The highly publicized death of a 44-year-old man in an Edmonton emergency room was a tragedy. It is also the tip of the iceberg.

More and more, Canadians wait for hours, in agony, while their long-term health outcomes permanently worsen. And yes, some are dying preventable deaths in our waiting rooms.

Most of Canada’s EDs now operate in a perpetual state of what we used to consider disaster-mode. Physician groups in every province have raised alarms and warnings, and at this late date, our elected leaders can no longer hide behind plausible deniability.

The near misses are constant. On most shifts, we are barely able to intervene before a patient’s wait becomes lethal. We still manage to save most, but often at permanent cost to their health.

Too often, my colleagues and I witness preventable deaths and prolonged waits that cause avoidable, life-altering disability. These outcomes are unmistakable features of an underfunded and collapsing system. Sometimes they make the news. Most of the time, they don’t.

Mr. Shreekumar’s death was not an anomaly. In the two weeks that followed, emergency physicians across Alberta provided repeated examples of preventable deaths and near-misses.

In response to our pleas for help, the provincial government first dismissed them as “misguided,” later defaulting to the standard playbook of internal reviews and striking a formal inquiry.

The last thing we need is more time and money wasted searching for answers we already know.

Neither these failures, nor the refusal to address them, are unique to Alberta. With unsafe care delays now routine across provinces, the question is no longer whether the federal government can intervene, but why it chooses not to.

The Canada Health Act guarantees reasonable access to medically necessary care. This is being violated daily, everywhere. The Act is meaningless if it is not enforced.

People are dying in waiting rooms, while provincial governments enable preferential access for those who can pay. The federal government has a duty to intervene.

Governments at every level can no longer ignore the consequences of inaction.

Emergency medicine leadership has repeatedly approached governments with concrete solutions, offering our CAEP EM:POWER report as a framework for urgent action. Physician experts have not been able to find a willing partner in government to repair our failing health care system.

The Canada Health Act was once a global exemplar of fair and equitable health policy. Its enforcement has been neglected for decades by successive federal governments. Each chose jurisdictional comfort over accountability, and allowed violations of access to become routine.

None of this is a mystery, nor is it a failure of individual hospitals or exhausted clinicians. The simultaneous collapse of every provincial health system is the predictable result of years of policy decisions that constrained staffing and treated emergency care as a cost to be contained.

Governments now face a choice. Continue to delay, commission reviews, and argue over jurisdiction while patients deteriorate in waiting rooms. Or acknowledge that people are needlessly suffering and dying under the current rules and act accordingly.

Failing to act is not neutrality. It is a decision.

Dr. Paul Parks is an emergency physician in Medicine Hat, Alberta and the previous president of the Alberta Medical Association.