The Canadian Healthcare System

THE CANADIAN SYSTEM:

- The Canadian healthcare system consists of a universal coverage system in which the doctors cannot legally practice as free agents and patients cannot legally purchase more speedy treatment.
- There is strict price/fee control as dictated by Ottawa by withholding transfer of funds.
- It consumes about 10.5% of the GDP which is higher than any other country in the world except the United States.
- It will soon consume a much higher percentage of the GDP as patients (some being high-tech fanciers) and doctors (some being ass coverers) favor the more expensive tests (albeit less sensitive) over the cheaper ones. Examples:
1. Almost no clinic/hospital offers ultrasound exam of the shoulder because of the low payment. Ultrasound and MRI can diagnose complete tears of the rotator cuff equally well. Ultrasound can differentiate between degeneration and partial tear very well and MRI not at all (not even after the injection of gadolinium [MRI dye] into the shoulder joint). Government payment for a shoulder MRI is about 70 to 100 times higher than that of an ultrasound exam.
2. Very few clinics in British Columbia offer barium enemas. Those that still do book only a few a week. This is in spite of reports in the past 6 years that the false negative rates for polyps of about 20% and 10% for colonoscopy and double contrast barium enema respectively. Government payment for colonoscopy is 10 – 15 times higher than barium enema. It is likely that fewer and fewer clinics will offer barium enema in the future.
- The Canadian system serves the Canadian politicians and media persons very well:
• There is absolutely no waiting for people in these two groups.
• People in these two groups get the care which rivals the best care available in any country in the world.
• People in the first of these two groups do not have to pay premiums - part of their benefits.
- It serves the general public poorly. The waiting list for the general public is longer than that in any other country in the world without any exception.
- "2-Tier" is a dirty word. This term is taken to mean that patients who can pay get better care than those who cannot afford to pay. However, before the Medical Care Act of 1966, there were private and public hospital/doctors in Canada. The best equipments and the most knowledge doctors were in the public system.
- "Extra-Billing" is not only a dirty word. It is illegal. A $1 and a $10 surcharge had been ruled illegal in Saskatchewan and British Columbia respectively.
- Universal coverage is motherhood.
- Unfortunately, "mother" sometimes abuses her children: Regarding patients from another province, their provincial government often denies payment for any service. Insurance policies of patients who recently move house are not honored. Same with policies of women who recently get married and assume their husbands’ last names. About 10 to 20% of patients do not show up on time (or not at all) for their appointments.
- "Children" sometimes abuse their mother: Many patients "forget" to pay their premiums. Diagnosis shopping is a common practice – patients keep visiting ER’s and walk-in clinics until a diagnosis he/she likes is reached. Demands for expensive tests such as CT scans are often made, when an ordinary x-ray would do. Same for a colonoscopy when an occult blood test may suffice.

Don’t get me wrong. Universal coverage is good, but not the Canadian version. There are ways to fix the Canadian system, but none is appealing to the Canadian politicians.

THERE ARE PROVEN HEALTHCARE SYSTEMS:
- There is a system in a country in Asia – Universal healthcare consuming about 1.5% of GDP. West-European class care. Little or no wait list.
- There are at least 4 other Asian systems – Universal healthcare consuming about 8.0% of GDP. West-European class care. Little or no wait list.
- There are at least 7 European systems – Universal healthcare consuming about 8.0% of GDP. West-European class care. Little or no wait list.

CONCLUSION: COPY THE CANADIAN SYSTEM? ANYBODY WHO THINKS THAT MUST BE OUT OF HIS/HER MIND!!!

SUGGESTION: Copy-and-paste the URL (as follows) of this article and send it to your congressperson. http://www.buzzle.com/articles/the-canadian-healthcare-system.html

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CONFLICT OF INTEREST STATEMENTS:
- I took early retirement a number of years ago.
- Currently, I’ve re-entered the work force and locum [substitute] at the rate of about 1 day a month for radiologists who are sick or need a last minute absence. I limit my practice to a clinic where barium enema is still offered. (Many clinics in British Columbia – including my former partnership – stopped doing barium enema years ago.)
- I do not have any child or a close relative who is a medical doctor.
- I have no plan to practice in the United States.