Canada’s medical care is bad for your health
Politicians and reporters often mention the Canadian health system as a model the United States should accept to improve medical care. I am no expert on this, but in Washington, D.C., at the National Orthopedic Leadership Conference, I listened with interest as Dr. Brian Day of Vancouver spoke on the state of Canadian health care. Day has been an Orthopedic surgeon for 30 years and is now president of the Canadian Medical Association. From his point of view, one word describes Canadian health care today -- rationing.
Among the facts he presented were: 36 percent of Canadians with acute illness have to wait six or more days to see a doctor. He personally has a 250-patient waiting list -- patients waiting for bone and joint surgery. Despite this, his operating room time was cut, as a cost savings measure, from 22 hours per week to five hours per week. There is a chronic shortage of facilities. Canada has only been able to afford one-tenth as many MRI, CT and ultrasound scanners compared to Japan on a per capita basis. The future is even more grim. Money for research has dried up. New technology is denied. Half of newly trained medical graduates leave. They are now 30 percent short of physicians. Canada was fourth in the world in per capita physicians; now it is 24th. A total of 700,000 patients have been on waiting lists. More than 8,000 have died while waiting.
The cost of waiting is estimated at $15 billion per year -- medical complications plus lost time at work and sometime irretrievably lost health. This waiting is so pervasive that on the bottom of the pre-printed form telling one patient the date and time of a scheduled test is written -- "If the person named on this computer generated letter is deceased, please accept our sincere apologies."
Has this rationing at least brought control to the rising health care costs? No. There is no reward for productivity. Hospitals receive block grants, rather than fees for services provided. Eighty percent of the new jobs in the system are in management. Yet the costs of the system now consume 50 percent of the provincial budgets. In the year 2000, the burden of health-care costs to the Canadian government had risen to 10 percent of the GDP. Fully one-third of Canadians are now baby boomers approaching full retirement. There are currently 180 seniors for every 1,000 citizens. By 2030, the number will be 430 supported by 1,000.
By every possible measure, the system is unsustainable. A total of 68 percent of Canadians polled recently recommended a compete overhaul. The United States is 10 times the size of Canada. Do we want 10 times these problems here? Medical care is based on science, and science is based on the careful analysis of experimental results. I would say Canadian health care was a noble experiment carried out on an unsuspecting population. We in the United States can take note of the results. Canada is a good model for what not to do in this country.
John Bellatti, M.D., is an orthopedic surgeon in Kealakekua, Hawaii.