CIHI - Wait Times for Healthcare in Canada

[Michael Hardner]

https://www.cihi.ca/en/health-system-performance/access-and-wait-times

We don't have a free market to speed up competitive information in Canada, so it's up to a public of concerned citizens to monitor healthcare statistics and put pressure on providers to provide coverage, at quality, for a decent cost.

And yet, I never hear people speak about CIHI - Canadian Institute for Health Information.

[Michael Hardner]

Good starting point -> http://waittimes.cihi.ca/

[waldo]

And yet, I never hear people speak about CIHI - Canadian Institute for Health Information.

there's been prior discussion on key lackings within CIHI... particularly those related to the most presumptive and unsubstantiated statements made here that the role/responsibilities of the Canada Health Council (CHC), as shuttered by Harper Conservatives, were integrated into the CIHI. When you had provincial premiers repeatedly calling for national level meetings to, in part, extend the mandate of the CHC... when you had Stephen Harper categorically refusing to ever meet collectively with Canada's premiers... on anything, let alone health care, the lack of that prior level of CHC oversight/control, says much about any inability to put in place national level standards in anything related to health care, including wait times. Of course, Harper wanted to punt the CHC... oversight/control just got in his way!

I note you and I had a somewhat related exchange where you used ER wait times as an example point - this following prior exchange... one that I think is key in helping to frame your OP, as invariably, given the oft displayed tendency of one MLW member here, this thread will very quickly devolve into a comparison of the U.S. versus Canadian wait times:

Hmmmm.... maybe if we framed the ER wait times question as some kind of competitive thing we'd get more interest in it, I'm thinking.

of course, as I'm sure you're aware, the granularity isn't there to the level of 'ER wait times'... but I think I get your drift, particularly in how 'ER wait times' has been so often framed in many past MLW threads. And yes, as I infer from your comment, the apparent 'lack of interest' might relate to how this type of opportunity for broader, higher-level country comparisons (say Canada to the U.S.), gets ignored by those proponents who instead favour pushing/flogging lower-level metric comparisons (like ER wait times).

Depending on what you mean, it IS actually. CIHI aggregates these per province and releases the numbers regularly to the utter apathy of those who would rather use healthcare discussion as a forum for talking about why we're better than the USA.

my context was within the purview of the Social Progress Index report/study... that the granularity within it, doesn't extend to the lower-level of a metric like your 'ER wait times' example. My response to you in regards you questioning interest was in that same vein; more pointedly, to an apparent lack of interest in comparative country review (say, Canada versus the U.S.).

in any case, that's an interesting perspective you hold. My alternate strong recollection, particularly in terms of the type of study/report that lends itself to Canada versus U.S. healthcare discussion/comparison, is that the broader level of comparative discussion of healthcare systems is the one that gets ignored (by some members). That is to say, discussions on the broader higher-level category summations that showcase overall system failings/deficiencies are purposely derailed/avoided/ignored, to instead, flog/beat on, the low-hanging fruit metrics... like ER wait times.

.

[Bryan]

There's a lot of data collected and managed by CIHI. I've subscribed to their reports for quite some time -- it's very informative. They post a lot of data on their Facebook feed as well.

[Bryan]

Regarding wait times -- I still can't complain too much. The posted expected wait times on provincial web sites are exponentially longer than anything I've ever sen in person.

For example: The current wait time for MRIs in Manitoba is listed at 23+ weeks. I injured my knee in jiu-jitsu last month, and I got an MRI in two days. Having had several injuries over the years from contact sports, I've had the "pleasure" of needing an MRI several times (as has my son). We've never waited more than a week, and sometimes even gotten one within a few hours.

So, the MRI revealed a torn ACL and meniscus. That meant my Doc needed to refer me to a knee surgeon for a consult. I saw the surgeon 6 days later.

[Michael Hardner]

That is to say, discussions on the broader higher-level category summations that showcase overall system failings/deficiencies are purposely derailed/avoided/ignored, to instead, flog/beat on, the low-hanging fruit metrics... like ER wait times.

Waldo - what summations specifically ? I called out Wait Times as a low-hanging fruit but there are other metrics on there.

Also, I never understood how CHC vs CIHI became a question for anyone. CIHI provides health information and has been doing so for over 20 years, early in the Chretien years.

[Argus]

There is no inherent economic savings in making people wait for weeks or months for necessary medical treatment. Whether you do it now or next June the cost of providing the service is the same. The only saving would be people dying before getting the medical treatment. On the other hand, that 'saving' is only on paper, as it is more than surpassed by the loss of income production from people waiting treatment.

Why, then, do we have wait times? The provinces will all tell you it's because they need more money. Yet we spend more on health care than most European countries who do not have these wait times. The government has, even through the Conservative years, retained a Stalinist view of health care as a state monopoly, refusing to even consider allowing the private sector health models ALL other western nations have.

Since the Liberals have never wavered in their support for the same Stalinist system I expect zero improvement in health care under their reign.

Edited December 8, 2015 by Argus

[Wilber]

There is no inherent economic savings in making people wait for weeks or months for necessary medical treatment. Whether you do it now or next June the cost of providing the service is the same. The only saving would be people dying before getting the medical treatment. On the other hand, that 'saving' is only on paper, as it is more than surpassed by the loss of income production from people waiting treatment.

Why, then, do we have wait times? The provinces will all tell you it's because they need more money. Yet we spend more on health care than most European countries who do not have these wait times. The government has, even through the Conservative years, retained a Stalinist view of health care as a state monopoly, refusing to even consider allowing the private sector health models ALL other western nations have.

Since the Liberals have never wavered in their support for the same Stalinist system I expect zero improvement in health care under their reign.

The Canada Health Act just stipulates the minimum services required. Healthcare is provided by the provinces so we have 10 different approaches to the same problem (plus the territories). That just begs for inefficiencies.

[Argus]

The Canada Health Act just stipulates the minimum services required. Healthcare is provided by the provinces so we have 10 different approaches to the same problem (plus the territories). That just begs for inefficiencies.

It also forbids the provision of private, for fee health care services similar to those you can find in every other western country.

[Topaz]

I, for one, at least right now, can't complain because my hubby has one more day of radiation to go out of 35 treatments for pre-skin cancer. I don't like the fact we have to drive 1 1/2 hrs to and back for treatments but there are older seniors who have a 3 hr one-way drive to the same hospital. In Ontario, the small community hospital do have chemo now but still patients have to travel to the nearness cancer hospital for radiation. Let me tell u there are more people with skin cancer or pre-skin cancer now than ever before.

[Wilber]

It also forbids the provision of private, for fee health care services similar to those you can find in every other western country.

No it doesn't. I can get a MRI tomorrow from a private for fee clinic but they can't bill the public system as well.

[Smallc]

No it doesn't. I can get a MRI tomorrow from a private for fee clinic but they can't bill the public system as well.

Which is, to be quite frank, an idiotic rule.

[socialist]

https://www.cihi.ca/en/health-system-performance/access-and-wait-times

We don't have a free market to speed up competitive information in Canada, so it's up to a public of concerned citizens to monitor healthcare statistics and put pressure on providers to provide coverage, at quality, for a decent cost.

And yet, I never hear people speak about CIHI - Canadian Institute for Health Information.

I agree, Michael. You make another astute point. Why don't people speak about the CIHI? That question has bothered me and kept me up at night many nights. It's time people started speaking about the CIHI. Thanks for the excellent link, Michael. You bring to the forefront a very important topic that people are ignorant of.

[Wilber]

Which is, to be quite frank, an idiotic rule.

I kind of agree as long as it doesn't result in all physicians adding surcharges to fees paid by the public system.

[Smallc]

I kind of agree as long as it doesn't result in all physicians adding surcharges to fees paid by the public system.

I think you should be able to charge privately and publicly, but not to attach fees that are being paid for and received under the public system.

[Bryan]

No it doesn't. I can get a MRI tomorrow from a private for fee clinic but they can't bill the public system as well.

That differs by province. Privately billed MRIs are not allowed in Manitoba. One company tried, but the govt put a stop to it.

Which is, to be quite frank, an idiotic rule.

I think we should have private billed care in Manitoba, but it's a good thing to keep the two completely separate to preserve the integrity of the public system. People of means can pay to get out of the queue, making the wait less for the public. If the same place is doing both, there's no efficiency and it sets things up for abuse where the cash patient could bump the public one.

[Smallc]

I think the public system should be able to buy care from a parallel private one if needed at certain times. That's the kind of thing I'm talking about.

[Bryan]

I think the public system should be able to buy care from a parallel private one if needed at certain times. That's the kind of thing I'm talking about.

The problem with that is, the govt could just step in a buy all the capacity, effectively shutting down the private option. That's essentially what they did with Maples Clinic as an backdoor way to get rid of private MRIs.0.

[Smallc]

I don't see how it would be any different than contracts that Canadian health authorities have with US hospitals now.

[bush_cheney2004]

I don't see how it would be any different than contracts that Canadian health authorities have with US hospitals now.

Difference being that provinces are not able to book all the U.S. "contract" capacity. U.S. private investment would just add more.

[Smallc]

Difference being that provinces are not able to book all the U.S. "contract" capacity. U.S. private investment would just add more.

Why would the response be any different? In such a case, Canadian private investment would just add more.

[bush_cheney2004]

Why would the response be any different? In such a case, Canadian private investment would just add more.

Then why hasn't it done so ? Why do provinces have U.S. provider contracts at all ?

Edited December 9, 2015 by bush_cheney2004

[Smallc]

Then why hasn't it done so ?

It isn't permitted, as was said above.

[Argus]

I think you should be able to charge privately and publicly, but not to attach fees that are being paid for and received under the public system.

I recently went to a private, for-fee clinic for a check-up. When I go to my regular OHIP doctor he does a very cursory exam then gives me a paper to take to one of those grubby, crowded labs where I wait around for an hour or more in a jam-packed waiting room.

This clinic charged, but it also collected through OHIP. The way they did it was to charge for extra services. For example, I spent over an hour with a physical therapist doing various fitness tests and getting advice on exercises. I spent another hour with a dietitian going over my diet, and then more time with a nurse who ran vision, hearing, cardio and circulatory tests, and who had earlier taken specimens for lab tests. When I saw the doctor he performed a thorough physical that my OHIP doctor simply never does because he's rushing through things, and then went over every aspect of what my lab tests showed with me. All in all I was in the clinic about four hours. Typical yearly check-up with my OHIP doctor would be 5-10 minutes and would not include fitness, cardio, muscle mass, circulatory, hearing, vision, etc. I'm not sure what part OHIP paid for. Certainly the lab tests, and probably the actual doctor's physical. However, the extra money for other services subsidized the physical and allowed him to spend a lot more time.

So there is room for a mix of public and private money, and if that could be extended as it is in the rest of the world I think there could be a lot of new money coming into the system and private sector efficiencies taking hold.

[Michael Hardner]

http://www.leaderpost.com/health/canadian+health+care+wait+times+need+improvement+reports/11573797/story.html

Two separate reports being released Tuesday have used different strategies to reach the same conclusion — Canada's health care wait times leave much to be desired.

The Wait Time Alliance, a group consisting of major doctor's associations across the country, has analysed data from provincial health care ministries.

The Alliance says there's been some improvement in wait times for certain services like cardiac or radiation treatments, but many others are unacceptably high.[/size]

Both report authors agree that measuring wait times in Canada is a challenge complicated by a lack of universal standards across the country.[/size]

Alliance chair Dr. Chris Simpson said the data collected by provincial health ministries varies widely, since different regions and even individual hospitals track different numbers according to their own criteria.

No matter what figures are being presented, however, Simpson said the message is clear — the system as a whole needs to be fixed.

Wait times and quality of care are half of the equation - the other half is costs. Canada needs to formalize a process that puts government, service providers, and patients together to come up with new approaches.