Posted on 03/19/2005 7:14:19 PM PST by Heartofsong83
By BETH DUFF-BROWN, Associated Press Writer
TORONTO - A letter from the Moncton Hospital to a New Brunswick heart patient in need of an electrocardiogram said the appointment would be in three months. It added: "If the person named on this computer-generated letter is deceased, please accept our sincere apologies."
The patient wasn't dead, according to the doctor who showed the letter to The Associated Press on condition of anonymity. But there are many Canadians who claim the long wait for the test and the frigid formality of the letter are indicative of a health system badly in need of emergency care.
Americans who flock to Canada for cheap flu shots often come away impressed at the free and first-class medical care available to Canadians, rich or poor. But tell that to hospital administrators constantly having to cut staff for lack of funds, or to the mother whose teenager was advised she would have to wait up to three years for surgery to repair a torn knee ligament.
"It's like somebody's telling you that you can buy this car, and you've paid for the car, but you can't have it right now," said Jane Pelton. Rather than leave daughter Emily in pain and a knee brace, the Ottawa family opted to pay $3,300 for arthroscopic surgery at a private clinic in Vancouver, with no help from the government.
"Every day we're paying for health care, yet when we go to access it, it's just not there," said Pelton.
The average Canadian family pays about 48 percent of its income in taxes each year, partly to fund the health care system. Rates vary from province to province, but Ontario, the most populous, spends roughly 40 percent of every tax dollar on health care, according to the Canadian Taxpayers Federation.
The system is going broke, says the federation, which campaigns for tax reform and private enterprise in health care.
It calculates that at present rates, Ontario will be spending 85 percent of its budget on health care by 2035. "We can't afford a state monopoly on health care anymore," says Tasha Kheiriddin, Ontario director of the federation. "We have to examine private alternatives as well."
The federal government and virtually every province acknowledge there's a crisis: a lack of physicians and nurses, state-of-the-art equipment and funding. In Ontario, more than 10,000 nurses and hospital workers are facing layoffs over the next two years unless the provincial government boosts funding, says the Ontario Hospital Association, which represents health care providers in the province.
In 1984 Parliament passed the Canada Health Act, which affirmed the federal government's commitment to provide mostly free health care to all, including the 200,000 immigrants arriving each year. The system is called Medicare (no relation to Medicare in the United States).
Despite the financial burden, Canadians value their Medicare as a marker of egalitarianism and independent identity that sets their country apart from the United States, where some 45 million Americans lack health insurance.
Raisa Deber, a professor of health policy at the University of Toronto, believes Canada's system is one of the world's fairest.
"Canadians are very proud of the fact that if they need care, they will get care," she said. Of the United States, she said: "I don't understand how they got to this worship of markets, to the extent that they're perfectly happy that some people don't get the health care that they need."
Canada does not have fully nationalized health care; its doctors are in private practice and send their bills to the government for reimbursement.
"That doctor doesn't have to worry about how you're going to pay the bill," said Deber. "He knows that his bill will be paid, so there's absolutely nothing to stop any doctor from treating anyone."
Deber acknowledges problems in the system, but believes most Canadians get the care they need. She said the federal government should attach more strings to its annual lump-sum allocations to the provinces so that tax dollars are better spent on preventive care and improvements in working conditions for health-care professionals.
In Alberta, a conservative province where pressure for private clinics and insurance is strong, a nonprofit organization called Friends of Medicare has sprung to the system's defense. It points up the inequities in U.S. health care and calls the Canada's "the most moral and the most cost-effective health care system there is in the world." "Is your sick grandchild more deserving of help than your neighbor's grandchild?" It asks.
Yes, says Dr. Brian Day, if that grandchild needs urgent care and can't get it at a government-funded hospital.
Day, an English-born arthroscopic surgeon, founded Cambie Surgery Center in Vancouver, British Columbia — another province where private surgeries are making inroads. He is also former president of the Arthroscopy Association of North America in Orlando, Fla.
He says he got so frustrated at the long delays to book surgeries at the public hospitals in Vancouver that he built his own private clinic. A leading advocate for reform, he testified last June before the Supreme Court in a landmark appeal against a Quebec ruling upholding limits on private care and insurance.
George Zeliotis told the court he suffered pain and became addicted to painkillers during a yearlong wait for hip replacement surgery, and should have been allowed to pay for faster service. His physician, Dr. Jacques Chaoulli, said his patient's constitutional rights were violated because Quebec couldn't provide the care he needed, but didn't offer him the option of getting it privately.
A ruling on the case is expected any time.
If Zeliotis had been from the United States, China or neighboring Ontario_ anywhere, in fact, except Quebec — he could have bought treatment in a private Quebec clinic. That's one way the system discourages the spread of private medicine — by limiting it to nonresidents. But it can have curious results, says Day.
He tells of a patient who was informed by Ontario officials that since Ontario couldn't help him, they would spend $35,000 to send him to the United States for surgery.
Day said his Vancouver clinic could have done it for $12,000 but the Ontario officials "do not philosophically support sending an individual to a nongovernment clinic in Canada."
Canadians can buy insurance for dental and eye care, physical and chiropractic therapy, long-term nursing and prescriptions, among other services. But according to experts on both sides of the debate, Canada and North Korea (news - web sites) are the only countries with laws banning the purchase of insurance for hospitalization or surgery.
Meanwhile, the average wait for surgical or specialist treatment is nearly 18 weeks, up from 9.3 weeks in 1993, according to the Fraser Institute, a right-wing public policy think tank in Vancouver. A Fraser study last year said the average wait for an orthopedic surgeon was more than nine months.
Prime Minister Paul Martin's Liberal government has pledged $33.3 billion in new funding to improve health in all provinces and territories over the next 10 years. But critics aren't impressed.
"It won't make a difference," said Sally C. Pipes, a Canadian who heads the conservative Pacific Research Institute in San Francisco. "They need to break the system down, or open the system up to competition."
Pipes is a big supporter of the Bush administration proposal to allow Americans to divert some of their payroll taxes into medical savings accounts. She claims the two-tiered system feared by Canadian liberals already exists because those with connections jump to the head of the medical queue and those who can afford it can get treated in the United States.
"These are not wealthy people; these are people who are in pain," said Pipes.
Another watershed lawsuit was filed last year against 12 Quebec hospitals on behalf of 10,000 breast-cancer patients in Quebec who had to wait more than eight weeks for radiation therapy during a period dating to October 1997.
One woman went to Turkey for treatment. Another, Johanne Lavoie, was among several sent to the United States. Diagnosed with invasive breast cancer in 1999, she traveled every week with her 5-year-old son to Vermont, a four-hour bus ride.
"It was an inhuman thing to live through," Lavoie told Toronto's Globe and Mail.
"This is the first time someone has decided to attack the source of problems — the waiting list," said Montreal attorney Michel Savonitto, who is representing the cancer victims. "We're lucky to have the system we do in Canada," he told the court. "But if we want to supply proper care and commit to doing it, then we can't do it halfway."
An estimated 4 million of Canada's 33 million people don't have family physicians and more than 1 million are on waiting lists for treatment, according to the Canadian Medical Association. Meanwhile, some 200 physicians head to the United States each year, attracted by lower taxes and better working conditions. Canada has 2.1 physicians per 1,000 people, while Belgium has 3.9, according to the Organization for Economic Cooperation and Development.
The World Health Organization (news - web sites) in 2000 ranked France's health system as the best, followed by Italy, Spain, Oman and Australia. Canada came in 30th and the United States 37th.
Alberta Premier Ralph Klein is pushing what he calls "the third way" — a fusion of Canadian Medicare and the system in France and many other nations, where residents can supplement their government-funded health care with private insurance and services.
But some Canadians worry even partial privatization would be damaging.
"My concern is that the private clinics would only serve to further drain the scarce physician resources that we already have," said Dr. Saralaine Johnstone, a 31-year-old family physician in Geraldton, a papermill hamlet in northern Ontario.
"We first need to guarantee that everybody has access to quality health care," she said, "and we just don't have that."
___
On the Net:
Government Health Council of Canada: www.hcc-ccs.com
Fraser Institute: www.fraserinstitute.ca
Canada Institute for Health Information: www.cihi.ca
Federal Ministry of Health: www.hc-sc.gc.ca
The US system is definitely not perfect, although seems to work better for the majority of the population. Private insurers and delivery should be an option, although I do believe that all working people, as well as disabled and seniors, should be guaranteed to at least basic, essential health care, funded privately or publicly.
Beth Brown better start polishing up her resume. She has attacked the holy grail of the liberal left, and they will not forgive her for this sacriligeous column.
I hope Hillary and co. are reading this as well.
Are you trying to say it in a positive or negative way?
Yeah for sure; your system has serious flaws too but copying the existing Canadian system will make things worse.
Even with such evidence they'll continue to hold up Canada and Cuba as such ideals of universal health care.
Totally positive (for our side). I cannot imagine seeing this column in an AP forum. This is more suited to the editorial page of the Wall Street Journal. She has committed a career ending move. This is too much truth for liberals to bear.
Familiar stuff and thanks for posting the warnings of socialized medicine.
Hordes of Canadians living near or far to the border with the US come to the states for treatment foregoing long often fatal waits. Even though they've been scammed for years by their govts, they are willing to fork over even more to get treatment in the US...or indeed anywhere.
A friend in pain in Toronto was told that his condition (gallstones) was low in priority and he would have to wait...in severe pain. He finally bit the bullet and came down to NYS and got relief in a week.
When taxes reached 30% in france (circa 1794), the royals lost their heads. Too bad the Canucks are such sheeple! Accepting the warm security of perpetual govt. care, but given a stone blanket.
(Denny Crane: "Sometimes you can only look for answers from God and failing that... and Fox News".)
I know that about 45% of provincial taxes go to pay for health care. For this garbage, that is just wrong.
That's correct. They should only fund such health care for those without private insurance, although they should strongly encourage private companies to fully cover everyone so no one is left behind. (Except for criminals and illegal aliens)
The universal free access to medical care in Canada is wonderful. There may be a waiting period for some and the system may generate it occasional anomalies, but... Overall it works! Big time!
How do you judge a country's success or failure?
As my late but still great high school history teacher,Mr James (Jim) H. Bocking, used to say:
You judge a country by how it treats its "have-nots" not simply by how it treats it "haves."
Let's have a bit more compassionate conservatism on this board!
My wife's nephew is just now beginning a career as a doctor in that system. His father has assured me that it is the best sytem for health care in the world. He is a brilliant, liberal educator.
Do I as a health-care provider, in this belief of yours, get guaranteed, basic and essential compensation to cover my costs of providing this guaranteed care along with a some profit to provide for my family for things like food, education and retirement?
I'll yet y'all know how it goes when my boy is born this July in a Toronto hospital. It went rosy last time with the first...
You gotta be kidding! I hope we never "improve" our system to be more like Canada. What about Canadians comming to USA for medical treatment?
That is on the issue of insurance, not delivery. The government would not be your employer.
Note that I would try to encourage private companies (or even religious organizations) to fully cover everyone; that is an extreme situation.
One problem is that free health care encourages people (especially hypochondriacs and the lonely elderly) to consume "routine services".
It's definitely frightening.
The worst part is that is quite "good" in the beliefs of the system; many have to wait up to 18 months or more!
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