has its own version of bureaucracy. Long waits for diagnostic tests. Delays for specialist appointments. Programs that are nearly impossible to navigate, and yes, diabolical mayhem with making claims to provincial programs or insurance companies.

If this isn’t making people sick, their medications certainly are. Everywhere seniors are juggling too many medications because physicians and pharmaceutical companies have created an epidemic of excessive prescriptions.

It should be no surprise what’s happened as a result. Older people and their caregivers are beaten down.

What is the price of the absurdity? Governments worry about the rising cost of caring for an aging population, but what’s truly worrisome is the failure to care at all. Getting care has become too complex, for all of us, but especially for the elderly. A national survey should ask this question, “Have you given up?”

Can’t get an appointment? Can’t get there if you do? Can’t get the right forms or figure them out? Don’t even know you are missing the forms?

How much time and money is spent dealing with paperwork? How many hospital admissions could be avoided if someone took the time to review a senior’s dozen prescriptions? How many older people deteriorate unnecessarily while waiting for approvals, referrals or appointments?

These are not questions for debate. They are management imperatives. In other industries, executives measure customer satisfaction, identify bottlenecks and eliminate waste. If an airline stranded thousands of paying customers every day, heads would roll. If a bank required six approvals to cash a cheque, shareholders would revolt.

The excuse is always that health care is complex, but so is aviation. So is nuclear power. Complexity is not an excuse for inefficiency. It is a reason to manage better.

What worries me most is the growing distance between decision-makers and patients. Increasingly, care is being managed by algorithms, utilization reviews, budget targets and policy frameworks. Somewhere beneath all that paperwork is an 82-year-old woman recovering from pneumonia who simply wants to go home, or an 89-year-old man hoping to walk again after hip surgery.

Here is my challenge to every health minister, deputy minister, insurance executive and hospital CEO. Go spend time shadowing an 85-year-old who is trying to book an appointment or trying to get to it. Check to see if they understand their medication list. Try to join them for a call with their physician and see if anyone answers the telephone.

Then tell us that the system is working as intended and that it cares for those who need it most.

This column offers opinions on health and wellness, not personal medical advice.

Newsletter Signup

Stay in the loop with exclusive news, stories, and insights—delivered straight to your inbox. No fluff, just real content that matters. Sign up today!

In this article:#LatestPost

Up Next:

Why Canada’s lack of race-based data keeps Black health disparities invisible

Don't Miss:

Dr. James Frizzell: Bringing Difficult Conversations Into Medical Education

Written By W. Gifford-Jones MD & Diana Gifford-Jones

Dr. W. Gifford-Jones, MD is a graduate of the University of Toronto and the Harvard Medical School. He trained in general surgery at Strong Memorial Hospital, University of Rochester, Montreal General Hospital, McGill University and in Gynecology at Harvard. His storied medical career began as a general practitioner, ship’s surgeon, and hotel doctor. For more than 40 years, he specialized in gynecology, devoting his practice to the formative issues of women’s health. In 1975, he launched his weekly medical column that has been published by national and local Canadian and U.S. newspapers. Today, the readership remains over seven million. His advice contains a solid dose of common sense and he never sits on the fence with controversial issues. He is the author of nine books including, “The Healthy Barmaid”, his autobiography “You’re Going To Do What?”, “What I Learned as a Medical Journalist”, and “90+ How I Got There!” Many years ago, he was successful in a fight to legalize heroin to help ease the pain of terminal cancer patients. His foundation at that time donated $500,000 to establish the Gifford-Jones Professorship in Pain Control and Palliative Care at the University of Toronto Medical School. At 93 years of age he rappelled from the top of Toronto’s City Hall (30 stories) to raise funds for children with a life-threatening disease through the Make-a-Wish Foundation. Diana Gifford-Jones, the daughter of W. Gifford-Jones, MD, Diana has extensive global experience in health and healthcare policy. Diana is Special Advisor with The Aga Khan University, which operates 2 quaternary care hospitals and numerous secondary hospitals, medical centres, pharmacies, and laboratories in South Asia and Africa. She worked for ten years in the Human Development sectors at the World Bank, including health policy and economics, nutrition, and population health. For over a decade at The Conference Board of Canada, she managed four health-related executive networks, including the Roundtable on Socio-Economic Determinants of Health, the Centre for Chronic Disease Prevention and Management, the Canadian Centre for Environmental Health, and the Centre for Health System Design and Management. Her master’s degree in public policy at Harvard University’s Kennedy School of Government included coursework at Harvard Medical School. She is also a graduate of Wellesley College. She has extensive experience with Canadian universities, including at Carleton University, where she was the Executive Director of the Global Academy. She lived and worked in Japan for four years and speaks Japanese fluently. Diana has the designation as a certified Chartered Director from The Directors College, a joint venture of The Conference Board of Canada and McMaster University. She has recently published a book on the natural health philosophy of W. Gifford-Jones, called No Nonsense Health – Naturally!

Click to comment