Health care wait times at 20 year high in Canada

[Argus]

The Fraser Institute has come out with a study of wait times across Canada, and the results aren't good. Yet health care wait times are not even a part of political argument in this country, because none of the parties have the courage to address the real issue, which is the failed funding formula which requires almost all major health care services to be funded by government. No one wants to examine the European model except the Conservatives, and they've been too afraid to bring it up for fear of being accused of wanting a 'two tier' health care system. Yet European countries generally have better health care outcomes and shorter wait times than Canada for the same or less money.

And if the wait times are bad now, well, just wait (no pun intended) for the aging boomers to put more strain on the already overloaded system. Meanwhile, the Liberals are busy bringing in elderly immigrants to take their place in lineups for health care services.

“This year is the longest [median] wait that we’ve ever measured between general practitioner [and] getting treatment. That’s quite remarkable,” said Bacchus Barua, the think tank’s senior economist for health-care studies. “It’s a clear indication of the trajectory we’ve been following over the last 20 or 25 years.”

http://www.theglobeandmail.com/news/national/wait-times-for-medical-procedures-at-20-year-high-in-canada-study/article33001028/

[Michael Hardner]

Thanks for posting this.

 

I have long maintained that our inattention to service levels is a cultural problem and national shame.

 

I believe that two-tier is a natural solution, however our problems with ignorance of service levels have to be addressed.  If not, two tier will experience the same problem as we have seen happen with MRI services.

[Goddess]

I managed a private doctor's office for 2 years and this is what I saw in healthcare:

Because the perception is that healthcare is "free" in Canada, many patients abuse it.  They run to the doc for every little thing and demand to have procedures and tests done that the doctor didn't feel was necessary. Just one example:   I had a patient call in and demand to see the doctor immediately because she woke up from a nap and felt like she was getting a cold....(Sorry, folks, still no cure for the common cold)  She then demanded to have a chest x-ray done at the hospital although there was no indication it was necessary. When a patient demands unncessary tests/procedures, a doctor's hands can be tied if he doesn't comply.

My idea was to allow a certain number of doctor visits a year and then charge a sort of "user fee" for adiitional visits - unless you have a condition that requires more attention (cancer or such).  

I believe that patient abuse is partially responsible for the excessively long wait times for procedures and tests.

[?Impact]

There is no such thing as "European health care", it varies from country to country. In many cases public health care in European countries includes many of the privatized practices we have in Canada, like dental. What about the higher eduction system in France that produces the health-care professionals, are we going to replicate that? This grass is always greener proposal lacks any clear analysis of the bigger picture. What is really amusing is those who use it most are the same one that continually rally against the "Euro Trash" for every thing else.

Edited November 23, 2016 by ?Impact

[Argus]

5 minutes ago, ?Impact said:

There is no such thing as "European health care", it varies from country to country. In many cases public health care in European countries includes many of the privatized practices we have in Canada, like dental. This grass is always greener suggestion lacks any clear analysis of the bigger picture. What is really amusing is those who use it most are the same one that continually rally against the "Euro Trash" for every thing else.

There have been numerous studies and statistics which demonstrate quite clearly that Canada pays top level health care costs for, at best, middling health results. They've been posted here repeatedly, and shown many times in the media. The only people who refuse to even acknowledge there is any issue whatsoever are government apologists and activists of the far left who would rather see people die in waiting lines than allow anyone to profit from delivering health services.  I don't find that amusing, however, but contemptible. 

[Argus]

Canada ranked last in OECD for wait times to get in to see regular GP. Add this to the lengthy wait times for MRIs and other diagnostics, and then the lengthy wait times to get in to a specialist. But of course, the marxist set will continue to stick their fingers in their ears and go 'tralalalalala'.

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

[?Impact]

2 minutes ago, Argus said:

There have been numerous studies and statistics which demonstrate quite clearly

... that Canadian health care costs are middle of the pack. Yes, when you ignore the big picture and exclude many factors like dental, public higher education (in exchange for lower wages for many health-care workers), then you can present a biased argument to further the get rich scheme of the private health insurance industry and the far right extremists.

[dre]

First of all wait times have nothing to do with the single payer system. We have a chronic shortage of physicians (especially family physicians), and theres not enough residency slots to keep up. Theres thousands of doctors that have aced the medical exams but still cant practice. This creates scarcity in services, and whether the payer is private or public will make no difference. Also we have provincial "medical associations" that in a blatant conflict of interest. Not only do they control the certification process but they negotiate wages on behalf of doctors with each province. Its in their interest to create artificial scarcity because that drives up wages.

These medical associations need to be castrated, and we need to triple the amount of residency slots which will result in lower prices and a glut of new people willing and able to perform every kind of medical service.

Screwing around the who the payer is will do nothing.

 

 

[Argus]

2 minutes ago, ?Impact said:

... that Canadian health care costs are middle of the pack. Yes, when you ignore the big picture and exclude many factors like dental, public higher education (in exchange for lower wages for many health-care workers), then you can present a biased argument to further the get rich scheme of the private health insurance industry and the far right extremists.

Canadian health care costs are not middle of the pack. They're near the top of the pack. Only the Americans spend significantly more. And other countries which spend more or less what we do have far better services, and more extensive coverage. France, as an example spends less than we do but their health coverage is much more universal.  It covers prescriptions, for example, while ours does not

https://en.wikipedia.org/wiki/Health_care_in_France#Health_care_system

And my interest has nothing to do with profit but with effectiveness and efficiency. Take your Marxist hatred of the profit motive to Cuba, where I'm sure you'll be quite content.

[Argus]

2 minutes ago, dre said:

First of all wait times have nothing to do with the single payer system. We have a chronic shortage of physicians (especially family physicians), and theres not enough residency slots to keep up. Theres thousands of doctors that have aced the medical exams but still cant practice.

Because government doesn't want more doctors that it has to pay, so it deliberately limits the number of internships and residencies. And there are no private hospitals to take up the slack.

 

[?Impact]

When using OECD data, it would be helpful if the real OECD data were actually looked at. It would be important to note that Canada and Norway for example are singled out as not using the same metrics as other nations. The CTV article above is not about an OECD report, but rather one written by KPMG. What is missing from the "wait times" survey that KPMG took is the effect of the walk-in clinics operated by many primary health care physicians - that is a glaring oversight.

Edited November 23, 2016 by ?Impact

[dre]

2 minutes ago, Argus said:

Because government doesn't want more doctors that it has to pay, so it deliberately limits the number of internships and residencies. And there are no private hospitals to take up the slack.

 

Doctors in private hospitals would still need 2 years of residency to practice. But its the governments and medical associations that control the certification process. Its not a fix for whats "broken". If anything private hospitals would increase wait times and drive up costs by offering higher salaries to entice doctors to leave the public system.

[Wilber]

It's unfortunate that we share a border with the US. By comparing everything different and labeling it "American", it makes us incapable of thinking for ourselves and doing what is necessary to improve our system.

[bush_cheney2004]

1 hour ago, Wilber said:

It's unfortunate that we share a border with the US. By comparing everything different and labeling it "American", it makes us incapable of thinking for ourselves and doing what is necessary to improve our system.

 

Really ?   Losing the U.S. border would have serious health care services implications for Canadians as well as a much larger bi-lateral trade impact.  Perhaps you mean a much narrower context.

[Argus]

2 hours ago, ?Impact said:

When using OECD data, it would be helpful if the real OECD data were actually looked at. It would be important to note that Canada and Norway for example are singled out as not using the same metrics as other nations. The CTV article above is not about an OECD report, but rather one written by KPMG. What is missing from the "wait times" survey that KPMG took is the effect of the walk-in clinics operated by many primary health care physicians - that is a glaring oversight.

In my experience, the people who use walk-in clinics are, for the most part, those who can't get appointments with their own doctors, or who have been unable to get a GP.

[Argus]

1 hour ago, dre said:

Doctors in private hospitals would still need 2 years of residency to practice. But its the governments and medical associations that control the certification process. Its not a fix for whats "broken". If anything private hospitals would increase wait times and drive up costs by offering higher salaries to entice doctors to leave the public system.

Yet that hasn't happened in Europe.

[overthere]

4 hours ago, Michael Hardner said:

Thanks for posting this.

 

I have long maintained that our inattention to service levels is a cultural problem and national shame.

 

I believe that two-tier is a natural solution, however our problems with ignorance of service levels have to be addressed.  If not, two tier will experience the same problem as we have seen happen with MRI services.

We have had 2 tier forever already.  It is simple enough to go to anywhere in the world to get medical care, nothing prevents this except the contents of your wallet.  True two tier, like the UK, is a mess that is probably unfixable.

 

What I would like to see is user fees, similar to France- they are not onerous for the vast majority, are applied to everybody, and kicked back to the truly needy. .  I strongly believe it would free up resources overall.

[overthere]

2 hours ago, Argus said:

Because government doesn't want more doctors that it has to pay, so it deliberately limits the number of internships and residencies. And there are no private hospitals to take up the slack.

 

Admissions and graduations from medical schools, and physician accreditation, are heavily influenced or controlled by doctors and medical associations.

[?Impact]

19 minutes ago, Argus said:

In my experience, the people who use walk-in clinics are, for the most part, those who can't get appointments with their own doctors, or who have been unable to get a GP.

I don't know what your experience is, are you a doctor or administrator in a walk-in clinic? Regardless, the question posed by KPMG that you cite above was about ability to get an appointment for the same day or next day with their family doctor. The question of walk-in clinics is very directly related to that situation. I may have a GP for long term relationship, but generally the requirement for same/next day appointments have nothing to do with that long term relationship. It might be a sore throat, minor diagnostics or surgery, etc. where a walk-in clinic is often far better than a hospital or waiting for my GP. The last 2 times I remember using a walk-in clinic were for:

1. After a sports injury I was having some mid-lower back pain that seemed more than just sore muscles. I visited a walk-in clinic and they were able to get an x-ray in the same building and while they did see some hairline fracture it appeared older. Basically this was my reassurance, and I avoided a visit to an emergency room.
2. I was out visiting some properties one day a few years ago, one of them being a small farm that had been only about a year out of operation. Later that day I visited another property, while not a farm, I was wearing the same sandals I had worn earlier. I stepped on a broken glass bottle. While the cut did bleed quite a bit for a short while, which is good in washing it out, it was not deep enough to need stitches or at most one. Since I was several hours from home, and wanted to stay in the area I visited a walk-in clinic. I was not really concerned about any stitches, but the fact that I hadn't had a tutus booster in a very long time. While the clinic didn't have just a tetanus booster, they did have a supply of DPT which is as good or better and I was quickly on my way.

In neither of these cases would my long-term relationship with a GP offered any advantage. Perhaps if I had serious medical conditions then the story would be different, but for the vast majority of the population these type of situations for scheduling a short notice appointment are better served with the walk-in clinics. The point is that a survey that asked a question that was so relevant, and totally ignored walk-in clinics is meaningless.

[poochy]

44 minutes ago, ?Impact said:

I don't know what your experience is, are you a doctor or administrator in a walk-in clinic?

Are you, smart guy?

 

 

[drummindiver]

2 hours ago, overthere said:

We have had 2 tier forever already.  It is simple enough to go to anywhere in the world to get medical care, nothing prevents this except the contents of your wallet.  True two tier, like the UK, is a mess that is probably unfixable.

 

What I would like to see is user fees, similar to France- they are not onerous for the vast majority, are applied to everybody, and kicked back to the truly needy. .  I strongly believe it would free up resources overall.

Roughly 70% of our taxes will go to health care by 2020. You think people who are carrying that tax burden should ante up even more? 

[Michael Hardner]

2 hours ago, overthere said:

We have had 2 tier forever already.  It is simple enough to go to anywhere in the world to get medical care, nothing prevents this except the contents of your wallet.  True two tier, like the UK, is a mess that is probably unfixable.

I think that is too broad a definition of two-tier.

Quote

What I would like to see is user fees, similar to France- they are not onerous for the vast majority, are applied to everybody, and kicked back to the truly needy. .  I strongly believe it would free up resources overall.

 

Sure, but like I say... Canadians aren't good at managing services.  The government just provides worsening service and we accept it.  If we had two-tier, I expect most of us would end up paying more for marginally better services, and those who can't afford it would get terrible care.

 

We need someone with vision to set up a new way for us to think of these services - allow competition and monitoring of the bottom line costs as well as service levels.  It's a massive rethink I'm asking for and I don't know who could do it, frankly.

[?Impact]

1 hour ago, drummindiver said:

Roughly 70% of our taxes will go to health care by 2020.

Could you provide any evidence for that. Currently about 39% of our provincial (Ontario) budget goes to health and long-term care, how are you extrapolating that to 70% of our total taxes? It would be nice to have a thorough accounting across the country, but it is certainly less than 20% of taxes overall, and probably between 10-15%.

Edited November 24, 2016 by ?Impact

[eyeball]

3 hours ago, Michael Hardner said:

Sure, but like I say... Canadians aren't good at managing services.

That's because we suck at making our governments accountable - the more fundamental level of the problem.

[OftenWrong]

The problem goes beyond government. Hospital administration is incompetent and extremely wasteful. There's too many high paid directors and managers, not enough front line staff. Most of the nurses are not even full-time workers any more, thanks to the administrative model of human resources.

Meanwhile these folk (admin) collect some of the finest paychecks in the province, especially in the public sector. There is no serious accountability. And where there is, it's a facade. They write reports and simply lie. Utterly incorrigible.