Monday, July 6, 2009

Is Canada's health system better?


There's an interesting article on CNN titled, "Reality check: Canada's government health care system." According to CNN, the story highlights include the following points:
  • Woman with tumor said wait would have been too long; she got costly U.S. treatment
  • Canadian man with cancer says he was put on fast track for treatment
  • Sen. Mitch McConnell says U.S.-run program would mimic Canada's problems
  • Some doctors who spoke to CNN say McConnell doesn't have facts right on waits
Here's a snippet from the story: "The Senate's top Republican, Mitch McConnell, R-Kentucky, asserted several times on the Senate floor last month that a government-run health insurance option, which President Obama and Democrats want, could lead to a government-controlled health care system like Canada's."

I know many Canadians who have traveled to the U.S. to get an MRI or other type of imaging study. Some travel to the U.S. for surgery. If you can afford the luxuries associated with U.S. healthcare (and even concierge medicine), then why not? Right? What happens to all those patients who are unable to afford the luxuries of such healthcare? At least in Canada, you have some level of healthcare coverage. Here in the U.S., millions of people live without any level of healthcare coverage. Why? Because they're not old enough to qualify for Medicare and they have too much to qualify for Medicaid. These days, so many doctors don't accept Medicaid, so what benefit is that anyways?

What will healthcare look like after we go through major reform? Will we mimic the Canadian system on some level? Many are predicting a tiered healthcare system where a basic, universal plan will be available to everyone, and then those who can afford more will basically get more. Who determines what types of medical tests you deserve? The same person who complains of symptoms such as dyspnea, headache, and a cough may get one type of workup in Canada (few, if any tests) and another totally different battery of tests (necessary or unnecessary) here in the U.S. Why such disparities? Do we live in such a litigious society here in the U.S.? (Don't answer that last question) To read the entire CNN story, click here.

18 comments:

  1. It is unfortunate that you chose to highlight the worst of the Canadian Health Story. The truth is that, in general, we have an absolutely excellent system. Some hospitals/clinics are managed better than others - as happens everywhere. However, every person living in Canada has total and free health care. Wait times vary with the hospital, but are always medically acceptable. Living in a border city, we see and hear the horror stories coming from our US neighbour. First of all, US hospitals prefer hiring Canadian-trained professionals. We learn that wait times at major US medical centers are no better than here; secondly, we learn that because of the high cost of medical care, too many US residents do not seek medical help until it is too late. In Canada, no one is between the patient and his/her doctor. We have total freedom of choice of physicians and treatment options. NO INSURANCE COMPANY BEAN COUNTER TELLS US WHAT WE CAN AND CANNOT DO. Please do a little bit more research and correct your story. Americans would be well served to take an HONEST look at our system. FYI - our government has had to put in stringent controls to keep Americans from coming over with fake Canadian health cards.

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  2. As a Canadian nurse who has also worked in some Third World settings, our Canadian system may have its faults but is better than MANY other places. I find it interesting that your story focuses on the woman's wait for treatment but downplays the fact she is now deeply in debt and suffering emotionally and financially as the result of her going to the US.The Canadian doctor(s) you have condemning our system are more interested in their pocketbooks than patient care...THEY can go to the US and stay there if they like.....

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  3. I admit that whenever we focus on an example (like a single hospital), that there are many limitations to such an approach. My intent was to write my reactions on the CNN story without going into all the lengthy details or ethics behind population health vs. individualized medicine. I agree that the system in Canada works well for many people. The system here in the U.S. is very broken and it may be a good system for those who have access, but the lack of access is a huge problem.

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  4. If the woman in Kingston went to an Emergency room, she would have seen a neurosurgeon immediately. It`s her fault that she now has such a high bill.
    I have used the Canadian system a lot and I have never waited for anything. I was booked for a MRI that they said might take a month. They called me in 7 days.Many of my American friends wait a lot longer, and they pay, or have an HMO that tell them what they can and can`t do. In Canada, the Dr. makes the decision what is needed, not the government.

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  5. I'm sure the Canadian health story is true. And the woman was able to come up with the $100K for the Mayo Clinic. But, isn't waiting (not for critical needs) better than never getting access as it is the U.S. for 47M of the population?

    I have yet to hear from someone who does NOT have health insurance who is AGAINST health care reform.

    I have a common heart irregularity. I've instructed my family that if I have a problem, and make it to the emergency room, NOT to have me admitted. Treated OK and released. They are not going to liquidate my bank account in a matter of days as to leave my heirs penniless.

    Something terminal rears its head? Just make me comfortable. But no, the FDA wants vicodin and percocet off the market. Cancer? I'll ask for morphine, but will probably be offered aspirin.

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  6. this is all scare tactics and myths. See article:

    Debunking Canadian Health Care Myths (from Denver Post):

    http://www.denverpost.com/recommended/ci_12523427

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  7. I must say that yes, the Canadian system isn't perfect, but it works. Everyone gets healthcare to some degree or another. Yes, there are waits, but those waits vary depending on where is the patient and what are the patient's symptoms. Typically the wait times are short. I personally think that there is nothing wrong with going into the U.S. or elsewhere to private doctors for care, as long as the public option is there. Of course, some Canadian doctors do the same -- they leave Canada to work "south of the border" in the U.S. because they don't get the financial rewards as their American counterparts do. But this simply tells me that these doctors who leave weren't interested in the altruism of medicine anyway.

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  8. As a dual citizen (US & Canadian) I have used both systems. I currently live in the US and I pay for an individual health insurance plan. Given a choice, I wouldn't think twice - the Canadian system is far better. I know of too many people here in the US who don't have any insurance and they live in hopes that they will not get sick. In my work I often deal with insurance companies and I am privy to some of their workings. I'd much rather rely on a government system to make decisions for costly procedures than a corporate entity. Wake up America!

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  9. Refreshing to hear the truth from Canadians. Stories of bad medical treatment options are just as common in the USA.
    This is another lame excuse for repugnucans to whine about anything that has 'change' written on it. It's broke, folks, and needs fixing. Americans should grow up and get educated. Mr. Obama is tackling a huge problem with solutions, not with negativity like the reps do. Let a good President work, dummies!

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  10. I am Canadian and NOT a privileged Canadian, with no inside information nor am I lucky enough to have inside friends to help me through the highly controlled Canadian system. My father in law went through an agonizing bout with cancer - a quick cancer that killed him. As much as the doctors seemed to care, he had to wait when he couldn't. He finally acted by himself and went to the Philippines for treatment - but it was too late.

    That's the injustice for average patients in Canada. However, the real injustice is to Canadian doctors who must become socialized in order to survive Canada's central system. They must now think of a whole bureaucrat of interventions - that distorts their rational thinking that should be reserved to giving only the best care to their patients. Like any communist system, Socialized health care cannot be efficient. The doctors must become pleasers to those holding the strings.

    I'm not a politician, so I will just say what I think outright, Hugh Segal is an intelligent liar!

    The vast populace of Canadians who do not have any special pull will and must be treated unjustly in a Canadian style health care arrangement. Serious, direct help will not be available. Canada's healthcare system has no special uniqueness to it. Its skeleton is characterized by central power and control. American doctors should not even entertain this form of enslavement. Remain free!

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  11. Actually, the article in CNN is really one-sided. It fails to look at the comparative data on wait times, which is available via wikipedia, and it doesn't even mention costs. Canada's system costs about $3000 less per capita than the US system. It's a bad, lazy article that reas more like an insurance industry lobbyist pamphlet than a news article. Very irresponsible and lazy reporting.

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  12. As a retired physician, I can say that my family and I are very happy to live in Canada and to be covered by the Canadian health care system.
    Doubtless, every system world-wide has problems, in part due to the burgeoning cost of new technologies.
    However, all of my family have always received excellent medical care.
    We may worry about developing serious conditions, but we do not worry about receiving appropriate treatment or paying for them.
    I think Americans are exposed to much false & inaccurate information about our system, put out there by persons with various agendas.
    Rob

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  13. Unless you are a Canadian, you do not know what you are talking about in regards to our health care system.

    This is an issue between the U.S. government and the people of the United States.

    I am a proud Canadian and I am exceptionally proud of our health care system.

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  14. I live in Canada... I find the health care to be adequate. My mom had the same problem as this lady and got treatment twice. Mind you there was a wait period but it is was reasonable due to more urgent priorities. I feel you will either die cause you can't pay (US) or you die cause you wait (Canada)... its almost a catch 22.

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  15. Considering that there are millions in the US that have no health care beyond the ER then in the long run the Canadian system doesn't look so bad. You can find cases like the woman, but I can also tell of a woman that spent months going through all the hoops the insurance company wanted her to do. I can also show where there are many in the US that go to the far east to get medical procedures done and I remember reading of a insurance company that was giving a trial run on having people go out of country for care.

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  16. Check out the link to a wait time report card for Canadian health care. Note also that this is total wait time which includes the time waiting for a specialist appointment and time for treatment. Often the wait times quoted are time on a "wait list" which is the time waiting for treatment after diagnosis.
    http://www.waittimealliance.ca/June2009/Report-card-June2009_e.pdf

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  17. CNN's article is truly one sided. I'm disappointed they did not give the option to comment on the article - they must know it's biased.

    As a Canadian - it's great to have peace of mind to go to the doctor anytime. I don't have to budget for Health Care, everything is free. I can't imagine leaving the dr's office and paying a bill. I also can't imagine choosing between my bank account and my life, that is just so sad. The Canadian system has its flaws, but it is a far superior program then the private one to the south. Healthcare is a right, not a privilege.

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  18. Like many other Canadians that have commented, we can all agree that the Canadian Health Care system is not a perfect system but I don't think any system could ever be perfect. We however have a system that provides for ALL CANADIANS. One important factor to consider that has not been mentionned in the article regarding accessibility issues is the fact that too many of our best physicians and specialized doctors end up practicing in the US to get higher pay (for their pocketbooks as Colleen said)and avoid some of the buraucracy that comes with the Canadian system. We invest a lot to train and develop top performing medical personnel (doctors and nurses) but unfortunately they move down south to practice their profession therefor contributing to fewer practionners to provide for diagnostics and treatments here in Canada resulting in longer waiting periods for patients.

    America may stand for the Land of the free, the Land of Opportunity and Open Market but the reality is that its own people do net get access to the deserved proper care and Canada cannot compete with the wealth that America provides to some of our professional health providers.

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