by Klaus Rohrich
July 12, 2004
Last week John Kerry called for a national healthcare system in the U.S., like the one in Canada. If you americans are planning to institute a national universal healthcare system similar to ours, you might want to look somewhere other than Canada for the ideal model.
To give you a brief overview of Canada’s Universal healthcare system, it all started off well enough and ran like a top for many years. I remember when it was normal to call a doctor and get an appointment the same day, when one could get to see a specialist the next day or when someone needed a by-pass operation he or she didn’t have to wait a year to get it. Of course, in those days health care wasn’t exactly free, either. You see, all Canadians (except those who truly could not afford it) had to pay a monthly premium for their coverage.
Then the federal Liberals (the equivalent of your Democrats) decided to pass the Canada Health act, which made medical coverage a basic human right. The act stipulated that health care was to be provided by the government only and that any form of private care was illegal. It put the burden of paying for healthcare into the hands of taxpayers, as the service would now be paid from the government’s general coffers.
In addition, there were numerous other provisions, such as controlling costs by limiting doctors’ salaries and keeping nurses and other healthcare professionals at relatively low wages.
So the first thing that happened was that the doctors threatened to go on strike. The government called their bluff and told them to go ahead, but the doctors chickened out. Next, many of our best doctors moved to the United States, where government was not going to limit the amount of money they could earn.
Of course, the end result is predictable. Most jurisdictions in Canada now have a doctor shortage, despite the government’s denial of this stark reality. anyone without a family physician is forced to attend a soviet-style walk-in clinic to receive routine medical care. as transient physicians staff these clinics, there is no relationship that develops between the doctor and his patients and items such as annual physical examinations are not available in these clinics. If one’s family doctor should retire, move or become deceased, then all of the doctor’s patients will be scrambling to find a new doctor. Yet, the government appears to be creating this doctor shortage on purpose, as enrollment in medical schools is strictly regulated and only a certain number of applicants are ever accepted, regardless of their academic standing.
The patient to doctor ratio varies from 2,000 to 4,000 patients per doctor, depending on geographical location. and many tests and procedures are beginning to be de-listed; meaning that the public healthcare system will no longer pay for them. among these are items such as PSa examinations, which is used to screen for prostate cancer in men, physiotherapy or chiropractic treatments, certain dermatological procedures, such as the removal of skin growths and eye examinations.
The province of Ontario has recently decided that its "free health care" is now subject to an annual premium (spelled T-a-X), imposed on every taxpayer in the province. While this has angered most Ontario taxpayers, the government is refusing to look at any other alternatives to the way it currently provides healthcare.
While on a recent visit to Toronto’s Orthopedic and arthritic Hospital, a facility specializing in the treatment of bone and joint problems, I overheard the harried receptionist at the clinic explaining why the patient would have to wait four to five months to receive surgical treatment,
"There are only so many orthopedic surgeons to go around." She explained. The patient was fortunate to have seen a surgeon and was waiting for a date for his procedure. Prior to his appointment with the surgeon, the patient had to be referred in writing by his family doctor, which usually takes from four to six weeks. after the initial visit, the surgeon likely requested an MRI, or magnetic resonance imaging procedure to determine the severity of the problem. Getting an MRI in Canada can take up to six months, although many Canadians choose to cross the border into the U.S. where they can get it next day for about $450.
after the MRI, the results of which can take as long as six to eight weeks to get back to the doctor, the patient has to make another appointment with the surgeon to find out if the procedure is warranted. From there an appointment is made, which usually takes two to three months. So from the time that one is aware of a serious problem, such a herniated vertebral disc until the time, the problem is actually dealt with, as much as a whole year can pass.
Other procedures can take longer, as in the case of hip or knee replacements, which can take three to four years of waiting.
Those Canadians who can afford it (including, by the way Paul Martin, our Prime Minister) will get their medical treatment at private clinics in the U.S. to avoid waiting. Often individuals who do this are vilified by other Canadians as "line jumpers", even though they jump the line outside the public healthcare system and pay for it themselves.
From where I sit, the U.S. healthcare system looks pretty good. Yes, it’s expensive, but the facilities are in place to provide care in a timely fashion. Those unable to afford medical treatment can still receive treatment provided at charity or county hospitals.
The Canadian healthcare system is currently threatening to collapse of its own inertia. Yes, it’s a good system we have here in Canada, so long as you make sure you never get sick. That’s why americans would be well advised to look at a more flexible system than ours.