Sunday, July 26, 2009

Canadian Healthcare Haters’ Club….The Wait Time Delusion.


Late last week, I came out of the RailGate bubble just long enough to get really pissed off about this 'Canadian HealthCare Haters Club, Inc.' business that 'pale' at 'A Creative Revolution' writes eloquently and comprehensively about here.

Anyway, as a result I wrote a couple of posts about one of our own who has been shilling for the Haters' Club headboy, Rick Scott, and his friends.

And then I cross-posted those screeds, in a slightly different form, over at Firedoglake, which is an American progressive site that is really doing it's best to try and force Democratic legislators (ie. the ones that are supposed to be on their side) to do the right thing on healthcare reform down there.

The result was some really good discussion, but it quickly became clear to me that a real bogeyman, even amongst progressives, is this business about how wait times are so much worse in Canada than in the States.

Below is how I responded......


Hi FDL'ers.

As a Canadian who has lived in your country, I got mighty upset when I saw my fellow countryperson, Ms. Shona Holmes, acting as a shill for the Canadian Healthcare Haters' Club, Inc.

So I wrote a couple of diaries about it here and here.

Which led to some good discussion, much of which seemed to center around wait times which, I've come to learn, is something that seems to be spooking even progressives.

As a result, I tried to write something realistic in response that goes like this:

First off, let me say the following (skip the next passage if you want to get straight to the answer)…..When we lived in the States I worked for a University and had what, I now understand (but didn’t then) is a Cadillac plan….We had our first kid down there and the care was very, very good….but, overall the co-pays and the nickle-and-diming with just about every visit and every prescription just about drove me crazy (I was a post-doctoral fellow so, even though I got the benefits, my actual pay was crap)…. And then, when I had an old chonic problem of my own flare up, it took some time, but not an unreasonable length of time, to get referred to the required specialist….I knew precisely what I needed (given my past experience with a similar specialist up here in Canada) but this guy, a staffer with the HMO, hemmed and hawed and ultimately would not give it to me (it involved a course of expensive antibiotics). Instead, he handled the problem very conservatively and it took much longer to resolve than I was used to… So, what’s the point?….Well, in Canada, where the system is Universal, when something like that happens you can go back to your family doctor and ask for another referral…Nobody at the HMO would help me do anything as crazy as that, so I just waited it out (nothing life-threatening, just a pain the, almost literally, rear end).

Now, getting right down to wait times….Anything urgent is dealt with immediately….Anything truly elective is most definitely not dealt with immediately…In between, say a knee ligament reconstruction after you’ve hurt yourself running around on the softball field, is where it becomes greyer.

However, overall, in my experience the following passage, from another border straddler named Rhonda Hackett who wrote a very good piece recently in the Denver Post that every American who has nagging concerns about really going for Universality and/or a true Public Option should read called ‘Debunking Canadian Healthcare Myths’:

Myth: There are long waits for care, which compromise access to care.
There are no waits for urgent or primary care in Canada. There are reasonable waits for most specialists’ care, and much longer waits for elective surgery. Yes, there are those instances where a patient can wait up to a month for radiation therapy for breast cancer or prostate cancer, for example. However, the wait has nothing to do with money per se, but everything to do with the lack of radiation therapists. Despite such waits, however, it is noteworthy that Canada boasts lower incident and mortality rates than the U.S. for all cancers combined, according to the U.S. Cancer Statistics Working Group and the Canadian Cancer Society. Moreover, fewer Canadians (11.3 percent) than Americans (14.4 percent) admit unmet health care needs.

Hope this helps you all.

Sorry to be so verbose about all of this, but I’ve just got to reiterate the central tenet of the Canadian system that I mentioned in my original post…..We never worry….We may gripe sometimes…..But we never worry….For example, want to change jobs?…..We don’t worry about losing our coverage…..Lose your job?….We don’t worry about losing our coverage….Get sick?…..We don’t worry about losing our house to pay the hospital bills….Why?…Because the thing is completely portable and it’s always there.OK?

Best of luck with the battle.


Oh, and if you want the real hard stuff, from a guy I like to call our own version of Steve Gilliard, check this out..



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