opinion: ontario's health system wasn’t built for chronic disease—but it's not too late
ontario's healthcare system was designed more than half a century ago to manage acute care rather than the long-term needs of people living with chronic conditions.
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individuals with type 1 diabetes must regularly navigate complex administrative processes to justify continued access to essential supplies, even though they have a lifelong disease.
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a century ago, dr. frederick banting of the university of toronto saved the lives of millions by discovering insulin. it turned diabetes from a fatal condition into a chronic disease—canada’s greatest medical gift to the world.
yet, in the very province of that groundbreaking discovery, we are failing those living with diabetes and other chronic diseases.
how is that? the problem is that our healthcare system is outdated. it was designed more than half a century ago to manage acute care—injuries and short but severe illnesses—rather than the long-term needs of people living with chronic conditions. these include diseases like diabetes, heart disease, arthritis, bowel and intestinal diseases, neuromuscular illnesses and more.
today, chronic diseases are the leading cause of death and disability in ontario. by 2040, 3.1 million adults will be living with major illnesses in ontario, a 72 per cent increase from 2020. these conditions do not exist in isolation. they compound: one illness triggers another, leading to severe complications, pain and suffering for ontarians. they also significantly drain our healthcare system and economy.
diabetes is often considered a “gateway disease,” linked to the development of heart disease and even cancer. the cost of inaction is not just measured in healthcare dollars but in lost quality of life and preventable death and suffering.
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in 2023, ontario took an encouraging first step by passing motion 45, which called for the creation of a provincial framework to address chronic disease, beginning with diabetes. the motion was a recognition that our current approach is failing. yet, nearly two years later, there has been little tangible progress. we need to move beyond symbolic gestures and commit to real, systemic change.
a good chronic disease strategy must start with prevention and early detection. we need to educate the public, beginning in schools, and continue the success we have seen with anti-smoking campaigns and efforts to reduce childhood obesity. helping people recognize the early signs of chronic illness when it can be treated with fewer resources can reap large rewards for patients and the health system. if we don’t prioritize prevention and early detection now, we will continue to play catch-up rather than stopping chronic diseases before they develop, or worsen.
pharmacies should play a greater role in screening for diabetes and other chronic illnesses, ensuring that ontarians at risk are diagnosed earlier, when treatment is more effective, and complications can be avoided. the reality is that many people do not see a doctor regularly, but they do visit their local pharmacy. leveraging this existing infrastructure is a practical and immediate step toward improving early detection rates.
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a truly modern healthcare system must also embrace innovation. ontario has an opportunity to lead in the use of technology to improve chronic disease management. remote patient monitoring, telemedicine and data-driven healthcare solutions can transform how we treat chronic conditions, ensuring that patients receive timely care while reducing unnecessary hospital visits. there are already promising examples, such as the grace health centre in toronto, which has pioneered remote monitoring for thousands of patients, saving costs and improving outcomes. scaling such initiatives across the province could be a game-changer.
access to treatment must also be improved. many ontarians with chronic diseases face barriers to obtaining the medications and therapies they need due to bureaucratic hurdles or out-of-pocket costs. for instance, individuals with type 1 diabetes must regularly navigate complex administrative processes to justify continued access to essential supplies, even though they have a lifelong disease. simplifying these unnecessary burdens would help both patients and healthcare providers
ontario cannot afford to let chronic disease care remain an afterthought. the current approach is unsustainable, both financially and morally. we must stop treating chronic disease as an individual problem and recognize it as the systemic crisis that it is. the framework for action exists. motion 45 was the first step, but it must be followed by investment and the implementation of an ontario chronic disease strategy.
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dr. banting’s legacy reminds us that ontario has been a leader in transforming health outcomes before. we must do it again. the question is not whether we can afford to act – it’s whether we can afford not to. the cost of inaction is simply too high.
dr. jason field is president and ceo of life sciences ontario.
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