CIHI - Wait Times for Healthcare in Canada

[Bryan]

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

They probably would be largely the same: Canadians would see little of the benefit.

[Argus]

In some ways, the situation in Cuba is one Canadians can only dream about. You don't even have to go to the doctor since the doctor comes to you.

Cuba has 8 doctors for every 1000 people. Canada's rate is 224 per 100k, or 2.2 per 1000 people. So how do the Cubans have more than three times as many doctors as we do? The story doesn't say but we all know, don't we? Medicine is a calling in Cuba, not a business. Cuban doctors are middle class professionals who live modestly. Cuban doctors make about $50 a month, which is about double that of the average public servant there. Canadian doctors make about five times the average public service salary in Canada.

Imagine your doctor knocking at your door to give not just you, but your whole family, an annual health check-up.

As well as taking blood pressure, checking hearts and asking all sorts of questions about your job and your lifestyle, this doctor is also taking careful note of the state of your home, assessing anything which could be affecting the health of you and your family.

http://www.bbc.com/news/health-35073966

Edited December 13, 2015 by Argus

[Topaz]

Argus, my parents had a doctor that would make house calls and back in the "60's" when my sister had pneumonia, the DR came to see her and in 2008, when my mom was dying of cancer, the doctor came to her at home. Maybe being in a small community creates a better chance of that happening than the big cities.

[cannuck]

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.

It definitely varies from province to province as to just how much Joe Stalin is having his way. I live in SK, the birthplace of government sick care (and socialism) in North America, so pretty much have had a ringside seat to what went right and what went left (not necessarily wrong) in sick care. I am also a US taxpayer and employer, so get to see that side of the equation.

To begin with, we need to separate out what we do have that is universal and similar to all other G7 countries with a qualified exception being the US (yes, I am leaving China out of this) - and that is sick care insurance. Regardless of whether there are user fees or not, we all have a tax funded insurance scheme that runs the whole sick care system. This is obviously where the US differs dramatically: they consider sick care a business, where as most of the rest of us at least realize that sick care insurance is a public service - as, IMHO, it should be. The yanks have their head so far up their rectum in this respect, they tend to politicize this issue to the extreme, and just can't wrap their head around (hard to do when it is placed as previously mentioned) the whole concept of how EVERYONE else in the G7 funds sick care.

Where I have to disagree with Argus, is that if Joe Stalin were running out sick care DELIVERY system, we would not have any waiting times (as, for instance, you would find in Japan where the legally allowed waiting time is ZERO). Similarly, Cuba is a good example of how a genuinely full function Marxist-Leninist (Marti-ist?) economy treats health care and sick care. It is purely a social service with service delivery by the state. Where we screw up is by adopting the quasi-US stance of making medicine a near-business. BUT: instead of a wide open competitive, free market, we instead grant the very special privilege for medicine to be practiced by cartels, whose rates and procedures are set WITH NO COMPETITION by colleges of physicians and surgeons. By the same token, we stop medicine short of BEING a real business by the state limiting who can provide what services, how, when and where.

In Alberta, you can get an MRI any day of the week on short notice - just pay the bill. In SK (or MB) you will wait for an indefinite period of time - in which you might very well deteriorate or die - just because the damned government administered cartel could not organize a piss up at a brewery. Now, if you happen to be a ward of the state in SK, and they want to get diagnostic results (for worker's comp for instance), what do you think they do? Yup, the FLY or bus the patient to AB for a quick MRI!!!!! Talk about que jumping! Of course, back here in the last millenium (as of this year) the public service unions will cry foul about the recent introduction of private MRI services in SK - all focused on the standard politics of fear and envy by citing that same thing (que jumping) with NOBODY having the sense to point out that these are new MRIs to the system, and anyone using their own cash to get an image are FREEING UP their spot in the public screw-up system for everyone else to move up a notch.

Why that paragraph? Simple: in most of the rest of the G7 (except obviously USA) public and private service co-exists with very little conflict. Euros especially seem to realize that sick care is a social service, and whether provided by a state employee or a contractor willing to work for the posted fees, who really gives a damn? It should not be an ideological battleground, it should simply be what is practical - and there it is just that.

BTW: I have left a lot of the US stuff out of the mix for now, but I will be the first to admit, some of the very best sick care in the world can be bought in the USA - for quite a price. But the VERY best (IMHO) comes from the Mao Clinics - that are, wait for it....A NOT FOR PROFIT COMPANY. Just thought I would throw that out as food for thought.

[bush_cheney2004]

....BTW: I have left a lot of the US stuff out of the mix for now, but I will be the first to admit, some of the very best sick care in the world can be bought in the USA - for quite a price. But the VERY best (IMHO) comes from the Mao Clinics - that are, wait for it....A NOT FOR PROFIT COMPANY. Just thought I would throw that out as food for thought.

The usual deflections and comparisons to the U.S. public and private "sick care" system are not adequate excuses for the long wait times in Canada. The Mayo Clinic operates as a non-profit organization in several cities for tax purposes, but the costs can still be quite high compared to other providers.

[cannuck]

The usual deflections and comparisons to the U.S. public and private "sick care" system are not adequate excuses for the long wait times in Canada. The Mayo Clinic operates as a non-profit organization in several cities for tax purposes, but the costs can still be quite high compared to other providers.

I did not say there were any good excuses for the wait times in Canada - except that our various government monopoly on service delivery provinces screw up pretty much everything they touch when it comes to management, whereas provinces that behave in a more European way (accept public and private mix) score so much better.

I added the not-for-profit comments since the buzzwords of the left and unions (i.e. same, same) are that profit is evil. I have to say, though, that when delivering a social service, it actually is.

BTW: yes, the costs a Mayo can be relatively high, but the results tend to be extremely good (thinking now of diagnostics).

Edited December 17, 2015 by cannuck

[bush_cheney2004]

I did not say there were any good excuses for the wait times in Canada - except that our various government monopoly on service delivery provinces screw up pretty much everything they touch when it comes to management, whereas provinces that behave in a more European way (accept public and private mix) score so much better.

For years I have asked this forum what Canadians are waiting for when it comes to even basic "sick care" procedures and diagnostics. The only answer I get consistently is that Canadian provinces triage their limited (public and private) resources and those not near death are expected to tough it out for the team.

Consistent with other areas, Canada appears to be under-capitalized in this area as well, but rejects the public-private solutions that you speak of, because that would be "American style" health care. Keeping everyone at the lowest public common denominator is more important.

[waldo]

The usual deflections and comparisons to the U.S. public and private "sick care" system are not adequate excuses for the long wait times in Canada.

in regards your declared "usual deflections and comparisons to the U.S.", you could certainly aid in that regard by finally taking up the long standing and oft-repeated challenge put to you concerning U.S. wait times. Are you still working on presenting a comprehensive accounting of U.S. wait times; an accounting inclusive of all manner of U.S. public/private systems, regardless of insurance categorization/existence? Will we see it soon?

[waldo]

For years I have asked this forum what Canadians are waiting for when it comes to even basic "sick care" procedures and diagnostics. The only answer I get consistently is that Canadian provinces triage their limited (public and private) resources and those not near death are expected to tough it out for the team.

what you call "limited Canadian (public and private) resources" reflects upon Canada's publicly funded universal health insurance system... you know, what Americans typically refer to as a "universal single payer health care system". Since the U.S. doesn't have such a thing... since the U.S., even after recent changes to expand Medicaid and introduce 'Obamacare', still has ~13% of its population without any form of medical insurance (down from an all-time high of 18%-45 million Americans)... I'm unclear by what measure you presume to continually question Canadian wait times. Care to elaborate?

past MLW thread discussions have clearly outlined respective, per province, accepted benchmark thresholds for focused procedures/diagnostics... unlike the U.S., Canada publishes its wait time benchmarks, measures... and deficiencies. Equally, MLW thread discussions have detailed the 'triage concept' within respective wait time queues... those with the most urgent need are/should be moved to the top of the respective queue.

.

Consistent with other areas, Canada appears to be under-capitalized in this area as well, but rejects the public-private solutions that you speak of, because that would be "American style" health care. Keeping everyone at the lowest public common denominator is more important.

no - that's not "American style" health care... not in the least! There's a past MLW thread that captures it quite well, captures a certain, as you say, "common denominator" quite well: US dead last in health care

[cannuck]

I would not put the US dead last in sick care, nor health care, but I would certainly put them dead last in cost vs. results. - bang for the buck.

What I do find deplorable - and inexcusable - that the most common cause of personal bankruptcy is sick care bills. Back to the root of the problem: not being able to separate business from social services.

[bush_cheney2004]

I would not put the US dead last in sick care, nor health care, but I would certainly put them dead last in cost vs. results. - bang for the buck.

Nothing about health care in the United States or any other country is a valid excuse for the stupidly long wait times for even basic procedures in Canada (the actual topic). What are Canadians waiting for ?

[waldo]

Nothing about health care in the United States or any other country is a valid excuse for the stupidly long wait times for even basic procedures in Canada (the actual topic). What are Canadians waiting for ?

still waiting for you to present those all encompassing U.S. wait times... inclusive of all manner of the public/private options within the U.S., inclusive of those ~30 million+ without insurance, inclusive of all those with limited/constrained insurance coverage, etc..

until you present those U.S. wait time stats, here's a little teaser for you: New York Times, July 2014 - The Health Care Waiting Game

In recent weeks, the Veterans Affairs hospitals have been pilloried for long patient wait times, with top officials losing their jobs.

Yet there is emerging evidence that lengthy waits to get a doctor’s appointment have become the norm in many parts of American medicine, particularly for general doctors but also for specialists. And that includes patients with private insurance as well as those with Medicaid or Medicare.

So it turns out that America has its own waiting problem. But we tend to wait for different types of medical interventions. And that is mainly a result of payment incentives, experts say

In our market-based system, patients can get lucrative procedures rapidly, even when there is no urgent medical need: Need a new knee, or an M.R.I., or a Botox injection? You’ll probably be on the schedule within days. But what if you’re an asthmatic whose breathing is deteriorating, or a diabetic whose medicines need adjustment, or an elderly patient who has unusual chest pain and needs a cardiology consultation? In much of the country, you can wait a week or weeks for such office appointments — or longer if you need to find a doctor who accepts your insurance plan or Medicare.

And those waits are likely to get longer as the Affordable Care Act brings tens of millions of newly insured patients into a system that is often already poorly equipped to provide basic care. “I fully expect wait times to be going up this year for Medicaid and Medicare and private insurance because we are expanding access to care, but we’re not really expanding the system of providers,” said Steven D. Pizer, a health care economist at Northeastern University in Boston.

what are Americans waiting for?

.

[bush_cheney2004]

Krikey...there are even long wait times for abortions...and Canadian women can't just dash across the U.S. border the way they used to for much faster "reproductive services". What are Canadians waiting for ?

[Smallc]

What are Canadians waiting for ?

Some Canadians are waiting for you to give an answer. Anything to contribute?

[bush_cheney2004]

Some Canadians are waiting for you to give an answer. Anything to contribute?

Stay on topic if you can.....why are there such long wait times for basic procedures, including abortions...in Canada (which is not the U.S.).

[On Guard for Thee]

Krikey...there are even long wait times for abortions...and Canadian women can't just dash across the U.S. border the way they used to for much faster "reproductive services". What are Canadians waiting for ?

Who'd be stupid enough to head down there and pay a shitload for what we get here for free?

[Smallc]

Stay on topic if you can.....why are there such long wait times for basic procedures, including abortions...in Canada (which is

Krikey...there are even long wait times for abortions...and Canadian women can't just dash across the U.S. border the way they used to for much faster "reproductive services". What are Canadians waiting for ?

not the U.S.).

Follow your own advice?

[bush_cheney2004]

Follow your own advice?

Yes...wait times are so long in Canada that people cross the border for faster access to services, not a provincial wait list.

What are Canadians waiting for ? Why are so many things under capitalized in your country ?

[Smallc]

Yes...wait times are so long in Canada that people cross the border for faster access to services, not a provincial wait list.

Ah, but that's not the topic. People in glass houses....

[bush_cheney2004]

Ah, but that's not the topic. People in glass houses....

Then why does this topic even exist ? Are wait times a figment of Canada's imagination ?

[Bryan]

Are wait times a figment of Canada's imagination ?

For the most part, yes.

[Smallc]

For some things I would certainly agree. I had some problems with swollen lymph nodes. I went to a walk in clinic in Dauphin. I got in within 20 minutes. I was sent for some blood work at the hospital the same day. I had a CT just over one week later and had the results in less than a week after that (at this point I was classified as semi urgent. I could have had the results sooner, but when they called, they told me it wasn't urgent and so I waited until the next week to go in). Long story short, I have chronic left side sinusitis resulting in nasal polyps. I now have an appointment with an ENT in Winnipeg just over one month from the diagnosis for something that is not much more than elective at this point.

[waldo]

What are Canadians waiting for?

why are there such long wait times for basic procedures, including abortions...

What are Canadians waiting for? Why are so many things under capitalized in your country ?

already asked... and answered! What you call "under capitalized" reflects upon Canada's publicly funded universal health insurance system... you know, what Americans typically refer to as a "universal single payer health care system". Since the U.S. doesn't have such a thing... since the U.S., even after recent changes to expand Medicaid and introduce 'Obamacare', still has ~13% of its population without any form of medical insurance (down from an all-time high of 18%-45 million Americans)... I'm unclear by what measure you presume to continually question Canadian wait times. Care to elaborate?

past MLW thread discussions have clearly outlined respective, per province, accepted benchmark thresholds for focused procedures/diagnostics... unlike the U.S., Canada publishes its wait time benchmarks, measures... and deficiencies. Equally, MLW thread discussions have detailed the 'triage concept' within respective wait time queues... those with the most urgent need are/should be moved to the top of the respective queue.

now, again, still waiting for you to present those all encompassing U.S. wait times... inclusive of all manner of the public/private options within the U.S., inclusive of those ~30 million+ without insurance, inclusive of all those with limited/constrained insurance coverage, etc..

until you present those U.S. wait time stats, here's a little teaser for you: New York Times, July 2014 - The Health Care Waiting Game

what are Americans waiting for?

.

[CITIZEN_2015]

Two-tiered health care system is the answer to our sick system.

Health care is better even in many third world countries than Canada, Something is not right here in this advanced country with the health care system and long waiting list and I think I know what is wrong. It is the socialist way of thinking by a likely majority of Canadians that good health is not for purchase!!!!! Well nonsense when everything else is for purchase why not health? I am not talking about buying body parts no that is very wrong. But I do believe strongly that we need PRIVATE health in this country and that is something long overdue.

Those who can afford it must pay for their cost and yes get faster and better services too and then the public health care will be freed up for the rest of public and as a result again faster service and likely better service too for the public as well. Private clinics and hospitals will open up as the return would be great. Everybody will win in the situation except the damn leftists may be who try to push the idea that good health is not for sale!!! well everything else is; Those with money buy bigger houses, better cars, better clothing and yes eat better food resulting in better health and longer life spans as a result of having money too so why not health care??!!!!

Edited December 22, 2015 by CITIZEN_2015

[bush_cheney2004]

Canada's "sick care" system will continue to have long wait times for even basic procedures as long as capital investment remains in short supply. Access gatekeeping for care and facilities investment will remain on starvation diets by design and legal barriers to private sick care insurance.