And one of those common mantra arguments you hear from the right is "do you know how long the wait times are for these countries with universal health care???" And although hypocritical, I'm more inclined to believe these arguments without confirming them as over the years of my life, the "right wing" arguments tend to prove true and leftist arguments tend to prove false. It's why I will take a capitalist or libertarian at their word and confirm what they claim at my leisure, and will listen to a socialist with an eyebrow raised, believing nothing they say until I can confirm it.
Regardless, thanks to a friendly Canadian, he pointed me in the direction of the Fraser Institute where they conducted a study on wait times in Canada. And it seems not only were they not joking about wait times being horribly long in Canada and other countries, but they're getting worse. Here are just two charts from the report (but the report is just full of charty goodness);
Now only if the OECD or some outfit had "wait times" as a measure we could compare different countries against.
The rather liberal, The Right Honourable Beverley McLachlin, P.C.
ReplyDeleteChief Justice of Canada, famously wrote "Access to a waiting list is not access to health care". I think that sums it up very nicely (disclosure: despite being rather more conservative than the CJC, I've been a fan ever since meeting her when she visited my law school).
http://www.opinionjournal.com/editorial/feature.html?id=110006813
http://www.scc-csc.gc.ca/aboutcourt/judges/mclachlin/index_e.asp
ALL YOUR SPECIALISTS ARE BELONG TO (the) U.S.
ReplyDeleteten years ago health care was the big issue and politicians quaked in fear at being ripped apart over horror stories.
ReplyDeleteThen along comes the Global Warming Sky-is-Falling broohahah and presto, the biggest problem faced by our politicians is now off the political radar screen.
A bit of a comment on the second graph showing province-by province comparison of wait times. It should noticed that the four highest, New Brunswick, Nova Scotia, Newfoundland and Prince Edward Island are small, economically-disadvantaged provinces on Canada's east coast. Their combined populations would be less than the city of Toronto or Montreal. If the national average was weighted relative to population, the contribution of these four provinces would be minute.
ReplyDeleteSecondly, the next two longest wait times are in Alberta and Saskatchewan, two provinces that are undergoing a population boom because of their petroleum resources. These provinces are suffering from significant infrastructural deficits as a result of this rapid growth.
Part of the reason wait times grew so much during the 90's is that Canada started training less doctors around the start of them. A report was released that (unbelievably and idiotically) suggested that we were training too many doctors.
ReplyDeleteYes, you heard that right : they thought they were training too many doctors.
I may be biased as a medical student, but what on earth would make you think having less doctors is a good idea?
Even in Europe it's commonly known that there is nothing worse than Canadian or British health care. They are infamous for long waiting times, bad treatment, and dangerous infection epidemics in hospitals.
ReplyDeleteSweden is almost identical, Italy has mainly hygienic problems in their hospitals (think 3rd World, e.g. India). Germany, once famous for its good health care (partly state, partly privately funded) has also been getting worse for the last 15 years. They are now heading to a fully state funded system (think Canada), also with access restrictions (which are already common practice, but nobody wants to admit it).
As far as I can tell, there are probably only two countries in the whole world with a rather well-functioning health care system, the USA and Switzerland. They are also the most expensive ones, since the goverments don't restrict access.
Although I have no data to prove my arguments, you will trust me since I am a capitalist AND a libertarian. Besides, my parents work in the health care business since 30 years.
Interesting how those ballooning wait times coincided most precisely with the Liberal government coming into power, then commencing with massive service cuts to "balance the budget".
ReplyDeleteWe paid for our balanced budget with our health care. Lovely tradeoff. Too bad they never told us that was what they were doing.
Need to dig a bit deeper...waitlists are for elective surgeries. If you have an emergency (eg. break your hip falling down), you'll get your joint replaced in hours/days regardless of income or where you live in Canada.
ReplyDeleteIf you have a chronic illness (eg. obese, diabetes, arthritis) that is degenerating the hip over time, you'll go on the waitlist for an appointment for a consult.
Not the best system, but I prefer that we wait so that everyone has access (delayed or not), rather than a premium service for a few.
Admittedly it is amazing what is classified as "elective" surgery, but it is variable on the graph that needs to be defined better before we make conclusions.
A "cleaner" look is the % of GDP spent on medical care. US spends more than Canada and does not get as good of a result.
A final comment (I work in health care administration and could go on and on)...a better system would be one that balances the relationship between the patient and the care provider. Currently the physician and other care providers have all the power. The client cannot even take their purchasing power elsewhere due to government payer. I want the government to continue paying, but we need more transparency in cost of care and involvement of patients in their own care decisions.
Great blog!
Heh.
ReplyDeleteYou know that brain thing that Teddy Kennedy had treated 'stat'?
I have a friend in Canada You who after a 6 months wait finally got to see the specialist who promptly looked at the charts and x-ray and ordered more, that'll be in 8 weeks, and after than he can make an appointment with the specialist again...est. 3 months after that.
An this is Canada, you aren't ALLOWED to pay for faster service
A couple points:
ReplyDelete1) RM - We do not weigh wait times by percentage of population. I would think that with a smaller population it should be easier to keep wait times under control (200 vs 2000 waiting for a hip replacement). The reason for wait times is rationing of services (think bread lines in the USSR). Also, SK's wait times have been atrocious for over a decade.
2) Seymour - As regards percentage of GDP devoted to healthcare, see above. Costs are controlled by establishing a coercive state monopoly on the provision of healthcare and then taking the approach of rationing the amount of care provided. If there are only enough funds for 1000 MRI's a year and you are #1001, try again next year. Beyond that, it is illegal to attempt to purchase these same services outside the gov't monopoly. It is also tricky to go outside Canada and write the expense off, so that route has challenges too.
Like all politicians and governments, whatever comes up that has the opportunity for more and greater taxation and control is just jim dandy for them.
ReplyDeleteWe are not getting our money's worth from any government and we are continually lied to by all politicians.
When will the citizenry wake up and put a stop to those bastards?
Seymour - you clearly have never had to wait for 'elective' surgery - I had a ruptured disk tha prevented me from doing anything other than lie in bed (not great if you are self-employed and only get paid if you provide clients with product). 10 weeks later my family doctor convinced a specialist to fit me in for a consult - thank god for my family doctor becaus I got surgery right away, but if I didnt have a famiy doctor nothing would have happened (I ha already gone to the ER and was told to 'ice' it.
ReplyDeleteIt is right that it is ILLEGAL to pay for faster service and that service is enormously expensive.
ReplyDeleteIF you are a politician or a hockey player/ sports celebrity you go straight to the head of the line, Ala Kennedy.
Otherwise you sit and wait or you go underground and pay through the nose. THIS is what Obama and Hillary want to bring to the US.
Just say NO!
Seymore,
ReplyDeleteyou're incorrect; the physician has no power (my wife is a doc). They're limited by the health-board administration as to what procedures can be approved, how much operating room time they can book, etc.
I'm in Alberta. A friend at my kid's school spend several years in Alabama as a nurse. She'd worked in both systems, gave birth to a child in both systems. Guess which one she preferred? Alabama.
The issue is competition. Everyone complains about the HMO's, but in Canada it's effectively one big HMO per province. There's no incentive to improve patient care. Patients are seen as a cost, not a customer.
In 1993 the Liberal government, in it's wisdom, and based on a ridiculous study, capped medical school enrolment. Why? Because the study in question correlated higher physician #'s with higher health costs. In other words, the more doctors in your region, the higher the costs. Dumb, dumb, dumb. What did they thinking? That the "surplus" doctors were making up diagnoses?
Now we have an aging population, and a shortage of doctors. The few doctors we have are also rapidly approaching retirement. Many of the new doctors are females who don't want to work the crazy hours doctors did in the past. Result: people who don't even have a family doctor and are therefore forced to use the emergency room when they get sick.
Hell, if your toilet is plugged you expect same-day service from your plumber, but if you have cataracts, or need hip replacement, get in line. Ridiculous.
Oh, and to top it off, our esteemed politicians (hi Belinda Stronach) see nothing wrong with going to the US for care when they need it.
In Canada, your access to health care is often dependent on who you know. Does your mother-in-law need a hip replacement? You have two choices: 1) go to your GP, and wait six months, or 2) if you belong to the right golf or tennis club, or your daughter goes to school with an ortho's daughter, or you're well connected in political circles, talk to your connection. You'll be seen in two weeks or less.
ReplyDeleteThis is the dirty secret of Cdn health care: the so-called "elites" get faster and better access to the system by using their connections than so-called "ordinary Canadians". In other words, they get all the benefits of wealthy Americans in terms of quick and timely care *WITHOUT* having to pay extra for it. No wonder the elites fight tooth and nail to keep the system as it is.
How do I know this is true? Easy - my mother-in-law needed both hips replaced (not at the same time). The first time, naive monkeys that we were, we stayed in the line, and it took almost nine months (while she was in stoic pain) to get the operation done. When the time for the second came, we mentioned (whining, actually) to a friend who works for a large bank. Turned out his neighbour was a well-known ortho. The friend put in a word for us; my mother-in-law had a new hip in less than 2 months. As the ortho put it: "I get paid the same whether I operate on a stranger or a friend. So why not do a favour for a friend?".
As a captive consumer of the Canadian Rationed Healthcare system I can only say it stinks.
ReplyDeleteI had to wait 2 1/2 years for a colonoscopy(?), my 82 year old mother in-law, had to wait 6 weeks to see a specialist for what turned out to be a fractured humerous, by that time it had already began to heal and the Dr.'s thought it wasn't worth the surgery. My aging parents were unfortunate, they out lived their family doctor and now have to rely on walkin clinics, this is very hard on them as they are in their 80's. An MRI or CAT scan can take 6-8 months, although yesterday I booked my Labrador for an MRI, I take her in July 2.
Cappy in Kingston
The wait lists are only part of the picture of poor healthcare in Canada. In rural Alberta in the past 20 years hospital services have been 'consolidated' and hospitals closed. In some areas you need to drive an hour or more just to recieve emergency services and that is if there is a doctor available at that specfic time.
ReplyDeleteDan
That wait list is misleading. It is much worse for some. My mom had to wait over a year to see a ophthalmologist about her eyes and two years for an orthopedic surgeon about her arthritic knees.
ReplyDeleteWant to see a GP - good luck. First you have to find one, then if you do, book months in advance.
That is what super high taxes get you in Trudopia!
I had a friend who ended up in an Italian hospital. We had to bring her sheets and blankets.
ReplyDeleteI wonder what the same charts would show for the US? I have never waited more than ONE WEEK to see a specialist here in California. MRI? Knee surgery? Will the day after tomorrow be OK? Meanwhile in Canada you get prescribed pain pills for months while a slot opens up. Most people who need advanced medical care aren't literally dying, but they have a really shitty quality of life until they get their condition fixed.
ReplyDeleteSeymour wrote: "Not the best system, but I prefer that we wait so that everyone has access rather than a premium service for a few."
ReplyDeleteLet me try to debunk this canard once and for all. First, ALL Canadians pay 'health care premiums' for access.
So let's say 10 of us are in line for knee surgery. I want to pay the $5k from my own pocket to have it done at a private facility.
Now we have 9 people in the lineup and those nine still have the benefit of my health care premium, which I haven't used. Where's the downside to the nine in line - other than jealous and resentment that I've gotten my surgery immediately?
I've shortened their time in line, they get their surgery sooner and... the 'extra' premium that I haven't used, can be used to benefit others.
It's absolutely retarded. We can spend unlimited amounts on our dog, and in fact I have a neighbour who just spent $2,500 on a hip surgery for hers and is about to spend another $2,500 for the other - with no waiting whatsoever. But if your kid needs help.... too bad, so sad.
And I have to say, I was at our local clinic last week and it was so dark and dingy that I immediately thought it must be what 'Soviet' health care must have been like.
"When will the citizenry wake up and put a stop to those bastards?"
ReplyDeleteThe same citizenry that has put Obama & McCain to the head of the class? WE ARE TOAST!
Seymour: so, the Canadian mother about to undergo delivery of triplets, who was refused entry at any Canadian hospital because they were not competent to handle multiple births and wound up having to go to South Dakota to deliver ... where does she fit in in your wonderful scheme of Canadian medicine?
ReplyDeleteI and my father are from Saskatchewan. It was determined that he needed both hips replaced and was placed on the 'emergency' wait list for the first and the 'regular' list for the second. He waited over a year for his 'emergency' replacement and over two years for the second, during which time he was forced to retire from his vocation of farming and #1 pastime of playing hockey, while sitting around sucking back a cocktail of drugs for pain and of course more drugs to counter the side effects of the first drugs. A worthy sacrifice on the altar of equal access and 'free' care for all, right?
ReplyDeleteOn their best days, governments/ bureaucracies barely manage to accomplish the very merest of tasks. DO NOT let them within a parsec of your health care!
I am an American with a cottage near Ottawa and a girlfriend in Ottawa who was treated for breast cancer two years ago. She was told by the public system that she could not get a PETSCAN unless she had obvious symptoms. Her sister-in-law coordinates health care for a large company in Toronto and ALWAYS refers employees to a private clinic which is clearly not illegal though picketed by public healthcare employees. I paid out of pocket - WELL WORTH IT hoever undemocratic .It took my girlfriend only 7 to 10 days to get appointments for exceptionally thorough testing of all sorts and only three days to get responses. The PETSCAN detected a shadow in her stomach that did not exist a year ago. Not having to wait for "obvious symptoms" and getting results in days instead of months may save her life. Over the past 2 years she has had 14 procedures/ operations of different types. I have been horrified how long it takes to be scheduled for operations (other than immediate life threatening types) and to arrange for tests and receive results-always months rather than day!. In Philadelphia I can consistently get any test that I want - X-Ray, CTSCAN, MRI, etc. within TWO DAYS instead of MONTHS. As I see it, the very rich can run over the border to the US with a wad of cash in hand, the "poor" (though a smaller percentage of the Canadian population) are MUCH better off in Canada where problems can be detected before they become critical BUT the majority of the Canadian population has to wait FAR, FAR longer than their US counterparts. Clearly something must be done for those who truly cannot afford healthcare in the US (versus those who choose not to get it). Like scholarships, government assistance should be based on need. In any case, Canadian health care IS NOT "FREE" (check your receipts for taxes on taxes) and should be studied but NOT COPIED.
ReplyDeleteWhile vacationing in the US several years ago, my son came down with a very bad influenza. An american friend brought to a hospital in Washington, DC where his friend was a doctor. The hygiene at this hospital was at the levels of the third world which I experienced when working in Nigeria. Then after a short examination and a prescribing, the invoice was for $320. It was unbelievable. The system here in Tuscany (we have regional systems in Italy) would not allow such a hospital to operate, or would charge so much.
ReplyDelete