Canada's Medical Nightmare

Canada's Medical Nightmare
September 1, 2004

For decades, Canadians have cast pitying glances at us poor American neighbors who actually have to pay for our medical care while they get theirs for "free."

Yet the major candidates in Canada's recent national election both agreed the country's health care system is failing. They made the usual socialist diagnosis of "not enough money." None of the candidates mentioned government control as what ails the Canadian system.

On this side of the border, Senator Edward Kennedy (D-Massachusetts), with presidential candidate Senator John Kerry, also from Massachusetts, in tow, promotes Canadian health care to U.S. voters, in the hope we too can have "free" medical care.



High Costs, Low Quality

A July 2004 study by the Vancouver-based Fraser Institute, Paying, More, Getting Less, concluded that after years of government control, the Canadian medical system is badly injured and bleeding citizens' hard-earned tax dollars. The institute compared health care systems in the industrialized countries in the Organization for Economic Cooperation and Development (OECD) and found Canada currently spends the most, yet ranks among the lowest on such indicators as access to physicians, quality of medical equipment, and key health outcomes.

One of the major reasons for this discrepancy is that, unlike the countries in the study that outperformed Canada--Sweden, Japan, Australia, and France, for example--Canada outlaws most private health care.

If the Canadian government says it provides a particular medical service, it is illegal for a Canadian citizen to pay for and obtain that service privately. At the same time, the Canadian government bureaucracy rations medical services. According to another Fraser Institute survey, Waiting Your Turn: Hospital Waiting Lists in Canada (13th edition, October 2003), a Canadian health care patient, on average, must wait 17.7 weeks for hospital treatment. Those who live in Saskatchewan waited an average of 30 weeks, those in Ontario a relatively expeditious 14 weeks.



Dying in Queues

In 1999, Dr. Richard F. Davies, a cardiologist at the University of Ottawa Heart Institute and professor of medicine at the University of Ottawa, described in remarks for the Canadian Institute for Health Information how delays affected Ontario heart patients scheduled for coronary artery bypass graft surgery. In a single year, for this one operation, the doctor said, "71 Ontario patients died before surgery, 121 were removed from the list permanently because they had become medically unfit for surgery," and 44 left the province to have the surgery, many having gone to the United States for the operation. (According to the Canadian Institute for Health Information, 33 Canadian hospitals performed approximately 22,500 bypass surgeries in 1998-99.)

In other words, 192 people either died or became too sick to have surgery before they could work their way to the front of the line.

In a May/June 2004 article in the journal Health Affairs, researcher Robert Blendon and colleagues described the results of a survey of hospital administrators in Australia, New Zealand, Great Britain, the United States, and Canada. Fifty percent of the Canadian hospital administrators said the average waiting time for a 65-year-old man requiring a routine hip replacement was more than six months. Not one American hospital administrator reported waiting periods that long. Eighty-six percent of American hospital administrators said the average waiting time was shorter than three weeks; only 3 percent of Canadian hospital administrators said their patients had this brief a wait.



Bare-Bones Health Care

Barring epidemics and other disasters, fewer than one out of 10 people in prosperous societies will face a major medical crisis in any one year. Those suffering people, however, are the ones who need help the most, and the aging of the baby boomers in the United States makes it likely more serious illnesses will afflict more Americans in the next couple of decades. The kind of minor health care services the Canadian system provides well are not what America's aging Baby Boomers will need most urgently in years to come.

America's health care system already includes too much Canadian-style bureaucratic delay and inefficiency. For example, the slow acceptance by Medicare and Medicaid of medical innovation, their exacting paperwork requirements, delayed and low payments of claims, and the threat of overzealous prosecution by health care bureaucrats are driving doctors out of business and giving patients fewer medical options.

Fixing those flaws would seem to be a much more promising prospect than a further move down the road Canada has followed to high costs and low quality of health care.


Robert J. Cihak, M.D. (think@heartland.org) is a senior fellow and board member of the Discovery Institute and past president of the Association of American Physicians and Surgeons.