B.C. lawsuit set to reignite debate about private health care

overthere · September 7, 2016

That's because the posted wait times are the provincial average. When you take into account people in remote areas, it skews the average higher. Delivery of services is a geographical issue here. Having sparsely populated areas spread over large swathes of land makes it difficult and expensive to deliver care to everyone equally. For the most people, people living in major cities or densely populated areas have much faster access to care.

That makes little sense. People who live on farms or some distance from urban centers have access to modern conveniences like telephones. With these devices, their GP can make an appointment for a specialist or a procedure in the clinic/hospital, and get in the queue. Being across the street from the big hospital does not get quicker access to a MRI or knee surgery. The wait times for emergency care are the same too: move to the head of the line no matter where you live.

WestCoastRunner · September 7, 2016

This reminds me of a study I saw awhile back (I'll see if I can find it again) that found that people who use the system are highly satisfied with it and the wait times; those most concerned about wait times and most critical of the system are people who have had little exposure to it.

I can speak from experience and not from a study. While I have had fairly fast access to tests when needed, visiting ER or finding a family physician has been brutal.

ER wait times are atrocious here in BC and if you move and are trying to find a 'female' physician, it is next to impossible. Going to a walk-in clinic for day to day treatments in most cases results in 3-4 hour waits. Clearly, our system needs major improvements.

cybercoma · September 7, 2016

That makes little sense. People who live on farms or some distance from urban centers have access to modern conveniences like telephones. With these devices, their GP can make an appointment for a specialist or a procedure in the clinic/hospital, and get in the queue. Being across the street from the big hospital does not get quicker access to a MRI or knee surgery. The wait times for emergency care are the same too: move to the head of the line no matter where you live.

I'm sorry it doesn't make sense to you but this has been a recognized problem for a very long time.

http://publications.gc.ca/Collection-R/LoPBdP/BP/prb0245-e.htm

?Impact · September 7, 2016

According to Machjo, Canada has one of the worst health care systems in the world - So it must be so.

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On medical school caps. Yes, some of the limits may be due to doctor lobby efforts (supply/demand), but there is also a limit to the resources available to train doctors. Medical doctors are the most heavily subsidized education paths, several million dollars per individual. Money is not the only factor, trained educators and positions for the practical side of their training are also in limited supply.

Bryan · September 7, 2016

That's because the posted wait times are the provincial average. When you take into account people in remote areas, it skews the average higher. Delivery of services is a geographical issue here. Having sparsely populated areas spread over large swathes of land makes it difficult and expensive to deliver care to everyone equally. For the most people, people living in major cities or densely populated areas have much faster access to care.

I know people who have had MRIs at the rural clinics in Manitoba, and their experience has been similar to mine (a week or less, no matter what the "wait time" website said). The issue that does make remote living an issue is not available openings in the MRI schedule, it's those people's availability to show up for the MRI. If going for the scan involves a plane trip and a hotel, the clinic telling you that you can have your scan right now if you can get to there in 10 minutes isn't going to help you. For those people, scheduling the scans weeks in advance is what they actually need anyway.

Bryan · September 7, 2016

Being across the street from the big hospital does not get quicker access to a MRI or knee surgery.

It does when the big hospital calls you and tells you that they have an opening right now if you can get there right away -- but you live 750 km away.

Machjo · September 7, 2016

According to Machjo, Canada has one of the worst health care systems in the world - So it must be so.

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On medical school caps. Yes, some of the limits may be due to doctor lobby efforts (supply/demand), but there is also a limit to the resources available to train doctors. Medical doctors are the most heavily subsidized education paths, several million dollars per individual. Money is not the only factor, trained educators and positions for the practical side of their training are also in limited supply.

I never said it had the worst system, but certainly ranks low among developed countries.

Machjo · September 7, 2016

Correction. I did say Canada and the US were among the world's worst systems. My mistake. They're among the worst among developed countries only.

Bob Macadoo · September 7, 2016

I know people who have had MRIs at the rural clinics in Manitoba, and their experience has been similar to mine (a week or less, no matter what the "wait time" website said). The issue that does make remote living an issue is not available openings in the MRI schedule, it's those people's availability to show up for the MRI. If going for the scan involves a plane trip and a hotel, the clinic telling you that you can have your scan right now if you can get to there in 10 minutes isn't going to help you. For those people, scheduling the scans weeks in advance is what they actually need anyway.

Correct me if I'm wrong but you most likely are getting an app't where your GP has privileges. If that's a rural doc he's not setting you up downtown with multiple machines.

bush_cheney2004 · September 7, 2016

Correction. I did say Canada and the US were among the world's worst systems. My mistake. They're among the worst among developed countries only.

Debating OECD rankings won't solve cited health-care system problems in Canada.

But it is a great national past time each time this topic comes up.

Smallc · September 7, 2016

Debating OECD rankings won't solve cited health-care system problems in Canada.

Hurt feelings?

bush_cheney2004 · September 8, 2016

Hurt feelings?

No, I can buy health insurance and the government will help me do it....not put me in jail.

overthere · September 8, 2016

It does when the big hospital calls you and tells you that they have an opening right now if you can get there right away -- but you live 750 km away.

that is a rare exception and if they have a day or two- Farmer gets the call because he is next.

overthere · September 8, 2016

Debating OECD rankings won't solve cited health-care system problems in Canada.

But it is a great national past time each time this topic comes up.

True on both. And it won't change the amazing statistic that Canadians live on average almost 3 years longer than Americans. Same culture, same crappy food, same sedentary lifestyles, same large number of lardos- and Canadians live a very significant 3 years longer.

And the reason? All Canadians from birth have easy access to preventative medicine. Many Americans do not. It depends on income.

Oh, and the other embarrassing stat is that USA spends considerably more per capita overall on a public/private system than Canada does on a single payer system..

So, USA has both higher input costs, and worse measurable outcomes. You get less result for more cost. Please do not have a heart attack when you read this.

overthere · September 8, 2016

Correction. I did say Canada and the US were among the world's worst systems. My mistake. They're among the worst among developed countries only.

I agree that you are mistaken. In fact, in a measurable outcome like life expectancy- Canada is middle of the pack of developed countries, and the US is well down.

Machjo · September 8, 2016

http://www.photius.com/rankings/healthranks.html

bush_cheney2004 · September 8, 2016

True on both.

I know it's true....this debate takes the same, repeated path each time it is broached. Just tell the poor suckers waiting months in line for the simplest medical tests and procedures that the "system" is better than in the USA, the only benchmark that matters.

Bryan · September 8, 2016

Correct me if I'm wrong but you most likely are getting an app't where your GP has privileges. If that's a rural doc he's not setting you up downtown with multiple machines.

I can choose where ever I want to have my MRI. Even if my doctor (it's usually a sports med specialist, not a GP) does assign me to one hospital, I just call up the one that I do want and have the appointment moved there. My point was, that in Manitoba, unless you live in Winnipeg, Brandon, or Winkler, your MRI is going to involve a road trip no matter where your doctor practices or has privileges.

that is a rare exception and if they have a day or two- Farmer gets the call because he is next.

What's a rare exception? That you can get called right away for your MRI (if you're available)? NO, that is very much the norm here. I have gotten that very call several times. Luckily, I live only a few minutes away from one. They call, I run right down.

Smallc · September 8, 2016

I can choose where ever I want to have my MRI. Even if my doctor (it's usually a sports med specialist, not a GP) does assign me to one hospital, I just call up the one that I do want and have the appointment moved there. My point was, that in Manitoba, unless you live in Winnipeg, Brandon, or Winkler, your MRI is going to involve a road trip no matter where your doctor practices or has privileges.

What's really going to help is having MRIs in Dauphin and Selkirk, meaning that not everyone from up north needs to go Winnipeg for theirs.

Bryan · September 8, 2016

What's really going to help is having MRIs in Dauphin and Selkirk, meaning that not everyone from up north needs to go Winnipeg for theirs.

Dauphin is still closer to Winnipeg than it is to most towns in Northern MB. It might help a few people, but anyone who would have to overnight to do Dauphin (most of northern MB) would probably choose to come to Winnipeg anyway, especially since flight and hotel options would be better. Probably have to make it farther north to really make a difference --- Swan River maybe?

Of course ideally, Dauphin, Swan River, Flin Flon, Norway House, and Thompson would ALL have at least one MRI.

Smallc · September 8, 2016

Of course ideally, Dauphin, Swan River, Flin Flon, Norway House, and Thompson would ALL have at least one MRI.

The volume isn't there. Thompson would be the most likely candidate, after Steinbach.

Bryan · September 8, 2016

With one already in Winkler, I can't see Steiner getting one before other places that are farther away. But you're definitely right, the low volume is a serious issue. lack of density is by far our biggest issue with affordable delivery.

Smallc · September 8, 2016

With one already in Winkler, I can't see Steiner getting one before other places that are farther away. But you're definitely right, the low volume is a serious issue. lack of density is by far our biggest issue with affordable delivery.

Steinbach is about half the size of Brandon in area population. I'm surprised it didn't beat Selkirk to getting one.

Bryan · September 8, 2016

Steinbach is about half the size of Brandon in area population. I'm surprised it didn't beat Selkirk to getting one.

Winker for some reason is considered the central point for south-east Manitoba for a lot of things. Steinbach is growing really fast, I would have thought Bethesda would have gotten an MRI before Boundary Trails.

Argus · September 8, 2016

According to Machjo, Canada has one of the worst health care systems in the world - So it must be so.

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On medical school caps. Yes, some of the limits may be due to doctor lobby efforts (supply/demand), but there is also a limit to the resources available to train doctors. Medical doctors are the most heavily subsidized education paths, several million dollars per individual. Money is not the only factor, trained educators and positions for the practical side of their training are also in limited supply.

The only limits are the limits the government puts on how many medical school spaces it will pay for and how many internships/residencies it will allow in hospitals. There is no other limit on how many doctors we can train.