CIHI - Wait Times for Healthcare in Canada

[Topaz]

BC, u do realize that the US spends more money on health care than any nation, as it was said by one the Republican candidates running. Let's be fair, the US has its health problems also.

[bush_cheney2004]

BC, u do realize that the US spends more money on health care than any nation, as it was said by one the Republican candidates running. Let's be fair, the US has its health problems also.

Of course, but that is not what this thread is about. What the US spends has nothing to do with how under-capitalized Canadian health care is and has been for a long time. Healthy markets/margins for good and services will automatically get more private investment instead of being strangled by government policies/laws.

Edited December 22, 2015 by bush_cheney2004

[On Guard for Thee]

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.

Even with our wait times our outcomes are generally much better than yours and at much less cost. I reckon we will just tweak our system and let you fumble away with yours. But thanks for your concern.

[waldo]

Canada's "sick care" system

U.S. DEAD LAST in Health Care! U.S. Healthcare Ranked Dead Last Compared To 10 Other Countries

U.S. Healthcare: Most Expensive and Worst Performing

Most Efficient Healthcare 2014 ... U.S. near the bottom, ranked 44 of 51 countries... better than 2013 when the U.S. ranked 46

Infant mortality is higher in the U.S. than in comparable countries

Medical Bills Are the Biggest Cause of US Bankruptcies

2014 U.S. Citizens without health care insurance - per CDC, after factoring Obamacare and expanded Medicaid, 33 million Americans are still without any form of medical insurance coverage... disproportionately poor, black and Hispanic; 4.5 million of them were children.

what are Americans waiting for?

.

Edited December 22, 2015 by waldo

[bush_cheney2004]

Canada's health care delusion...to suffer long wait times for the simplest of procedures is a patriotic duty.

One study ranked Canada dead last in timeliness and quality care

It’s a Canadian conceit that ours is one of the best public health care systems in the world, a defining characteristic of nationhood; something that separates us from the Americans. In a poll by Angus Reid Public Opinion in June, 69 per cent of Canadians said they’re proud of the health care system, edging out the state of Canadian democracy, multiculturalism and bilingualism.

Yet the reality, based on any number of international comparisons, shows that pride in a supposedly world-beating standard of care is often misplaced, an “illusion,” as Liberal MP and medical doctor Keith Martin puts it.

http://www.macleans.ca/news/canada/our-health-care-delusion/

Don't fix long waits in Canada...just point at the USA instead...far cheaper.

Edited December 22, 2015 by bush_cheney2004

[On Guard for Thee]

Canada's health care delusion...to suffer long wait times for the simplest of procedures is a patriotic duty.

One study ranked Canada dead last in timeliness and quality care

It’s a Canadian conceit that ours is one of the best public health care systems in the world, a defining characteristic of nationhood; something that separates us from the Americans. In a poll by Angus Reid Public Opinion in June, 69 per cent of Canadians said they’re proud of the health care system, edging out the state of Canadian democracy, multiculturalism and bilingualism.

Yet the reality, based on any number of international comparisons, shows that pride in a supposedly world-beating standard of care is often misplaced, an “illusion,” as Liberal MP and medical doctor Keith Martin puts it.

http://www.macleans.ca/news/canada/our-health-care-delusion/

Don't fix long waits in Canada...just point at the USA instead...far cheaper.

Point at the USA? No thanks.

http://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror

[Bryan]

Canada's health care delusion...to suffer long wait times for the simplest of procedures is a patriotic duty.

The only thing my family and I are waiting for is to actually have to wait for any health care delivery, for anything.

[waldo]

Don't fix long waits in Canada...just point at the USA instead...far cheaper.

Canada has a focus on improving wait times... you simply choose to ignore the information provided in that regard. You also selectively choose to ignore just how Canada's medical system administers care and manages wait times... on a per province basis. Some provinces, broadly, perform better than others; some procedures are managed better in some provinces over others. And Canada, unlike the U.S., publishes an active update accounting of its wait times for profiled procedures... fully showing benchmark versus results... fully showing trend lines that highlight improvements and/or deficiencies. You also choose to ignore... and purposely belittle... the "triage concept" within wait time management where those with the most urgent need are/should be moved to the top of the respective queue.

now, I profess I was wrong in my first response in this thread. In past related threads, given your past penchant for drawing relative wait times comparisons to the U.S., in your most selectively displayed manner, I wrote: "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:" Yes, I was wrong as you NOW don't want to have a thing to do with drawing relative comparisons to U.S. wait times... you clearly won't even acknowledge U.S. wait times as highlighted in this prior post --- New York Times, July 2014 - The Health Care Waiting Game

when you speak to and ask why there are "limited Canadian (public and private) resources"... and "under-capitalized Canadian health care", you continue to ignore the replies you receive; replies that speak to the very nature of Canadian publicly funded universal health coverage... 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 some 33 million+ American citizens without any form of medical insurance, one can't help but question why you so fixate on one facet of Canadian health care... while completely ignoring, deflecting from and refusing to acknowledge wait time issues within the U.S.. ... whether that's the wait times highlighted within this posts prior linked NYT article, or the recent U.S. Veterans Department wait time scandal, or the significant concern being raised by U.S. health care professionals in regards to the coming impact of Obamacare and expanded Medicaid on already deficient U.S. wait times.

again, given your purposeful refusal to acknowledge the principal behind Canadian wait time policy management, given your purposeful refusal to acknowledge the impact providing universal health care has on wait times, given your purposeful refusal to accept the nature/scope of actual U.S. wait times, I'm unclear by what measure you presume to continually question Canadian wait times. Care to elaborate?

with a wait time focus, in past threads you've chosen to even belittle the very nature of Canada's universal health care system... often referring to it as "Commie Care". As clearly shown through your past posts, apparently to you, there are degrees of being an American - not all Americans are to be considered equal... treated the same! Your oft proudly mentioned, "U.S. cash is king", is the fundamental measure of how you rate waiting for health care... as in, if an American has the cash, no problemo... but if you have no cash... if you have no insurance, you're not a part of the "American wait time mix"! How self-serving and selective of you - yes? Of course, your convenient answer to this is to simply state that, "within the American health care system there is no expectation of delivering universal care, hence, Americans get what they get"!

with a wait time focus, I will take the liberty of once again playing out your "Commie Care" theme and what it really does mean to and how it does impact upon health care wait times. In that regard I will remind you of a past thread reference where I provided U.S. wait times for select large U.S. metropolitan areas... where invariably, the city of Boston (and the state of Massachusetts) showed the highest and most significant wait times in the U.S..; you know, that U.S. representation of universal "Commie Care" (as in Massachusetts Romney Care)! Apparently, providing universal health care coverage has its consequences - that you simply choose to selectively and with self-service, ignore!

[waldo]

Canada's health care delusion...to suffer long wait times for the simplest of procedures is a patriotic duty.

Point at the USA? No thanks.

http://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror

looking back at prior related threads is so revealing... OGFT, clearly we've hit the mark as this is now, at least, the 5th time the guy has played that "Macleans delusion" article... an earlier post has me referencing 4 other times it's been played out! And now it's even more dated. As I did in that prior thread, I dropped the graphic that draws country comparisons. Of course your link provides an update on those country comparisons - equally, of course, it is always stated that Canada has work ahead, has much to improve upon; however, if only to make the most direct and pointed comparison (to the U.S.), in this latest and most recent published ranking undertaken "by Americans for Americans", the U.S. is once again overall, DEAD LAST in comparative country health care rankings:

.

[bush_cheney2004]

Another Canadian patient's sad wait time story...this one just might be a record of 10 years:

• December 2005: Burnup's doctor gets a response back from an Alberta neurosurgeon saying he is too busy to see Burnup, suggesting she be referred to another doctor or back to the doctor who originally performed her surgery in Minneapolis.
• 2006-10: Burnup is bounced from doctor to doctor and department to department within Alberta Health waiting to hear if the surgery will be done in either in Alberta, B.C. or Minneapolis.
• March 2010: Alberta Health finally agrees to pay for Burnup's trip to Minneapolis, but only for a consultation.
• April 2010: Burnup sees Dr. Joseph Perra in Minneapolis who confirms the need for surgery and suggests the option of getting a Canadian surgeon to do it.
• Late 2010: Burnup is told by Alberta Health she won't be going for surgery in the U.S., but would instead be sent to the Vancouver Spine Surgery Institute at Vancouver General Hospital.
• January 2011: A letter is sent to Burnup saying she is approved for travel funding for an appointment with Vancouver surgeons.
• Early 2013: Burnup calls the Vancouver Spine Surgery Institute to ask about an appointment and is told she is on the wait list and would be notified when an appointment became available.
• March 2013: The Vancouver Spine Surgery Institute tries to contact Burnup for an appointment time, but finds her number had been disconnected and her doctor did not have a new number. However, the number the institute called was not Burnup's general practitioner but one of the surgeons in Minneapolis. Burnup is unaware of the miscommunication.
• After three failed attempts to contact Burnup, the Vancouver Spine Surgery Institute puts her file into what it calls the "incomplete cabinet."

http://www.cbc.ca/news/health/patient-in-healthcare-blackhole-waits-10-years-for-surgery-1.3371713

[SpankyMcFarland]

There is an enormous amount of data available on CIHI, getting bigger every year, and it gets loads of media coverage. Some of the extra detail people want is not valid because the sample size may be too small to provide reliable results and would give rise to huge fluctuations.

Every country has wait times BTW and people complain about them everywhere. You can only have two out of three of fast, excellent and cheap service. I'd like to see CIHI co-operating with the industry leaders in Europe on key measures like wait time to produce simple annual league tables so we can easily see where we stand without any debate. One big challenge here compared to them is population density.

[cannuck]

Every country has wait times BTW and people complain about them everywhere.

As I understand it waiting times of any sort for treatment are illegal in Japan, but I do not know if that applies to electives.

While we really DO have pretty decent sick care, reality is of the OECD countries, we are dead last in elective waiting times.

[Argus]

As I understand it waiting times of any sort for treatment are illegal in Japan, but I do not know if that applies to electives.

While we really DO have pretty decent sick care, reality is of the OECD countries, we are dead last in elective waiting times.

Yet we pay as much if not more than countries which appear to have much more efficient health care systems.

[cannuck]

Yet we pay as much if not more than countries which appear to have much more efficient health care systems.

I have a long-developed theory that if you pay people too much for what they do, their focus turns to how to spend what you are paying them (and how to get more) instead of doing their job. If you think about it, that would fit very well into the sick care picture in Canada.

[SpankyMcFarland]

As I understand it waiting times of any sort for treatment are illegal in Japan, but I do not know if that applies to electives.

While we really DO have pretty decent sick care, reality is of the OECD countries, we are dead last in elective waiting times.

Have you a link?

[hitops]

As a doc, I deal with this stuff routinely. Our wait times for some things are decent, and terrible for others.

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.

If you are telling the truth, this is the extreme exception. The only patients of mine who get MRI in < month are those who's life may depend on it (cancer follow or emergent diagnosis). Every else waits months, usually more than 6.

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.

That's a false dichotomy. There is not a fixed number of divinely bestowed MRI machines, which much be parceled out into private and public. If a private system is allowed, more MRI machines get installed and operating compared to if not.

The issue is docs - the concern that docs will divert their time into private care if more lucrative, and wait times would suffer for public.

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

The NYT is overtly liberal, and of course this, like nearly every other article they do on the topic, completely ignores the fact that they have the largest government funded insurance system in the world - medicare (for those over 65). Obviously under such a model, you will get over consumption and wait time increases just like we do.

When you compare wait times overall in the US (including medicare), of course things will be dragged down the the government insured system. If you want to know the real difference, you need to compared private insurance vs government insurance.

They do however at least make a few honest points. One is that the VA, their only government-operated system, is awful. The other is that the problems they identify, will be made worse by the ACA.

The biggest overall wait problem they identify is finding primary care. Right now, this is most difficult in the government funded systems (medicare, medicaid). The main reason is that the payments for a consultation are lower than private. The ACA's solution? Just lower the fees more (as a cost control). For hopefully obvious reasons, that will not help the problem.

Edited January 11, 2016 by hitops

[cannuck]

Have you a link?

http://www.oecd.org/els/health-systems/waiting-times.htm

http://www.ctvnews.ca/health/canada-ranked-last-among-oecd-countries-in-health-care-wait-times-1.1647061

Sorry I could not respond yesterday, got a bit busy around here. I can not find anything about the legal issue of wait times, but the best overall and relatively non-biased article I found was from Wiki!! https://en.wikipedia.org/wiki/Health_care_system_in_Japan Somewhere in there it should cover wait times, which are definitely lowest in OECD, but I think by policy goal was legistlated to zero

Edited January 12, 2016 by cannuck

[waldo]

Somewhere in there it should cover wait times, which are definitely lowest in OECD, but I think by policy goal was legistlated to zero

no - the OECD itself does not even attempt to qualify a wait-times country list ranking. This point has been discussed in past threads where I've brought forward actual OECD quoted references that speak to the current lack of comparable standards between countries that would allow for meaningful and representative comparisons... notwithstanding there are at least 6 countries, as I'm aware, that have no actual consensus/comprehensive country-level monitoring/tracking of wait times (notably among those, the U.S., Germany, Switzerland). The lack of wait-time data for the U.S. has been discussed previously in this thread... something that certainly doesn't stop one particular MLW member from pressing the point on Canada's wait times while conveniently ignoring what U.S. wait-time information/data that is available... that has been presented here and in past related MLW threads.

as an aside, as I've related in a past MLW thread, the OECD has actually suggested that Canada's current methodology in monitoring and tracking wait times would be a good starting reference point for all countries to adopt.

[cannuck]

as an aside, as I've related in a past MLW thread, the OECD has actually suggested that Canada's current methodology in monitoring and tracking wait times would be a good starting reference point for all countries to adopt.

Thanks for the thoughtful reply. Yes, our methodology might be very good, but our wait times are unacceptable.

[waldo]

Thanks for the thoughtful reply. Yes, our methodology might be very good, but our wait times are unacceptable.

unacceptable by what measure? If you recognize... and accept... the principled concept of prioritizing the most needed/dire conditions... and dealing with those as higher priorities, those waiting are now subject to being managed within established time periods subject to threshold service targets all within the economies of related health care funding, resource allocations, efficiency improvements, etc..

[Argus]

unacceptable by what measure? If you recognize... and accept... the principled concept of prioritizing the most needed/dire conditions... and dealing with those as higher priorities, those waiting are now subject to being managed within established time periods subject to threshold service targets all within the economies of related health care funding, resource allocations, efficiency improvements, etc..

That is bureaucratic gibberish which can be used to excuse any length of wait.

[cannuck]

unacceptable by what measure? If you recognize... and accept... the principled concept of prioritizing the most needed/dire conditions... and dealing with those as higher priorities, those waiting are now subject to being managed within established time periods subject to threshold service targets all within the economies of related health care funding, resource allocations, efficiency improvements, etc..

I will give you a very broad sample of one.

One of my BILs has had a lot of shoulder problems, and is no stranger to the sick care system. In between major surgery 4 & 5, he had been given a list of diagnostic imaging appointments, with an X-ray coming a few weeks before an MRI. When he went to the clinic, he sat for several hours waiting for his X-ray appointment (obviously one that was several hours late. About half way through, he became extremely irritated listening to the radiology techs in the MRI room giggling and exchanging stories about their personal life. He went to the desk and asked that, since the MRI was clearly NOT being used and was fully staffed, why was he waiting weeks to come back and no doubt waste more hours in the same waiting room when he could just go in there while he was awaiting the x-rays he was to receive? The desk staff were apalled to think anyone could be so presumptuous, and explained to him that things just didn't work that way! 3+ hours, nobody in there.

Government is totally inept at providing any service, much less critical services such as medical diagnostics. Yes, I agree they have a place in the whole mess, but to deny the ability of the private sector to manage effectively and deliver a defined service to the sick care insurance plan at a reasonable cost is truly idiotic.

The irony is, Worker's Comp finally tired of the sick care bureaucrats and unions causing such a ridiculous delay in a vital diagnostic procedure that they bundled him up onto an airplane and flew him to a private clinic in Alberta for his MRI. From the time they decided to do so, until he spent a day going there and back was less than a week, vs. several MONTHS from the government sick care fiasco.

Edited January 16, 2016 by cannuck

[hitops]

Government is totally inept at providing any service, much less critical services such as medical diagnostics. Yes, I agree they have a place in the whole mess, but to deny the ability of the private sector to manage effectively and deliver a defined service to the sick care insurance plan at a reasonable cost is truly idiotic.

Quite right. Our (SK) biggest wait problems are MRI's, and elective surgeries. Private MRI's and private surgery centers put far more people through in the same amount of time, no surprise there. Brad Wall made a loud promise to bring surgical waits down. They contracted lots of ortho work to the private center, and waits fell to best in the country. They made their announcement, patted themselves on the back, published the results, and then did not renew the private contract. Now not even a year later, our waits are right back where they were.

The irony is, Worker's Comp finally tired of the sick care bureaucrats and unions causing such a ridiculous delay in a vital diagnostic procedure that they bundled him up onto an airplane and flew him to a private clinic in Alberta for his MRI. From the time they decided to do so, until he spent a day going there and back was less than a week, vs. several MONTHS from the government sick care fiasco.

Same comical/sad irony here. Worker's comp itself knows waiting for the public system is useless, they have their own private MRI. Workers comp patients get MRI's immediately. Everyone else waits and waits.

Edited January 17, 2016 by hitops

[SpankyMcFarland]

A mixed system is best - public and private.

One must keep a beady eye on unnecessary procedures in the private system. The US shows how easy it is to rip people off when health is at stake.

Edited January 20, 2016 by SpankyMcFarland