As Canada's Slow-Motion Public Health System Falters, Private Medical Care Is Surging - New York Times

As Canada's Slow-Motion Public Health System Falters, Private Medical Care Is Surging - New York Times
By CLIFFORD KRAUSS
Published: February 26, 2006

Article about waiting times in Canada: below are responses from Physicians for a National Health Plan's Nicholas Skala:

1. This writer is well known for peddling fake data, and this story is no exception. For his outrageous waiting time estimates, he uses data supplied by the Fraser Institute, an ultraconservative PR firm that masquerades as a legitimate research institution. Dr. Robert McMurtry, the Canadian orthopedic surgeon who is a former dean of a Canadian medical school and served on the national waiting times commission tells me that not even the right wing Canadians take them seriously. Their “scientific” method of determining wait times consists of bulk-mailing a list of pro-privatization physicians and asking them how long they think their patients will have to wait to see them. If they return the mailing they are entered in a drawing to win a $2,000 cash prize. It’s pathetic. Unsurprisingly, Fraser comes up with outrageous waiting time estimates (17.8 weeks last year, as I recall), and is quite adept at publicizing them in the American media. Wait times are scientifically measured every year by Statistics Canada (the counterpart to the U.S. Census Bureau). I’m sure most Americans would be surprised at the results of scientific measurement: In 2005, median wait times were 4 weeks for elective surgery, 4 weeks for specialist care, and 3 weeks for diagnostic tests.

http://www.statcan.ca/Daily/English/060131/d060131b.htm

Also, the Canadian Health Services Research Foundation has done a short, scholarly critique of Fraser’s methods and compared them with real studies. (In fact, I think they’re far too kind to Fraser).

http://www.chsrf.ca/other_documents/newsletter/qnv1n4p4_e.php

2. The Supreme Court decision was bad for a number of reasons, and since has been near universally derided in the Canadian press. Follow this link:
http://www.pnhp.org/single_payer_resources/Canadian%20Supreme%20Court%20Ruling.pdf

3. As far as proposals to create a parallel private system, compelling evidence shows that more private participation leads to longer waiting times and lower quality care because 1) private insurers “cherry pick” healthy and profitable patients and leave the sick and poor to the public system and 2) physicians have a perverse incentive to move to the private sector (where they make more money), draining the public system of capacity and resulting in lower-quality care (and eventually creating a self-fulfilling prophecy for the right wing, because they then say the public sector can’t do anything right).

The Canadian Health Services Research Foundation has a couple of great fact sheets on this too.
http://www.chsrf.ca/mythbusters/pdf/myth17_e.pdf
http://www.chsrf.ca/mythbusters/pdf/myth13_e.pdf
http://www.chsrf.ca/mythbusters/

Finally (and kind of philosophically), there is a reason that rationing in Canada gets so much attention in the media. Its because the Canadian health system is held publicly accountable. Grievances aired in public are likely to be addressed by policymakers (and in many cases have, as waiting times for many procedures have dropped dramatically). This is a foreign idea to us in the U.S., where the operation is exactly reverse: no one is ultimately accountable, and the forces that profit from the system have every reason to keep problems quiet. And so, although rationing (based on the ability to pay) in the United States kills at least 18,000 Americans every year (according to the Institute of Medicine’s most conservative data…Himmelstein and Woolhandler estimate it may be 10 times that many), our media acts as though Canada’s the place with the problems.

Hope this helps.

nick

Nicholas Skala
PNHP Staff

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