Canadian health care coverage: equal coverage for all — equally rotten

As our friends on the left keep telling us how a government-run, or at least government-overseen health care system would be a great improvement, perhaps they might be interested in seeing that such a system isn’t a great improvement for everybody:

Canadians Push for ‘Private Option’

A great report at today’s Los Angeles Times, “In Canada, a Move Toward a Private Healthcare Option“:

When the pain in Christina Woodkey’s legs became so severe that she could no long hike or cross-country ski, she went to her local health clinic. The Calgary, Canada, resident was told she’d need to see a hip specialist. Because the problem was not life-threatening, however, she’d have to wait about a year.

So wait she did.

In January, the hip doctor told her that a narrowing of the spine was compressing her nerves and causing the pain. She needed a back specialist. The appointment was set for Sept. 30. “When I was given that date, I asked when could I expect to have surgery,” said Woodkey, 72. “They said it would be a year and a half after I had seen this doctor.”

So this month, she drove across the border into Montana and got the $50,000 surgery done in two days.

“I don’t have insurance. We’re not allowed to have private health insurance in Canada,” Woodkey said. “It’s not going to be easy to come up with the money. But I’m happy to say the pain is almost all gone.”

Whereas U.S. healthcare is predominantly a private system paid for by private insurers, things in Canada tend toward the other end of the spectrum: A universal, government-funded health system is only beginning to flirt with private-sector medicine.

Hoping to capitalize on patients who might otherwise go to the U.S. for speedier care, a network of technically illegal private clinics and surgical centers has sprung up in British Columbia, echoing a trend in Quebec. In October, the courts will be asked to decide whether the budding system should be sanctioned.

More than 70 private health providers in British Columbia now schedule simple surgeries and tests such as MRIs with waits as short as a week or two, compared with the months it takes for a public surgical suite to become available for nonessential operations.

“What we have in Canada is access to a government, state-mandated wait list,” said Brian Day, a former Canadian Medical Assn. director who runs a private surgical center in Vancouver. “You cannot force a citizen in a free and democratic society to simply wait for healthcare, and outlaw their ability to extricate themselves from a wait list.”

Read the whole thing, here.

I’m surprised, frankly, that the Times’ editors even ran this piece. The paper’s been one of the country’s biggest journalistic shills for ObamaCare. When I reported on the massive Adam Schiff town hall in August – which was the lead story on that night’s local ABC News broadcast – the Times competely ignored the story in the next day’s paper. Instead, we saw a tearjerker piece on the massive free healthcare clinic at the L.A. Forum. I’m putting the Los Angeles Times practically in the same category as its New York Times counterpart. See, “The New York Times ACORN Cover-Up; or, How the Right-Roots Brings Down the Old Grey Lady.” Once in a while, some fair-minded journalism gets through, like today’s piece on Canada above. Otherwise, it’s pretty frustrating reading the newspaper in the mornings.

Our great neighbors to the north have certainly invested all of the compassion that they can into their health care system: everybody is covered, and health care is free, at least if you discount having to pay taxes to support the system. For singles without children, effective tax rates in Canada are slightly higher than in the United States (31.6% of income vis a vis 29.1% in the US), but married couples with two children pay almost twice as much as in the US, 21.5% as opposed to 11.9%. (Referring to that chart, only two developed countries, Iceland and the Republic of Ireland, tax married couples at a lower rate than the US.)

Yet, despite Canada’s great sympathy for people, and the country’s desire to provide good, quality health care for its people, stories like that of Christina Woodkey keep emerging. And I’ve noted many times, most extensively in this comment, just what average waiting times are like in Canada:

Waiting Your Turn: Hospital Waiting Lists in Canada, 18th Edition

The Fraser Institute’s eighteenth annual waiting list survey found that Canada-wide waiting times for surgical and other therapeutic treatments decreased in 2008. Total waiting time between referral from a general practitioner and treatment, averaged across all 12 specialties and 10 provinces surveyed, fell from 18.3 weeks in 2007 to 17.3 weeks in 2008. This nationwide improvement in access reflects waiting-time decreases in 7 provinces, while concealing increases in waiting times in Saskatchewan, Nova Scotia, and Newfoundland & Labrador.

Among the provinces, Ontario achieved the shortest total wait in 2008, 13.3 weeks, with British Columbia (17.0 weeks), and Manitoba (17.2 weeks), next shortest. Saskatchewan exhibited the longest total wait at 28.8 weeks; the next longest waits were found in Nova Scotia (27.6 weeks) and Newfoundland & Labrador (24.4 weeks).

The fall in waiting time between 2007 and 2008 results from a decrease both in the first wait—the wait between visiting a general practitioner and attending a consultation with a specialist—and in the second wait—from the time that a specialist decides that treatment is required to treatment.

The bottom line: Christina Woodkey was in pain, and the Canadian government and health care system was sympathetic to her plight, but sympathy did not translate into actually helping her. She has, I assume, been paying her taxes all along, including the taxes assessed to pay for Canada’s single-payer health care system, and, in the end, had to come up with $50,000 to get prompt and effective treatment, in the United States.

Note again this paragraph:

“What we have in Canada is access to a government, state-mandated wait list,” said Brian Day, a former Canadian Medical Assn. director who runs a private surgical center in Vancouver. “You cannot force a citizen in a free and democratic society to simply wait for healthcare, and outlaw their ability to extricate themselves from a wait list.”

Well, yes, apparently you really can force a citizen in a free and democratic society to simply wait for healthcare, and outlaw their ability to extricate themselves from a wait list. Fortunately, Canada can’t seem to outlaw medical tourism. Of course, had Miss Woodkey been unable to find a way to come up with fifty grand, then yes, Canada could have kept her waiting, in pain, until the waiting list had been worked through.

Dr Douglas didn’t quote this from the Times article, but I think it’s important:

Yet the move into privatized care threatens to make the delays — already long from the perennial shortage of doctors and rationing of facilities — even longer, public healthcare advocates say. There will be fewer skilled healthcare workers in government hospitals as doctors and nurses are lured into better-paying private jobs, they say.

“What it means is that people who have no money, who are chronically ill, disabled, who require medical attention frequently, are going to suffer dramatically,” said Leslie Dickout of the B.C. Health Coalition, which is involved in the lawsuit to determine whether the Canadian Constitution guarantees citizens the right to choose their own care.

“There’s so much money to be made by the insurance industry,” she said. “If this [legal] case succeeds, what we would have is a system of U.S.-style healthcare — along with a public system that is decimated.”

It tells you that Canada already has a shortage of medical personnel, because the Canadian system doesn’t pay them enough money, and it tells you that you can get good, prompt, American-style health care, if you are willing — and able — to pay for it.

Leslie Dickout put it pretty much bluntly: the choice is between a poor system that covers everyone equally poorly — the epitome of socialism, as it were — or allowing people to go outside the socialist system to buy better. Note that she said that, if Canadians were allowed to choose, they’d eventually create a US-style system.

44 Comments

  1. I did. I’ve also read the comparisons.

    Given that my own grandmother got a hip replacement under private care as a way of skipping waiting lists, I have no problem with it as a supplemental to a good public health care system.

    But, you know, if you’re going to cite major newspapers about Canadian medical horror stories, you might wanna look at the whole picture

    The bottom line is that if the Canadian system failed Christina Woodkey, the American system killed Monique White.

    Note that she said that, if Canadians were allowed to choose, they’d eventually create a US-style system.

    Uh-huh. And every opinion poll says she’s wrong. Your story is yet another distortion.

    My impression was that much of what they had heard had been the sort of right-wing, special interest nonsense that has subsequently characterized the health-care reform debate in the United States.

    I told them that Canadians value their single-payer government health-care system so strongly that any change that appears to pose a threat to it is the third rail of Canadian politics; that most Canadians value the system’s quality of care; and that although many do still complain about wait times to see specialists in certain fields, government has moved to address this issue in recent years. By April of this year, at least 75 per cent of patients in Canada were receiving non-emergency surgeries within appropriate wait-time benchmarks.

    [Pulled from spam-filter -- JH]

  2. (Bloody WordPress eating my replies!)

    I did. I’ve also read the comparisons.

    Given that my own grandmother got a hip replacement under private care as a way of skipping waiting lists, I have no problem with it as a supplemental to a good public health care system.

    But, you know, if you’re going to cite major newspapers about Canadian medical horror stories, you might wanna look at the whole picture

    The bottom line is that if the Canadian system failed Christina Woodkey, the American system killed Monique White.

  3. Note that she said that, if Canadians were allowed to choose, they’d eventually create a US-style system.

    Uh-huh. And every opinion poll says she’s wrong. Your story is yet another distortion.

    My impression was that much of what they had heard had been the sort of right-wing, special interest nonsense that has subsequently characterized the health-care reform debate in the United States.

    I told them that Canadians value their single-payer government health-care system so strongly that any change that appears to pose a threat to it is the third rail of Canadian politics; that most Canadians value the system’s quality of care; and that although many do still complain about wait times to see specialists in certain fields, government has moved to address this issue in recent years. By April of this year, at least 75 per cent of patients in Canada were receiving non-emergency surgeries within appropriate wait-time benchmarks.

    [Released from moderation -- JH]

  4. Dana says: “It tells you that Canada already has a shortage of medical personnel, because the Canadian system doesn’t pay them enough money, and it tells you that you can get good, prompt, American-style health care, if you are willing — and able — to pay for it.”

    Dana, you have inadvertently hit upon a major flaw in our system. American people are suffering needlessly because they cannot afford insurance and they cannot afford to pay the medical bills when serious illness or injury strikes. Over 50% of bankruptcies currently are due to unpaid medical bills.

    And I have to say, Phoenician very well put to rest the thesis of your piece, that the Canadian system is unpopular. You folks try to make your point by pulling out anecdotal information. This distorts the truth. But to try to make your point, the truth turns out to be secondary. This is not impressive!

    Moreover, the Canadian system is only one of many that are more successful than ours at delivering quality health care universally. This is an indisputable fact. We demonstrate our retrograde thinking on this issue when a small segment of our population, of which you are one, attempt to dominate the debate with your anecdotes and outright distortions.

    Even though I think the Swiss system fits us best, because it incorporates a private insurance element. However, for now, the House bill with the public option is a good start on reforming out system, in my view. We can migrate toward a more Swiss-like system from this quite readily in the near future. Here, take a look at some of the advantages.

    We must overcome our resistance to change for the better and drop the “not invented here” knee jerk reaction to so many things.

  5. The one point on govmint run health care that Perry, Pho et al overlook is population. NZ has 4 million people, Switzerland 7 mil, Canada 32 mil, and France 65 mil. We have 310 mil. That’s about 10 times the population of Canada and Canada is having waiting lists of 17 months. How long will they be here with 10 times the population?

    What makes anyone think we could come up with a one-size-fits-all for over 300 million people? Does anyone realize the enormity of a system which will decide 300 million doctor visits? Per freekin’ year?

  6. Perry, when you say “anecdotal information” do you mean things like:”The bottom line is that if the Canadian system failed Christina Woodkey, the American system killed Monique White.” (Pho’s comment)?

  7. Point taken, John.

    For one, with 300 million people, we would have an advantage of the economy of scale that the others do not have. For another, significant portions of administration of a nationwide system could be delegated to the individual states in an effort to provide more local control while operating under the same basic laws. Medicaid operates in this manner.

    A single payer system would simplify administration issues, but we are not even considering single payer at this time.

    It may well be that a Swiss-like system can be scaled up to our needs. Problem is, this best fit to us has not been seriously considered, for reasons unknown to me.

  8. Perry, I’m not sure the economies of scale work too well with govmint. I have seen no evidence that it does in anything the gov has done so far.

    The state delegation has some merit but once again, Medicade does not administer to 300 million people. Plus, you are now adding another layer of state bureaucracy to the brew.

    Any way, this can be fixed. We need open discussion but we don’t need to rush in and screw up. Gotta go, duty calls.

  9. I’m sure the Canadians love their government insurance ….. until their is a need for a procedure.

    The only difference between them and us is in the US you go bankrupt, and in Canada you suffer, or even die.

  10. Then why, pray tell, do other countries get better results with systems ranging from heavy regulation to single payer?

    Are you talking about cancer treatment rates?

  11. The one point on govmint run health care that Perry, Pho et al overlook is population. NZ has 4 million people, Switzerland 7 mil, Canada 32 mil, and France 65 mil. We have 310 mil. That’s about 10 times the population of Canada and Canada is having waiting lists of 17 months. How long will they be here with 10 times the population?

    Gee, if only there was some way to break the United States up into 60 different districts? I can’t imagine any way that the United States might conceptually be thought of as a collection of smaller units. What about you, John – is there anything about the United States which suggests an idea…?

    I also point out that America – I mean the United States – somehow also manages to run public education, transportation and highways and a military.

  12. How much do they pay you to print this stuff, Pho? It’s just like reading Pandagon or Think Progress without all the interesting bits.

  13. Pho, those 50 districts and their individual rules are part of our problem. They make their own rules based on their area’s needs. Then they all answer to the feds based on its mandates.

    But if the fed controls 300 million policies it’s a one-size thing again. Plus, can you imagine the lobbying that will occur? Gays want sex changes covered, Planned Parenthood wants abortions, etc, etc. You know how these guys lobby like hell in this country. How can we keep the very system our lives may depend on honest? I don’t see any way to keep the politicians away from the lobbyists. Look how they are in bed with Insurance co’s., drug co’s now. Can you imagine having the elderly and young, preexisting, racial, gender all vieing for their special piece of the pie?

  14. But if the fed controls 300 million policies it’s a one-size thing again. Plus, can you imagine the lobbying that will occur? Gays want sex changes covered, Planned Parenthood wants abortions, etc, etc. You know how these guys lobby like hell in this country. How can we keep the very system our lives may depend on honest?

    Now, that is a serious question – although you should be way more worried about the corporates than the gays and pro-choicers. The Baucus health care proposal seems likely to be a boondoggle designed to increase corporate profits.

    However, you first have to acknowledge that your current system is dysfunctional. One key point to note is that American health care costs are rising faster than the standard of living – the longer you wait, the more of your money is going to be wasted.

    As regards the basic problem of private-interest lobbying affecting US governance at the expense of the public good – sorry. I have no idea. As far as I can tell, the rot is embedded completely in your political structure and there’s no way out, transcending Republican vs Democrat. Public financing of campaigns, restrictions on political donations, or a proportional Congress might help, but all of those are politically impossible in the US.

    I don’t have any answer, except to keep track of your system as a bad example for the rest of us.

  15. The Phoenician tells us:

    Given that my own grandmother got a hip replacement under private care as a way of skipping waiting lists, I have no problem with it as a supplemental to a good public health care system.

    OK, you’ve just told us that your grandmother used private care to bypass waiting lists; great for her. But the notion that it was “supplemental to a good public health care system” seems rather odd, since if it was a “good public health care system” your grandmother shouldn’t have needed to go outside it to skip the waiting lists.

    How long were the waiting lists, Phoe? Miss Woodkey waited a year, in pain, and was then told that she’d have to wait another year and a half, and, the untold part of the story is, if the second opinion wasn’t whet the first specialist told her she could expect, it would have been what, yet another year before she could see another specialist?

    Her problem was not life threatening, but the woman was in pain, and she was told to wait her turn, not for days, not for weeks, but for over a year.

    So, your grandmother chose to spend what I assume was a considerable amount of money to get prompt, private care. Now, if the waiting lists your grandmother would have had to endure were just a few days or weeks long, it would seem a foolish decision to skip the “free” New Zealand care, and go the expensive route. In your own fine country, just how long a wait did your grandmother skip?

    And can someone tell me how a system which requires people in chronic pain to wait a year or more for treatment can be called, in the Phoenician’s words, “a good public health care system?” That’s not how I’d define good.

  16. The Phoenician wrote:

    Note that she said that, if Canadians were allowed to choose, they’d eventually create a US-style system. (me)

    Uh-huh. And every opinion poll says she’s wrong. Your story is yet another distortion.

    Capitalism and free enterprise work when someone sees a demand for a good or service, and seeks to provide it. The story Dr Douglas cited, from The Los Angeles Times, noted that private enterprise health care was growing and thriving by meeting a demand in Canada. If Canadians were as pleased with their single-payer system as you think they are, why would there be sufficient demand for private health care systems to survive and grow?

    No system is perfect, and there will always be a few people dissatisfied with anything. But a few people, a few nuts on the outliers of society, aren’t a sufficient market on which to base the growing private practices in Canada. A real demand must exist.

  17. Perry wrote:

    Moreover, the Canadian system is only one of many that are more successful than ours at delivering quality health care universally. This is an indisputable fact. We demonstrate our retrograde thinking on this issue when a small segment of our population, of which you are one, attempt to dominate the debate with your anecdotes and outright distortions.

    Some liberal friends of mine used to like the argument, “the plural of anecdote is not data.” However, if the anecdote is accurate — and a source citation of The Los Angeles Times would normally be considered as accurate and reasonable — then it actually is a datum, the singular of data.

    When you write, “the Canadian system is only one of many that are more successful than ours at delivering quality health care universally,” you have hit upon the precise point of difference: what is the definition of “quality?” To me, requiring a patient in pain to wait for 2½ years before her problem can be treated (if then) does not meet the standard of “delivering quality health care.” And if you think that Miss Woodkey’s story is just an anecdote, then you have ignored the Fraser Institute study I referenced in the main article concerning waiting times to see a specialist generally in Canada:

    Among the provinces, Ontario achieved the shortest total wait in 2008, 13.3 weeks, with British Columbia (17.0 weeks), and Manitoba (17.2 weeks), next shortest. Saskatchewan exhibited the longest total wait at 28.8 weeks; the next longest waits were found in Nova Scotia (27.6 weeks) and Newfoundland & Labrador (24.4 weeks).

    The shortest average total wait, 13.3 weeks, is a whole season! In two provinces, the average waiting time was more than half a year. Would you really call that “quality health care?”

    We demonstrate our retrograde thinking on this issue when a small segment of our population, of which you are one, attempt to dominate the debate with your anecdotes and outright distortions.

    Perhaps you’ll recall that when I needed to see a specialist, I was able to make an appointment for the very next day. Perhaps you can see why I would find our system somewhat preferable to waiting more than half a year in Nova Scotia.

    You also seem to think that those of us who don’t like the current proposals — or any proposals — to nationalize health care are just a “small segment of our population,” but if we were such a small segment, why hasn’t this been done, and done a long while ago? President Clinton found out just how popular his proposals actually were, as did his party in the 1994 elections.

    If this were really that popular, the Republicans would be falling all over themselves trying to get it done and get as much credit for it as they could.

  18. Perhaps Perry also defined the debate well:

    Moreover, the Canadian system is only one of many that are more successful than ours at delivering quality health care universally.

    It’s really very simple. The debate is over whether we want quality health care, or universally-delivered health care. Many people, including myself, do not believe that we can deliver health care universally, and still have quality health care. If it is a choice between quality health care for most, but not all — and five out of six Americans do have health insurance now — and poorer quality health care for all, I choose the former.

  19. John C asked:

    Does anyone realize the enormity of a system which will decide 300 million doctor visits? Per freekin’ year?

    When he was running for president, John Edwards said that if he provided universal health care coverage, we had better use it. I’m not sure if he planned to call out the gendarmes if we didn’t get our annual check-ups, but it was clearly part of his idea that we all had to have reasonably frequent medical check-ups, and that this would reduce the number of far costlier medical problems.

    We already have an overly-intrusive government trying to take lifestyle choices for us: bans on trans-fatty acids, all sorts of attempts to restrict smoking, a whole bunch of programs which are the equivalent of having your grandmother tell you that you had to finish your lima beans because they are good for you, despite the fact that they taste like dog feces.

    It is inevitable: the more government assumes responsibility for your care, the more government must take control of your life, because government has the need to control costs. The do-gooders can easily justify these things — don’t you know that smoking is bad for you? — but justifying restrictions on liberty because those restrictions are good for you (and you’re not mature or responsible enough to do it on your own) is a terrible thing.

  20. The Phoenician wrote:

    However, you first have to acknowledge that your current system is dysfunctional.

    But that’s just it: I do not acknowledge that, and in my own experience, my health care coverage has been just fine, has functioned very well.

    Now, other than the dentist, where visits are simply routine, I haven’t had to see the doctor very frequently, and know that I went seven years between visits. Alas! I am getting older, and have had to see three specialists in the past year: a gastroenterologist, an ophthalmologist, and an audiologist. In each case, appointments were set very quickly.

    Should anyone be surprised that I don’t want to foul up a system that has worked well for me?

  21. John C noted:

    The state delegation has some merit but once again, Medicade does not administer to 300 million people. Plus, you are now adding another layer of state bureaucracy to the brew.

    Medicaid is a particularly bad example. Medicaid, unlike Medicare, is a joint federal/state funded and administered program, and payment rates vary widely between the states, because the states have taken different decisions on just how much money they can spend. In many areas, it is extremely difficult to find a doctor who will accept Medicaid patients, because physicians know that Medicaid payments are both very slow and very low.

  22. OK, you’ve just told us that your grandmother used private care to bypass waiting lists; great for her. But the notion that it was “supplemental to a good public health care system” seems rather odd, since if it was a “good public health care system” your grandmother shouldn’t have needed to go outside it to skip the waiting lists.

    Incorrect. “Good public health” refers to the population as a whole. No health system is perfect, because demand for health care is essentially infinite.

    It’s really very simple. The debate is over whether we want quality health care, or universally-delivered health care.

    Do we have to bring out mortality rates and cost per capita again?

    However, you first have to acknowledge that your current system is dysfunctional.

    But that’s just it: I do not acknowledge that,

    Yes, we’re aware that you put your fingers in your ears when presented with comparitive studies.

  23. You can reduce infant mortality rates if you don’t count the first three days of an infant’s life as a live birth. You can further reduce infant mortality rates if you mandate women abort their less-than-optimal unborn babies.

    Me, I’ll take a higher infant mortality rate than either of those two options.

  24. You can reduce infant mortality rates if you don’t count the first three days of an infant’s life as a live birth. You can further reduce infant mortality rates if you mandate women abort their less-than-optimal unborn babies

    Already been looked at, and dismissed. The differences don’t make any significant statistical differences, and the US has worse mortality that the countries that use the same definitions.

    Incidentally, did you know that in Canada, if your wife wakes up bleeding from a nipple, you can take her to an emergency room without facing a hefty bill?

  25. The Phoenician wrote:

    Incidentally, did you know that in Canada, if your wife wakes up bleeding from a nipple, you can take her to an emergency room without facing a hefty bill?

    The Canadians pay for it in advance, in their higher taxes. That’s their form of insurance. And if I have to go to the ER, I will have a moderate co-payment (I think mine is $50 for the ER) but I won’t face “a hefty bill.”

  26. Phoe wrote:

    OK, you’ve just told us that your grandmother used private care to bypass waiting lists; great for her. But the notion that it was “supplemental to a good public health care system” seems rather odd, since if it was a “good public health care system” your grandmother shouldn’t have needed to go outside it to skip the waiting lists. (me)

    Incorrect. “Good public health” refers to the population as a whole. No health system is perfect, because demand for health care is essentially infinite.

    Are you trying to tell us here that your grandmother’s situation, facing an as-yet undefined waiting period, was either unique or very rare?

    Of course, I already addressed that, with the statistics concerning average waiting times; such should address your concern that “‘Good public health’ refers to the population as a whole.” To me, waiting times of more than a season don’t constitute good health care.

    It’s certainly not something Americans would find acceptable.

  27. Dana, are the wait times you reference for elective surgery only? If so, I would have no problem with it.

  28. Dana said: “The Phoenician wrote:

    However, you first have to acknowledge that your current system is dysfunctional.

    Dana: But that’s just it: I do not acknowledge that, and in my own experience, my health care coverage has been just fine, has functioned very well.

    Now, other than the dentist, where visits are simply routine, I haven’t had to see the doctor very frequently, and know that I went seven years between visits. Alas! I am getting older, and have had to see three specialists in the past year: a gastroenterologist, an ophthalmologist, and an audiologist. In each case, appointments were set very quickly.

    Should anyone be surprised that I don’t want to foul up a system that has worked well for me?”

    Dana, your experiences are anecdotal.

    In generating national health care policy, I hope you would agree that we need to take into account the needs of our population, aggregated.

    Like Phoenician asked, should we trot out all the statistics again, which show us far short in outcomes, in coverage, and far expensive in cost, compared to most other developed nations?

    What more will it take to convince you that our system is indeed dysfunctional? You don’t seem to respond to the data, only to your own self!

  29. Dana, your experiences are anecdotal.

    Possibly, but I suspect they’re typical. Long waits don’t seem to be the problem here that you hear about in other countries. Last time I had to use the hospital (bike accident) I was seen and treated within minutes, including getting a CAT scan.

    See if that happens in Canada or other countries with socialized medicine!

  30. Perry asked:

    Dana, are the wait times you reference for elective surgery only? If so, I would have no problem with it.

    The definition used by the Fraser Institure:

    Total waiting time between referral from a general practitioner and treatment, averaged across all 12 specialties and 10 provinces surveyed

    Such would include both elective and non-elective treatment.

    Then again, how would you define elective? Miss Woodkey’s condition was not life-threatening, and she could have lived with it, and did live with it for more than a year. Yes, she was in chronic pain, but the fact she was able to live with it for a year means that it could be defined as elective.

  31. The Canadians pay for it in advance, in their higher taxes. That’s their form of insurance.

    Correct.

    In 2006, per-capita spending for health care in Canada was US$3,678 – in the U.S. it was US$6,714.

    So the question might be – is it better to pay $3,600 in taxes for better results, or $6,700 for worse results? And please recall that health care costs in the US are rising way faster than GDP growth.

    And if I have to go to the ER, I will have a moderate co-payment (I think mine is $50 for the ER) but I won’t face “a hefty bill.”

    Assumign your insurance company pays. You may have missed the bit in the article where she already had insurance, but the company said that bleeding from the nipple wasn’t sufficiently “urgent”.

  32. Possibly, but I suspect they’re typical. Long waits don’t seem to be the problem here that you hear about in other countries.

    Uh-huh.

    Last time I had to use the hospital (bike accident) I was seen and treated within minutes, including getting a CAT scan.

    See if that happens in Canada or other countries with socialized medicine!

    The last two times I went to the emergency room, I got initial treatment immediately (IV hydration and an anti-histamine shot). Then they put me under observation to see that I was okay, and discharged me after a couple of hours.

    At the risk of spoiling your uninformed opinion with some ugly facts, see this.

    U.S. patients reported relatively longer waiting times for doctor appointments when they were sick, but relatively shorter waiting times to be seen at the ER, see a specialist, and have elective surgery. Specifically:

    - The percentage of U.S. patients who waited six days or more for a doctor appointment when sick was not significantly different from the rate in Canada (23% v. 36%), the worst-performing country.

    - Only 47 percent of U.S. patients were able to see a doctor on the same or next day when sick, versus 61 percent to 81 percent of patients in the four better-performing nations.

    - U.S. patients were less likely than patients in Canada (12% v. 24%) but more likely than patients in Germany (4%) to wait four hours or more to be seen in the emergency department.

    - U.S. patients were less likely than patients in four countries (except Germany) to wait four weeks or longer to see a specialist (23% v. 40%–60%) or to wait four months or longer for elective surgery (8% v. 19%–41%) (Schoen et al. 2005)

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