This is not just a problem with one hospital. It appears to be system-wide. A previous article cites cases from a number of hospitals in different provinces; and earlier articles in the series explore the regular flow of patients from Canada to the United States for faster access to necessary treatments like chemotherapy and radiation therapy for cancer.
A 2005 case in Quebec points to one of the largest problems in the system: the long waits for any kind of treatment. The typical 8 hour wait for essential treatment in an emergency can be the difference between life and death, which is why so many emergencies are being sent to US hospitals when they are nearby. The problem is just as bad for less urgent treatment or to see a specialist where the wait may be months - in some cases long enough to turn a minor concern into a life-threatening illness. In the Quebec ruling, the court declared that long waits were a threat to the "liberty, safety and security" of citizens and commented that "delays in the public health care system are widespread, and that, in some serious cases, patients die as a result of waiting lists for public health care."
A series of studies from the Fraser Institute look at waiting times for treatment in Canada, and the picture isn't pretty. Waits are long and getting longer every year and have almost doubled in the last 15 years. In 2006 the average wait was 16 weeks just to see an orthopedic specialist and another 24 weeks to see a surgeon. Eight months is a long, long time when your knee or hip is in such bad shape that you can't walk. Even the simplest tests take too long. It can take 3 weeks to get an ultrasound when virtually every doctor in the US can do one in their office as needed.
Article comments
— go to most recent comments1 - Dr Dreadful
Nice strawman, Dave. Careful with those matches now.
You paint a bleak picture of Canadian healthcare. However, I don't see anything in either Clinton's or Obama's policy statements which suggests that they simply want to crib the Canadian system.
2 - handyguy
Exactly. Both have gone out of their way to make it clear that their proposals are not single-payer systems. They mandate individuals to buy coverage, mandate insurance companies to provide it, and offer government assistance to some in buying policies.
Some of us think a single-payer system would be preferable. But the Schwarzenegger/Romney type of mandated universal care is the model for both Clinton and Obama. And Obama's proposed mandate applies only to children, not to adults.
3 - Jordan Richardson
Perhaps we should also tell the full story as to what's going on in Canada to avoid fear-mongering and partial information. Being Canadian, I'll shed some light on my personal experiences and go from there.
The problem with wait times comes as a result of a shortage of medical practitioners and of population overcrowding in areas of Canada that tend to be closer to the borders. The majority of the Canadian population lives towards the south of Canada and in the same metropolitan pockets, leading to overcrowding in medical facilities no matter how free or how costly the health care is. It isn't a flaw of the system that there is overcrowding, as there had been no link to wait times and universal health care, but there HAS been a link to wait times and extreme population growth. The government has recently poured billions of dollars into the health care system to help reduce wait times.
As per the wait times, non-emergency specialist surgeries tend to have long wait times because more people tend to get those surgeries than they would in the United States. When you've got the surgery essentially paid for, you do the surgery whether you need it or not. That's part of the downside to the system, one could say, as many people are crowding hospitals having medical procedures done that aren't necessary, leading to longer wait times for those that DO have emergencies. For the most part, however, in most major Canadian hospitals, the wait times are average with the rest of the world.
Wait times in Canada, according to the Commonwealth Fund, stack up differently than those in the United States, of course. Studies by the Commonwealth Fund found that 24% of Canadians waited 4 hours or more in the emergency room, vs. 12% in the U.S. 57% waited 4 weeks or more to see a specialist vs. 23% in the U.S. The Kaiser Family Foundation found that 63% of Americans were worried about not being able to afford health-care services, whereas Canadians do not have that concern. Lower costs DO impact the performance of the system, there's no question about that, and the key difference between the systems appears to be whether the "waits" for the surgery take place in a hospital with medical care or in one's home or on the street. There are still "wait times" in American systems, but these go unreported as people wait to afford basic health care.
Wait times are also impacted by the aging population, which is among the largest in centuries.
As for your claim that nobody from the United States comes to Canada for health care, that is patently untrue. For starters, there is a HUGE market for prescription drugs up here and "medical tourism" is big business in Vancouver especially. According to CMAJ, Canada's leading medical journal, the prescription drug business hauls in $1 billion a year simply from Americans.
Many Americans also enter Canada for minor surgeries, plastic surgeries, and other non-essential surgeries, much in the same way that Canadians go to the United States for similar surgeries.
Canadian health care is not socialized medicine. The government pays for about 70% of the health care costs here, which is slightly lower than the average of OECD countries. Publicly funded insurance plans pay for medically necessary care. Other services are distributed and decided on a provincial basis, with services like ambulances, dental care, home care, and other aspects of health care being decided on a more individual basis. Most services in Canada are delivered by private (both for-profit and not-for-profit) providers.
The United States is the only industrialized country that lacks some form of universal health care. Over half of the bankruptcies in the United States, according to a study in Health Affairs, had something to do with medical bills. The irony here is that the United States government actually spends more per capita than Canadian government does. However, U.S. government spending covers less than half of all health care costs. Administrative costs in the United States are also significantly higher than those in Canada.
So on and on we go and we can likely debate the merits of our systems all day long, but there are a number of misnomers when it comes to the health care discussion in the United States. Again, Canada does NOT have socialized medicine. Universal health care is NOT socialized medicine. In my experience, I've not had any problems with wait times or hospital issues. I have a chronic intestinal condition and have found the care in my local metropolitan (Vancouver-based) hospitals to be exemplary.
4 - Jordan Richardson
Also, the Fraser Institute is a conservative/libertarian think-tank with ties to many controversial issues. Their researching techniques have come under fire before for not being subjected to peer review or to standards of basic scholarship. The FI has also held to conferences denying the effects of tobacco, one such conference had the theme of "junk science" in reference to the risks of smoking. They are also skeptics of global warming and are heavily supportive of privatization of health care, security, and other government funded issues.
5 - Clavos
"They are also skeptics of global warming and are heavily supportive of privatization of health care, security, and other government funded issues."
My, my, my!
How could they be so absolutely, totally wrong about everything???
What a pack of dumbasses those conservative libertarians are.
When will they ever toe the line, repent, and accept the god of nannyism in their hearts?
Maybe we should round 'em up, put 'em in a camp and start re-educating them...
Evil bastards.
6 - Jordan Richardson
Clavos, I could take one sentence out of a few and re-frame it in my own context, too, but I choose to be more respectful than that. The Fraser Institute is renowned around here for fudging their research. My point is that they have a vested interest in providing supportive information as per privatized health care. Now settle down.
7 - Dave Nalle
Jordan, your use of the Kaiser foundation which is funded by an insurance company is far more questionable than my use of Fraser, which is at least not directly tied to the health insurance issue. Talk about having a vested interest.
The 'vested interest' of a libertarian think tank is the freedom of the people. I find I can live with that sort of allegiance.
he government pays for about 70% of the health care costs here, which is slightly lower than the average of OECD countries.
So Canada has made the choice that everyone should be inadequately and partially provided with healthcare rather than going with the US model where most have good coverage and a small percentage - often by choice - go uncovered. The facts you provide basically confirm my concerns.
Dave
8 - Dave Nalle
Of course, you can always discount my opinion as biased ranting since I had a relative who died because the German healthcare system made her wait too long to have the battery on her pacemaker replaced.
Dave
9 - Clavos
"My point is that they have a vested interest in providing supportive information as per privatized health care."
As does virtually everyone, pro or con. Theirs happens to be one you disagree with.
"Now settle down."
Yes, Daddy. Sorry, Daddy; I'll be a good little conservative and keep my mouth shut. Promise. Please don't tell the nanny...
10 - JustOneMan
Dave...
Isn't overcrowding, unskilled doctors and bureaucratic mismanagement the three pillars of the Dumbocratic health care reform platform?
JOM "Calling Dr. Moe, calling Dr. Larry, calling Dr. Curly"
11 - Jordan Richardson
"So Canada has made the choice that everyone should be inadequately and partially provided with healthcare rather than going with the US model where most have good coverage and a small percentage - often by choice - go uncovered. The facts you provide basically confirm my concerns."
MOST have good coverage? Most Americans are dreadfully under-insured or have their health insurance costs running them into bankruptcy or poor financial condition.
A peer-reviewed comparison study of health care access in the two countries published in 2006 concluded that U.S. residents are one third less likely to have a regular medical doctor, one fourth more likely to have unmet health care needs, and are more than twice as likely to forgo needed medicines. This study is from the American Journal of Public Health and was done in 2006.
And again, there's issues of spending to consider. If the United States health care system is so great, why is it so costly and why are Americans considerably less healthy than the rest of the world and considerably more likely to die from major treatable diseases or afflictions? Is it genetic or could it possibly be related to health care issues?
I do have to applaud the United States health care system for something, though, and that is their work with the elderly and the disabled. It's comforting that my wife, who works in the health care industry in the United States (she's an American citizen immigrating to Canada) is able to see the disabled and elderly receiving good quality care. The costs to this on the system are never called into question, despite the growing population of these individuals, and the growth of free clinics also shows that some things in the United States appear to be heading for a better ground.
I've discussed the feeble connection between the wait times and "universal health care" at length in my post. I think this speaks to the inadequacy of the Canadian health care system and the mythology of socialized medicine.
"The 'vested interest' of a libertarian think tank is the freedom of the people. I find I can live with that sort of allegiance."
Which is why they were so heavily couched with the tobacco companies and other corporate interests. Freedom for the people may be associated with libertarian ideals, but it isn't associated with the Fraser Institute.
12 - Jordan Richardson
"As does virtually everyone, pro or con. Theirs happens to be one you disagree with."
Yep. It's important to point out discrepancies, pro or con, too. This speaks to the broad variance of "facts" out there regarding Canadian health care. Mine are, as Dave pointed out, as subject to bias as well. I certainly take no issue with that being pointed out and welcome fact-checking of all kinds on my posts. I discuss things to learn and part of that learning is discovering where I'm wrong.
13 - Jordan Richardson
Re #8:
That truly is a heartbreaking experience that I wouldn't wish on anyone, but surely I could counter with stories of individuals being left for dead in alleys or on sidewalks because they couldn't afford the healthcare they were supposed to receive. Human dignity is important in any health care system. The Canadian system is flawed, some say deeply flawed, and I agree that it needs an overhaul. But the majority of Canadians overwhelmingly agree with the rest of the world that the American system isn't the answer.
All health care systems have drawbacks and issues that need to be addressed as the population of our world gets older and people start requiring more care. It's an important issue to look at and we have a lot to learn from each other in terms of developing good quality care that every human being can receive.
14 - alessandro
Jordan well said. I agree in some parts but overall I fear you are shortchanging the major problems we face. The Canadians system is socialized - in many ways it is almost communistic and Byzantine on many levels. The truth is that there are major problems. While I don't think it's as bad as painted the reality is that it is unacceptable especially considering how much we put into it. The Canadian health care system needs a major overhaul.
As for the stats, the Fraser Inst. is not that far off from what we found. Just because they are cons/lib doesn't mean they should be overlooked. I work in the field - www.findprivateclinics.ca - which is a directory we run and on our journey we discovered a lot about the Canadian health care system. In a nutshell, the theory of our system is noble, in practice it is proving to be a disaster.
This not some ideological battle - well, it shouldn't be. But the hard facts show that many Canadians are facing unacceptable conditions - again for what we pay into the system.
My suspicion is that the Fraser probably employ a more intelligent premise to build their cases than all these "organizations" with their own little agendas. They are right to question much of what we are being fed. But I won't get into this. There is indeed a lot of junk science out there that passes as science. Their findings fall closer in line with what we have observed with our company along with personal stories.
I'm glad you have not had any problems but I personally have had problems (to go along with the the good) and I know many Canadians who have nightmare stories.
One last thing: 5 million Canadians are without a family doctor or GP. In a system where the GP is the point guard so to speak to allowing you to see a specialist that's a bit of major crisis.
15 - Deano
"It's a relatively commonplace operation available in virtually every US hospital, but in Ontario they have virtually no surgeons capable of performing one."
Uh, yeah. Sure Dave. Virtually no surgeons capable of preforming angioplasty in Ontario...right.
So the 1,550 angioplasties performed in Ontario between September 2007 and November 2007 according to the Cardiac Care Network of Ontario were..imaginary? Performed by whom?
Interestingly enough the median wait time recorded was 3 days...
16 - Bennett
"It's a relatively commonplace operation available in virtually every US hospital, but in Ontario they have virtually no surgeons capable of performing one."
Not true.
My brother in Toronto had his third mitral valve replacement last year and, based on the severity of his condition was admitted a day after seeing his specialist.
The surgery took place 2 days later, performed by one of the most talented heart surgeons in the world Professor Tirone David, and was broadcast worldwide to other heart surgeons interested in seeing his techniques.
It was touch and go (there was almost no valve left) but my little bro pulled through and is doing great these days.
Much of what Jordan Richardson writes cannot be shrugged off as bias, and much of what Dave writes is, as always, fear mongering propaganda.
17 - Jordan Richardson
1. I never said that the Fraser Institute should be overlooked, nor did I suggest that their findings should be tossed out of the discussion. I did say that their facts and figures, like many of the facts and figures in this often-convoluted discussion, are subject to manipulation due to vested interests. The same applies across the board and anything I cite is no exception.
2. I agree with you about the major overhaul. I said as much in my other post. Large parts of how the system works is unacceptable, no question about it. There are things that must be changed and wait times is, I think, at the top of that list. I'm curious to see where Harper's funding is going to get us on that, as I have very little trust for his government thus far.
3. Canada is typically not thought of as having socialized medicine, but this all depends on how one defines the term. Finland, for example, has a much smaller private sector (between 3 and 4 percent) involved with health care and they are often referred to as having socialized health care. Do we draw the line at the percentage involved? With Canada having the private sector comprising about 30% of health care, are we still socialized medicine or do we offer universal care? Israel is said to have socialized medicine, too, through the National Health Insurance law.
4. Part of the problem lies with what is actually covered. My GP is not covered by Canada's basic health plan for individuals (universal health care) but it is offset by it somewhat. In the US, however, that same GP would be a pipe dream for me. While having a GP is a luxury for Canadians, the American system does not offer the same affordable access to GPs for most of its citizens, which is terrible considering the cost of that system. Our Canadian system is indeed costly, but it is nowhere near as costly as the alternative, both in lives lost and in dollars spent.
18 - Jordan Richardson
Deano, I think the latest is that we're pulling in Tim Hortons employees to perform open-heart surgery.
19 - Deano
Free timbits with every anglioplasty!
20 - Bennett
BTW Dave, You are a talented writer and I just don't understand why you choose to spend your time writing such blatant distortions.
Does someone pay you by the word to craft such irresponsible hit pieces?
Or is there some thrill you get from making up this shit any trying to pass it off as fact?
21 - Lumpy
The only reason Clinton and Obama aren't pushing for a true single payer system is that they know they could never get away with it. They are all about incrementalism as they inch us along to socialism.
22 - Clavos
"While having a GP is a luxury for Canadians, the American system does not offer the same affordable access to GPs for most of its citizens"
If by GP you mean General Practitioner (or Primary Care Physician, as they're called nowadays), then you couldn't be more wrong.
Virtually all HMOs and almost all PPOs require the patient to see a GP first. If the GP then determines the patient must see a specialist, he will refer the patient. If the patient sees a specialist without that GP's referral, the insurance will not pay the specialists fees, except for emergencies.
23 - Lumpy
But isn't one of the big inefficiencies of the US system that they use GPs as gatekeepers for access to care.
As for Canada, what I gather from reading the links in the article is that the big problem there is that they can't hold onto qualified doctors who can earn more in private practice usually outside the country.
24 - Andy
I am a Canadian, probably what you could call a healthcare "moderate". I like having an universal system but I'm not against the idea of a private tier as well, assuming such a dual system is tenable. What the Canadian system really needs is more money. Most of the flaws people point out would be fixed by a short term cash infusion and minor bump in long term funding. Of course I say the same thing about our military, and both might be too expensive to do at the same time..
For the US, I think expanding the government programs of Medicare and COBRA would be a good start. Working them into a basic guarantee of universal coverage might even make everyone happy. Doesn't seem like such a big expense considering the money going into Iraq and Pakistan lately.
25 - handyguy
The only reason Clinton and Obama aren't pushing for a true single payer system is that they know they could never get away with it. They are all about incrementalism as they inch us along to socialism.
I'm not sure whether you [or Dave, or Clavos, who has had some favorable things to say about Obama] actually believe this hyperbolic horse hockey, or simply say it out of habit. I find it utterly ridiculous.