Healthcare in Canada
Flaws in Canada's healthcare system
Flaws in Canada's healthcare system
-----------------------------------

Identified weaknesses of Canada's system were comparatively higher infant mortality rate, the prevalence of chronic conditions, long wait times, poor availability of after\-hours care, and a lack of prescription drugs coverage.A PRESCRIPTION FOR CANADA: ACHIEVING PHARMACARE FOR ALL (Government of Canada report, retrieved 2023\) Limited dental coverage was added in 2023  An increasing problem in Canada's health system is a shortage of healthcare professionals and hospital capacity.

Prescription medications have been consistently expensive in Canada, which has the third\-highest drug costs of any OECD nation, and a 2018 study found that almost 1 million Canadians gave up food or heat to afford prescription medications. In 2021, over one in five (21%) adults in Canada reported not having any prescription insurance to cover medication costs.

There is enormous waste in Canada's healthcare system related to medical records. Although the Canadian federal government has invested more than $2\.1 billion developing [health information technology](/wiki/Health_information_technology "Health information technology") (HIT), all 10 provinces still have their own separate incompatible HIT systems. A recent study showed that a shift to shared open source medical software could save Canada's healthcare system millions of dollars.

### Hospital and urgent care access

Canada's hospital beds per capita have decreased 63% since 1976,Hospital beds (per 1,000 people) \- Canada \| Data ([worldbank.org](https://data.worldbank.org/indicator/SH.MED.BEDS.ZS?locations=CA)) to 44% fewer beds than the OECD average. Overcrowding, or "hallway medicine," is common in hospitals, and hospital patients are instructed to sleep on concrete floors, in storage rooms, as hospitals often operate at over 100% capacity, and in some regions as high as 200% capacity. In 2023, more than 1\.3 million Canadians "gave up" waiting for emergency care, and left without being seen. The crisis is projected to continue to build, as Canada's hospitals are unable to operate safely at 90% or greater ongoing capacity.

In addition, ambulance access in Canada is also inconsistent and decreasing, with *Code/Level Zeros*, where one or no ambulances are available for emergency calls, doubling and triple year\-over\-year in major cities such as Calgary, Ottawa, Windsor, and Hamilton. As an example, cumulatively, Ottawa spent seven weeks lacking ambulance response abilities, with individual periods lasting as long as 15 hours, and a six\-hour ambulance response time in one case. Ambulance unload delays, due to hospitals lacking capacity and cutting their hours, have been linked to deaths, but the full impact is unknown as provincial authorities, have not responded to requests to release ambulance offload data to the public.

Plans to address ambulance access that included using taxis instead of ambulances to transport patients have drawn support from local leaders, but rejection from local residents and Ontario's provincial authorities.

  

Temporary hospital and emergency room closures are common in Canada, with over 1,100 in Ontario alone in 2023, and in 2022, the president of the Canadian Medical Association described Canada's healthcare system with the following quote;

Canada's healthcare system ranks poorly among peer nations on medical technology access indicators, ranking second\-to\-last in the G20 for MRI units and radiotherapy equipment, fifth\-to\-last for CT scanners, and has 33% fewer mammography machines than the G20 average.

### Wait times

In a May 28, 2020, report by the [Organisation for Economic Co\-operation and Development](/wiki/Organisation_for_Economic_Co-operation_and_Development "Organisation for Economic Co-operation and Development") (OECD) that examined wait times in member nations—all of which are democratic countries with [high\-income economies](/wiki/High_income_economy "High income economy") with a very high [Human Development Index](/wiki/Human_Development_Index "Human Development Index") (HDI), found that long waiting times for health services was an important policy issue in most OECD countries. In 2017, Canada ranked above the average on OECD indicators for wait\-times and access to care, with average scores for quality of care and use of resources.

In the 1980s and the 1990s, wait times for certain surgeries, such as knee and hip replacements, had increased. The year before the 2002 Romanow Royal Commission report was released, in 2001, the Ontario Health Coalition (OHC) called for increased provincial and federal funding for Medicare and an end to provincial funding cuts as solutions to unacceptable wait times.

In December 2002, the Romanow Report recommended that "provincial and territorial governments should take immediate action to manage wait lists more effectively by implementing centralized approaches, setting standardized criteria, and providing clear information to patients on how long they can expect to wait." In response to the report, in September 2004, the federal government came to an agreement with the provinces and territories add an additional C$41 billion over a ten\-year period, to the [Canada Health Transfer](/wiki/Canada_Health_Transfer "Canada Health Transfer") (CHT) to improve wait times for access to essential services, a challenge that most other OECD countries shared at that time. By 2006, the federal government had invested C$5\.5 billion to decrease wait times.

In April 2007, Prime Minister [Stephen Harper](/wiki/Stephen_Harper "Stephen Harper") promised that all ten provinces and three territories would establish wait\-time guarantees by 2010\. Media release [Canada's New Government announces Patient Wait Times Guarantees](http://pm.gc.ca/eng/media.asp?category=1&id=1611) , Office of the Prime Minister, April 4, 2007\. Retrieved November 19, 2007\.

In 2015, *Choosing Wisely Canada* promoted [evidence\-based medicine](/wiki/Evidence-based_medicine "Evidence-based medicine") in 2015\.[http://www.cmaj.ca/content/early/2015/06/08/cmaj.109\-5078](http://www.cmaj.ca/content/early/2015/06/08/cmaj.109-5078), CMAJ: More Hospitals Choosing Wisely, June 8, 2015\. Retrieved July 15, 2015\. Organizations like this focus on facilitating doctor\-patient communication to decrease unnecessary care in Canada and to decrease wait times.[http://www.huffingtonpost.ca/robert\-y\-mcmurtry/healthcare\-wait\-times\_b\_7292500\.html](http://www.huffingtonpost.ca/robert-y-mcmurtry/healthcare-wait-times_b_7292500.html) Huffington Post: How to Reduce Wait Times in Canadian Health Care, May 16, 2015\. Retrieved July 15, 2015\.

In 2014, wait times for knee replacements were much longer in Nova Scotia, compared to Denmark, Germany, the Netherlands and Switzerland.

A 2016 study by the [Commonwealth Fund](/wiki/Commonwealth_Fund "Commonwealth Fund"), based in the US, found that Canada's wait time for all categories of services ranked either at the bottom or second to the bottom of the 11 surveyed countries (Australia, Canada, France, Germany, Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States). Canada's wait time on emergency services was the longest of the 11 nations, with 29% of Canadians reporting that they waited for more than four hours the last time they went to an emergency department. Canada also had the longest wait time for specialist appointments, with 56% of all Canadians waiting for more than four weeks. Canada ranked last in all other wait time categories, including same\- or next\-day appointments, same\-day answers from doctors, and elective surgeries, except for access to after\-hour care, where Sweden ranks lower. The 2016 study also noted that despite government investment, Canada's wait\-time improvements were negligible when compared to the 2010 survey.

The 2021 *Waiting Your Turn: Wait Times for Health Care in Canada* report by the [Fraser Institute](/wiki/Fraser_Institute "Fraser Institute") found that the average waiting time between referral from a general practitioner and delivery of elective treatment by a specialist rose from 9\.3 weeks in 1993 to 25\.6 weeks in 2021\. Waiting times ranged from a low of 18\.5 weeks in Ontario to 53\.2 weeks in Nova Scotia.

### Gender gaps in healthcare

[thumb\|upright\=1\.05\|[Life expectancy](/wiki/Life_expectancy "Life expectancy") in Canada by gender](/wiki/File:Life_expectancy_by_WBG_-Canada_-diff.png "Life expectancy by WBG -Canada -diff.png")
Gender gaps in healthcare are significantly influenced by socioeconomic status, geographical location, and ethnicity. It has been hypothesized that women experience a higher rate of health\-related issues because of their reduced access to the material and social conditions of life that foster good health, as well as a heightened level of stress associated with their gender and marital roles. Moreover, research has shown that women with low income and who work full\-time outside of the house have poorer health status in comparison to their male counterparts. The added responsibilities women hold as primary caregivers in households not only creates additional stress, but also indirectly increases the difficulty of the scheduling and meeting of medical appointments; these implications explain women's poorer self\-rated health status in comparison to men, as well as their report of their unmet healthcare needs.

Women's additional healthcare requirements, such as pregnancy, further exacerbate the gender gap. Despite comprising approximately half of Canada's population, women receive the majority of Canadian healthcare.

Men and women also experience different wait times for diagnostic tests; longer wait times have been associated with a higher risk of health complications. One Canadian study reports, "mean wait times are significantly lower for men than for women pertaining to overall diagnostic tests: for [MRI](/wiki/Magnetic_resonance_imaging "Magnetic resonance imaging"), 70\.3 days for women compared to 29\.1 days for men."

#### Effects of healthcare privatization

Disparities between men and women's access to healthcare in Canada have led to criticism, especially regarding healthcare privatization. While most healthcare expenses remain covered by Medicare, certain medical services previously paid for publicly have been shifted to individuals and employer\-based supplemental insurance. While this shift has affected both genders, women have been more affected. Compared to men, women are generally less financially stable, and individual payments are a greater burden. Furthermore, many women work part\-time or in fields that do not offer supplemental insurance, such as [homemaking](/wiki/Homemaking "Homemaking"). As such, women are less likely to have private insurance to cover the costs of drugs and healthcare services.

The shift from public to private financing has also meant additional labor for women due to families relying on them as caregivers. Less public financing has shifted care to women, leaving "them with more support to provide at home."

Women's additional healthcare requirements, such as pregnancy, further exacerbate the gender gap. Despite comprising approximately half of Canada's population, women receive the majority of Canadian healthcare.

### Socioeconomic gap in healthcare

It has been previously documented that one's socioeconomic status significantly impacts their health. Another recent study re\-assessed this relationship and found similar results that demonstrated that people with higher levels of education or income experience longer life expectancies and [health\-adjusted life expectancies](/wiki/Healthy_life_expectancy "Healthy life expectancy"). The study discovered a distinct stepwise gradient in Canada, with life expectancy and health\-adjusted life expectancy incrementally increasing as social position improves. They also found that this socioeconomic gap in healthcare had gotten wider in the previous 15 years.

The reasoning behind the socioeconomic gap is complex and multifaceted. Certain relationships between socioeconomic status and health outcomes can be relatively easily explained through direct exposures. For example, lead or pollutant exposure tends to be more common in rural neighbourhoods, which can result in lower cognitive functions, stunted growth and exacerbated asthma. Higher income levels allow for the purchase of higher\-quality resources, including food products, produce and shelter, as well as faster access to services. Higher education is often thought to lead to greater health literacy, resulting in the adoption of healthier lifestyles.

Longer, more complex pathways can also be used to explain potential relationships between socioeconomic status and health outcomes. Duration of poverty has been related to increased chronic stress levels. Recent studies have described how these stress levels can result in the biological "wear\-and\-tear" for these individuals constantly exposed to social and environmental stressors. Increased stress and lower SES has been correlated with increased blood pressure, worser cholesterol profiles and increased risk for other cardiovascular diseases.

### Inequalities in care by community

#### Black community

In Canadian healthcare, [Black individuals](/wiki/Black_Canadians "Black Canadians") encounter pervasive discrimination from overt acts like harassment to subtle daily indignities, eroding trust and discouraging Black Canadians from seeking medical care. A quantitative study in the [Greater Toronto Area](/wiki/Greater_Toronto_Area "Greater Toronto Area") found that all 24 Black women participants experienced objectification, maltreatment, and unequal power dynamics in healthcare, mirroring historical patterns of oppression and exposing racial treatment disparities amid challenging healthcare access.

Black Canadians encounter significant racial treatment disparities, including lower rates of receiving [biologic](/wiki/Biopharmaceutical "Biopharmaceutical") treatments such as medications for rheumatoid arthritis and psoriasis, compared to White patients. Additionally, limited participatory visits with physicians and clinical trials, undermining treatment validation. Despite Canada's universal healthcare access, socioeconomic status exacerbates these disparities, hindering low\-income individuals' access to prescription drug coverage and specialist care. Evidently, racialized persons are twice as likely as non\-racialized persons to face these challenges. These issues are further compounded by historical and systemic contexts and a lack of diversity among healthcare workers, shaping negative healthcare experiences for Black individuals.

In contemporary Canadian healthcare, research indicates that everyday racism adversely affects the health outcomes of Black Canadians and other racialized communities. For instance, in Ontario, Black people, constituting 5% of the population, represented one\-quarter of new HIV diagnoses. Additionally, throughout the first 14 months of the [COVID\-19](/wiki/COVID-19 "COVID-19") epidemic in Toronto, Black people accounted for 14% of cases and 15% of hospitalizations, despite comprising 9% of the city's population. These findings highlight that Black Canadians face insensitivity and discrimination from healthcare providers, dissuading individuals from seeking care and exacerbating disparities in health outcomes. 

Studies highlight that evidence\-informed health promotion initiatives and interventions targeting racism's impact on health and within Canadian healthcare are crucial for promoting health equity, rebuilding trust within the healthcare system, and improving public health outcomes in Canada. Additionally, collecting ethically disaggregated ethno\-racial data for monitoring outcomes is essential for positive changes within the Canadian healthcare system.

#### Indigenous community

It is well documented in the literature that [Indigenous peoples in Canada](/wiki/Indigenous_peoples_in_Canada "Indigenous peoples in Canada") lack equitable access to healthcare services for a variety of reasons. One major reason for this inequitable access is due to Indigenous locations of residence. Statistics Canada reported that the majority of Métis live in urban centres, while almost half of First Nations people live on reserves. In rural northern communities, they struggle to attract and retain healthcare professionals, leaving a great shortage in services that results in far lesser access to care. In the Inuit Nunangat, it was found that just 23% of Inuit had a medical doctor they regularly visited. Additionally, due to the lack of healthcare access in northern communities, many are forced into lengthy transportation to southern Ontario to receive necessary care. One study examined an Inuit community in Rigolet, Canada, and looked at the direct and indirect costs of these long\-distance healthcare visits, including missed paid employment, mental well\-being costs, transportation costs and others. Altogether, this community experiences healthcare costs greater than other Canadian non\-Indigenous and urban areas.

Another prominent reason for inequitable access to care is the persistence of racism that remains in Canada. In 2012, The Health Council of Canada conducted a series of meetings across the country with a variety of healthcare workers, researchers and Aboriginal people. Through their conversations, they discovered that a large part of the problem comes from the healthcare system. They found that many Indigenous people simply do not trust mainstream health service due to stereotyping, racism and that they feel intimidated. One participant described their experiences as "being treated with contempt, judged, ignored, stereotyped, racialized, and minimized." Finally the Health Council of Canada went on to describe that this lack of equitable access comes as an extension of systemic racism in Canada.

A 2015 study examined 80 Indigenous women who experienced neurological conditions. Participants described their lack of access to health services to stem from the racism and sexism experienced in the system. In the same study, the researchers interviewed multiple key informants, including various types of health practitioners. They described how important it is for the health system to implement culturally safe care. They also discussed how many stereotyping problems occur in medical school and that Canada requires further Indigenous\-centred training. They recommend higher education and awareness training amongst medical schools and healthcare institutions to address the growing healthcare disparities between Indigenous and non\-Indigenous peoples in Canada.

#### LGBT community

Canadians in the [LGBT community](/wiki/LGBT_in_Canada "LGBT in Canada"), especially those in poverty, receive inadequate levels of treatment. A research study by Lori Ross and Margaret Gibson notes that of all demographics, LGBT members need mental health services the most due to systemic discrimination. According to the study, LGBT members often need to turn to mental health services that are mainly private and not covered by publicly funded healthcare. Low\-income LGBT members might be unable to afford these private programs; subsequently, their mental health issues may remain unaddressed or even worsen.

Researcher Emily Colpitts states that LGBT members in [Nova Scotia](/wiki/Nova_Scotia "Nova Scotia") experience ambiguous or alienating language in their health policies. According to Colpitts, the "heteronormative and [gender\-binary language](/wiki/Gender_binary "Gender binary") and structure of medical intake forms have the consequence of alienating LGBT populations." Colpitts adds that in the previous study of queer and transgender women in Nova Scotia, patients experienced significant discomfort in their meetings with healthcare providers and feared that because of the language of health policy, they would not be able to receive adequate healthcare based on their [sexual identities](/wiki/Sexual_identity "Sexual identity").

According to researcher Judith MacDonnell, LGBT members, especially childbearing lesbians, have trouble navigating through health policy. MacDonnell states that LGBT women encounter challenges at every point of the childbearing process in Canada and have to rely on personal and professional means to receive information that they can understand, such as in reproductive health clinics and postpartum or parenting support.

The healthcare needs of the LGBT community are affected by a number of social, behavioural, and structural factors.Rapid Response Service. The Rapid Response: Facilitators and barriers to health care for lesbian, gay and bisexual (LGB) people. Toronto, ON: Ontario HIV Treatment Network; March 2014\. Various bodies of literature have identified the health disparities associated with the LGBT community, and how these individuals receive disproportionate healthcare services. For example, mental health disorders such as depression and anxiety, eating disorders, obesity, and cardiovascular diseases are all of higher prevalence and a major concern amongst LGBT persons. These health issues are not sufficiently addressed either, as healthcare professionals (such as physicians) may be unaware of these individuals' sexual orientation. In 2008, Analysis of Canadian Community Health Service data showed that: LGB persons were more likely to seek out mental health services than heterosexuals; lesbians have lower reported rates of using family physicians. bisexuals report higher levels of unmet healthcare needs compared to heterosexuals(2\); and LGB persons perceive they have less equitable access to healthcare services compared to heterosexual persons.

Another barrier that exists with regard to the healthcare disparities experienced by LGBT persons is the stigma that continues to persist in society. Moreover, LGBT populations may fear that their health needs are not considered in primary health since healthcare has been historically been constituted through a cisnormative and heteronormative framework. As a result, LGBT populations are less likely to access primary healthcare services due to the fear of discrimination. In addition, recent data shows that healthcare professionals lack adequate knowledge and cultural competence when it comes to addressing health issues predominantly affecting the LGBT community. Cultural competence is an important consideration in assessing the quality of care received by the LGBT community, as a lack of cultural competency in healthcare professionals and systems leads to a reduced life expectancy, a lower quality of life, and an increased risk of acute and chronic illness amongst LGBT persons. Research has also highlighted that higher rates of chronic illness seen in LGBT persons is associated with discrimination, minority stress, avoidance of healthcare providers, and irregular access to healthcare services.

Another important consideration in addressing the quality of care received by the LGBT community is patient\-physician communication. Many health risks LGBT persons face come as a result of avoidance and/or dissatisfaction of healthcare services; this is in part due to assumptions made by the patient's healthcare providers, such as assuming the sexuality of the patient and predicting their sexual behaviours. In these scenarios, it can be very difficult for LGBT persons to feel comfortable in a clinical setting because they may experience a decline in self\-confidence and trust in their healthcare providers.

The underlying message in terms of providing equitable care, and access to care, for patients in the LGBT community is that healthcare providers and systems must be aware of the appropriate methods through which to administer care. The specific needs of LGBT persons must be appreciated in order to enhance the quality of care and provide it in a non\-judgemental, gender\-neutral manner.

#### Immigrants

Inadequate access to primary care and treatment interventions has been and continues to be a prevalent issue amongst minority populations in Canada. As a result, many immigrants are faced with constant barriers with regard to receiving high\-quality care. The patient experience is revered as one of the most significant aspects of healthcare, however its relation to immigrant status is not well defined. The "healthy immigrant effect" is a term that recognizes how immigrants on average enter Canada with better health than those born in the country. However, over time, this health advantage experienced by immigrants may begin to decline. Multiple factors contribute to this health decline, including: racialization and discrimination, stress of immigration, barriers accessing healthcare practitioners and others.

The most prevalent barriers faced by immigrants with regard to accessing primary care services are related to geography and geographic distribution, language, and culture. Moreover, the distribution of physicians has a direct impact on the utilization of primary care services by immigrants. Immigrants tend to settle in suburbs, and long term immigrants tend to migrate toward suburban areas. These areas offer the most affordable housing options for immigrants, however this creates a "spatial mismatch" between patients and physicians since physicians and medical services are primarily concentrated in urban areas.

Language is another strong barrier faced by immigrant populations due to the poor distribution of same\-language physicians. Immigrants often face challenges in terms of understanding English medical terms. These linguistic differences are yet another contributing factor to the discordance and miscommunication between immigrants and English\-speaking physicians.

Since healthcare services in Canada are paid in\-part by the federal and provincial governments and by health insurance systems, economic and financial barriers are generally not considered to be a severe issue dealt with by the immigrant community. However, local availability (i.e., spatial accessibility) of physicians and individual patient preferences such as ethnicity and language spoken by physicians are both impactful factors contributing to the precipitous decrease in primary healthcare access by immigrants.

Many immigrants report experiencing social isolation in Canada while also lacking social support from friends or family, which significantly impacts their mental health and also impacts their access to mental health services. Other racialized immigrants, specifically seniors, may be reluctant to access mental health services due to the stigmatization that surrounds these issues. Another significant barrier reported was the difficulty immigrants faced in finding mental health providers that were appropriately trained in cultural sensitivity.

Immigrants in Canada face multiple barriers to accessing mental health services. As with primary care access, the language barrier between healthcare providers and immigrants remains one of the greatest challenges in delivering mental health care and often leads to underuse. Many subpopulations of immigrants, including but not limited to: African women, Latin American men, Iranian immigrants and South Asian immigrants have been shown in studies to underuse mental health services due to the limited amount of services offered outside of the English language, which hinders their access to mental health care. One study discussed how immigrants avoided, or did not benefit from, mental health counselling services as there lacks an adequate amount of professional interpretation services.

Another study conducted in Montreal examined the reasons behind why immigrants were reluctant to access mental health services. They found a multitude of reasons as to why immigrants were hesitant to seek help, including the fact that their perception of Western doctors' over willingness to utilize pharmaceutical medications, while they believed in the curative powers of non\-pharmaceutical interventions, such as God and traditional folk medicine.

#### Refugees

[Refugees](/wiki/Refugee "Refugee") in Canada experience numerous barriers to healthcare, such as gaps in knowledge regarding healthcare needs, which may not be always considered by public health initiatives and policies. Immigrants and refugees are among the groups most at risk for negative health effects resulting from persistent [health disparities](/wiki/Health_disparities "Health disparities"); differences in race, socioeconomic status, income, citizenship status, and other social factors further exacerbate healthcare inequalities. Compared to immigrants, refugees often require additional healthcare due to previous conditions in their countries of origin.

The 2012 *[Protecting Canada's Immigration System Act](/wiki/Protecting_Canada%27s_Immigration_System_Act "Protecting Canada's Immigration System Act")* formed a tiered system that classified refugees and separated care based on these classifications. Differing levels of care were provided to refugees based on each refugee's home country and other factors. The act also reduced healthcare coverage for refugees provided by the Interim Federal Health Program (IFHP). The changes in refugee healthcare programs created in a rise in [emergency room](/wiki/Emergency_room "Emergency room") (ER) visits due to a lack of provisions of healthcare to refugees. This created concerns among Canadian citizens that the overall cost of healthcare will rise due. According to one study, the cuts to IFHP also made funding uncertain for programs that helped pay for ER costs.

In July 2014, Canada's Federal Court ruled that denying health services to asylum seekers was "cruel and unusual treatment" and therefore unconstitutional.

One study suggested open dialogue among policymakers, clinicians, and researchers and working with settlement programs to effectively respond to challenges encountered by the healthcare system regarding refugees. The study notes that supporting primary care and focusing on social accountability training in medical schools will help ensure the sustainability of the healthcare system's response to refugees.

#### People living with intellectual disabilities

Healthcare needs and comorbidities are often underdiagnosed in those living with intellectual disabilities. A study conducted in Quebec, Canada investigated healthcare utilization and access amongst people with intellectual disabilities in comparison to the general population. Of the study sample, approximately 30 percent reported not having had a comprehensive medical examination in the past year, which is what is currently advised in the 2018 Canadian consensus guidelines for practitioners providing primary care for those with intellectual disabilities.

Compared to the general population, women with intellectual disabilities aged 18–69 years were found to undergo cervical cancer screening less often. Results demonstrated them to be 1\.5 times less likely to undergo a Pap test in the past three years compared to similar aged women without disabilities. For breast cancer screening, women living with severe or profound intellectual disabilities or [Down syndrome](/wiki/Down_syndrome "Down syndrome") were found to be screened significantly less than those in the general population.

People with Down syndrome also reported the lowest usage of physiotherapy services compared to other measured population groups, which is a concern given that Down syndrome is associated with a variety of musculoskeletal problems that may be improved with physiotherapy.

### Added incentive to encourage assisted suicide

Canada since at least 2016 has legally allowed for a so\-called [right to die](/wiki/Euthanasia_in_Canada "Euthanasia in Canada"), or legalized [euthanasia](/wiki/Euthanasia "Euthanasia"). The [Associated Press](/wiki/Associated_Press "Associated Press") reported in August, 2022 that, "...human rights advocates say the country’s regulations lack necessary safeguards, devalue the lives of disabled people and are prompting doctors and health workers to suggest the procedure to those who might not otherwise consider it." Critics have raised concerns that doctors and medical professionals in Canada may have an added incentive to encourage patients to self\-select an early or possibly even unnecessary instance of euthanasia as a cost cutting procedure due to governmental budget pressures based around a system of socialized medicine. Scott Shackford of *[Reason](/wiki/Reason_%28magazine%29 "Reason (magazine)")* magazine reported on September 7, 2022, that, "Unfortunately, the philosophical argument for the right to die can also end up colliding with troubling decisions in a country where the government funds and controls access to healthcare. That is reportedly happening in Canada, where some citizens say health officials are actively encouraging people with disabilities and other chronic medical issues to consider suicide."


Are there any examples of successful programs that have helped integrate refugees into Canadian society?