Ca­na­da’s health-ca­re wait ti­mes worst in de­ve­lo­ped world

To re­tain the pro­mi­se of uni­ver­sal health ca­re that Ca­na­dians che­rish, we must chan­ge the way we at­tempt to de­li­ver it

La Jornada (Canada) - - ENGLISH SECTION -

Whet­her you ask phy­si­cians or pa­tients, the ans­wer is the sa­me – Ca­na­da is fai­ling to pro­vi­de ti­mely ac­cess to me­di­cal ca­re.

The U.S.-ba­sed Com­mon­wealth Fund, in con­jun­ction with the Ca­na­dian Ins­ti­tu­te of Health In­for­ma­tion, just pu­blis­hed the re­sults of their health po­licy sur­vey of adults in Aus­tra­lia, Ca­na­da, Fran­ce,

Ger­many, the Net­her­lands, New Zea­land, Nor­way, Swe­den, Swit­zer­land, the Uni­ted King­dom and the Uni­ted Sta­tes. The re­sults in­di­ca­te that Ca­na­da is not just lag­ging, but is li­te­rally scra­ping the bot­tom when it co­mes to in­di­ca­tors of ti­mely ac­cess to health ca­re.

He­re’s a sam­ple of our most spec­ta­cu­lar fai­lu­res:

Abi­lity to get a sa­me or next-day ap­point­ment when sick: worst

Abi­lity to get af­ter-hours ca­re (wit­hout re­sor­ting to vi­si­ting an emer­gency de­part­ment): se­cond-worst

Wait for treat­ment in the emer­gency de­part­ment: worst Wait to see a spe­cia­list: worst

Wait for elec­ti­ve sur­gery: worst

Of cour­se, the fact that Ca­na­dians fa­ce sig­ni­fi­cant wait ti­mes for treat­ment will not sur­pri­se an­yo­ne fa­mi­liar with the Fra­ser Ins­ti­tu­te’s an­nual wait ti­mes sur­vey. Last year phy­si­cians re­por­ted that their pa­tients wai­ted lon­ger, on ave­ra­ge, than they ever had in the sur­vey’s 26-year his­tory. Im­por­tantly, they al­so re­por­ted that pa­tients are wai­ting lon­ger than what they (the phy­si­cians) con­si­der to be cli­ni­cally reaso­na­ble.

Whi­le Ca­na­dian pa­tients suf­fer the reality of long de­lays, which may lead to de­te­rio­ra­ting and irre­ver­si­ble harm, apo­lo­gists claim wait ti­mes re­main a small pri­ce to pay for uni­ver­sal health ca­re. But that’s wrong – a quick glan­ce at the coun­tries in­clu­ded in the Com­mon­wealth Fund’s sur­vey re­veals that Ca­na­da’s fai­lu­re is not in­trin­sic to uni­ver­sal health ca­re.

Every country exa­mi­ned (ex­cept, so­me would ar­gue, the U.S.) has a uni­ver­sal health-ca­re sys­tem that en­su­res ac­cess to treat­ment re­gard­less of abi­lity to pay. They just do it dif­fe­rently. Most of the­se coun­tries ge­ne­rally allow the pri­va­te sec­tor to pro­vi­de co­re health-ca­re in­su­ran­ce and ser­vi­ces, re­qui­re pa­tients to sha­re in the cost of treat­ment, and fund hos­pi­tals ba­sed on ac­ti­vity (rat­her than the glo­bal bud­gets that are the norm in Ca­na­da).

In the Net­her­lands, the top per­for­mer in-terms of abi­lity to get a sa­me/next day ap­point and af­ter hours ca­re, in­di­vi­duals must pur­cha­se a stan­dard in­su­ran­ce pac­ka­ge from pri­va­te in­su­rers in a re­gu­la­ted, but com­pe­ti­ti­ve, mar­ket. A for-pro­fit com­pany is the mar­ket lea­der.

In Fran­ce, the top per­for­mer in terms of wait ti­mes in the emer­gency de­part­ment, uni­ver­sally ac­ces­si­ble hos­pi­tal ca­re is de­li­ve­red by pu­blic, not-for-pro­fit and for-pro­fit hos­pi­tals. In fact, about one-third of all hos­pi­tals in the country ope­ra­te on a for- pro­fit ba­sis.

Swit­zer­land, the top per­for­mer in terms of wait ti­mes to see a spe­cia­list, en­su­res uni­ver­sa­lity in an en­vi­ron­ment of ma­na­ged com­pe­ti­tion among in­su­ran­ce c com­pa­nies and prov vi­ders of health ca­re. L Li­ke most ot­her countr tries, cost-sha­ring is a c cen­tral fea­tu­re of the S Swiss sys­tem. In­di­vi­du uals are ex­pec­ted to p pay a de­duc­ti­ble be­fo fo­re in­su­ran­ce kick­sin in, af­ter which a 10-20 p per cent co- in­su­ran­ce r ra­te ap­plies up to an a an­nual ma­xi­mum, af­te ter which all ex­pen­ses a are co­ve­red.

In Ger­many, th the top per­for­mer in te terms of wait ti­mes for e elec­ti­ve sur­gery, in­div vi­duals can ge­ne­rally u use so­cial/sta­tu­tory ( (SHI) or pri­va­te (PHI) in in­su­ran­ce to ac­cess pu­blic or pri­va­te hos­pi­tal ca­re. Alt­hough 42 per cent of all hos­pi­tals ope­ra­te on a for-pro­fit ba­sis, al­most all hos­pi­tal beds in the country are ac­ces­si­ble to pa­tients with SHI-co­ve­ra­ge.

Whet­her it’s the Com­mon­wealth Fund most re­cent re­port or the Fra­ser Ins­ti­tu­te’s an­nual wait ti­mes sur­vey, the evi­den­ce is clear. Ca­na­dian’s wait far too long for treat­ment – com­pa­red to 26 years ago, com­pa­red to what doc­tors con­si­der reaso­na­ble, and com­pa­red to ot­her coun­tries with uni­ver­sal health ca­re.

It’s ti­me to fix the sys­tem. To re­tain the pro­mi­se of uni­ver­sal health ca­re that Ca­na­dians che­rish, we must chan­ge the way we at­tempt to de­li­ver it. -TROYMEDIA

Bac­chus Ba­rua is an eco­no­mist at the Fra­ser Ins­ti­tu­te.

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