It started with migraines. Now Canadian woman is having brain surgery - "A chiropractor who faced a two-year wait for an MRI scan after presenting symptoms of an acoustic neuroma is frustrated with the pace of medical care in her home province of Newfoundland. "There were delays along the way,” Alanna McDonald told the National Post. “Pretty much at every step. My tumour is three centimetres. If we’d gotten a diagnosis sooner I would have had other treatment options. But because it’s so big now I have to have surgery.”... “In Newfoundland family doctors can’t send for an MRI,” McDonald said. “It has to be through a specialist. So my family doctor did what she could do, and when I started to get some facial numbness she sent me to see an ENT (ear, nose and throat specialist) because he could send for more testing. But of course there’s a wait time to get in to see the ENT, so that took me a couple of months.” That doctor was able to send her for an MRI scan, but the wait time for that, since her condition still wasn’t considered urgent, was on the order of two years. A recent report by the Fraser Institute highlights the issue of MRI wait lists. It found that, across Canada, wait lists for MRI scans had a median of 12.9 weeks, which was two weeks longer than the previous year, and the longest on record in at least a decade. Much of that has to do with simple supply and demand. The same report found that, in 2019 (the latest year of available data) Canada placed 25th out of 29 similarly developed countries, with 10.3 MRI units per million population, well below the average of 18.3 per million, and far behind leaders such as Japan, Korea and Germany, which had more than 30 per million."
Why these doctors support Doug Ford's plan for private surgical clinics - "Ontario's Ministry of Health is currently laying the groundwork for the creation of what it calls community surgical and diagnostic centres, to open later this year. The centres will perform OHIP-covered procedures such as hip and knee replacements and MRI scans. The clinics could be privately owned. Ford and Health Minister Sylvia Jones insist that no Ontarian will have to pay for surgeries or scans in these facilities. Despite that, the government's plan is drawing criticism for allowing the private sector to profit from the publicly funded health system. CBC News did in-depth interviews with three Ontario physicians who believe that criticism is misplaced. They argue creating these clinics will increase the availability of procedures that typically have months-long waiting lists, making life better for patients. The most fundamental reason the three physicians put forward for supporting the creation of the clinics is that they predict they will shorten the time that patients spend waiting for procedures. "When you restrict surgeries to being only done in the hospital, it limits the access for patients," said Dr. Brian Rotenberg, a surgical specialist in otolaryngology (ear, nose and throat) , who also runs Surgical Services Ltd., a consulting firm with expertise in launching independent surgical clinics. Dr. David Jacobs, a radiologist and president of the Ontario Association of Radiologists, says independent clinics will bring efficiencies in the cost of delivering care and reducing wait times. "We are lacking access to care in Ontario," said Jacobs. "We have to decide whether we are going to take an ideological approach to healthcare or whether we're going to take a pragmatic approach." Dr. Bob Litchfield, an orthopedic surgeon and a professor of surgery at Western University, says Ontario's health system provides timely care for such things as trauma and cancer, but falls down when it comes to many other procedures. "I think we just should just take that on as a challenge to really look in the mirror and say can we do better," he said. The latest Canadian data shows Ontario has the best record among the provinces on patients getting hip and knee replacements within the national benchmark of six months, and the shortest median wait for an MRI. However, Canadian wait times (including Ontario's) for such procedures are significantly longer than what patients face in other countries with universal healthcare systems. The doctors point to such countries as the Netherlands, Sweden and Australia, where publicly funded surgeries and scans are delivered in private sector clinics outside of hospitals. "This model of care does exist all around the world," said Rotenberg. "We're way behind the times." Jacobs says comparable health systems in other countries provide patients better access to medical procedures and show better population-wide health outcomes... Litchfield says the private delivery of publicly funded healthcare in those systems takes pressure off public hospitals... One of the fundamental arguments made by critics of Ontario's plan is that creating new operating rooms in independent clinics doesn't actually increase the number of surgeons, nurses and medical technicians needed to perform those operations. They argue that Ontario patients are waiting too long for surgery because of a scarcity of health care professionals, and ask: when surgeons and nurses leave hospitals to work at independent clinics, how will that improve things? The doctors say the vast bulk of Ontario surgeons have the potential to spend more time during their weeks actually performing surgery, but are limited by the availability of staffed operating rooms. "
When left wingers don't know that the private sector already plays a huge part in the healthcare system, and the US is not the only other country in the developed world, because they hate the private sector more than they want better healthcare
Tasha Kheiriddin: Trudeau brings in substandard pharmacare to stay in power - "the NDP aren’t the only ones paying politics with this deal. The Liberals are as well, starting with the choice of contraceptive and diabetes medication as the first drugs to be covered. Contraception is a relatively low-cost item for the feds: it’s already fully covered in B.C. and Manitoba, and partly covered in Ontario. Most private health plans — which four in five Canadians have — pay for it as well. More importantly, the coverage appeals to a key voter demographic — women — that the Liberals need to get back. The latest polls show that 36 per cent would vote Conservative, compared to 26 per cent who would vote Liberal. As for diabetes, that is also a numbers game. Nearly ten per cent of Canadians — six million people — suffer from the disease, with an additional six million classified as “pre-diabetic.” Rates are even higher among seniors (20 per cent) and First Nations populations on reserve (17 per cent). Almost everyone knows someone with diabetes and knows that insulin is a life-saver. But that doesn’t mean you need universal pharmacare to cover people who can’t afford it. It’s like bringing in a $27 billion-dollar bazooka to kill a fly. A study released last week by the Montreal Economic Institute found that only 2.8 per cent of Canadians currently have no drug coverage whatsoever. Twenty-five million people have private insurance, and existing provincial plans subsidize or cover a host of medications for persons who do not, including low-income patients and seniors. The study also confirmed that imposing a single-payer universal drug insurance plan would jeopardize the quality of coverage for at least 21.5 million people. That’s because a single-payer model would not fund many medications currently covered by private plans, including innovative medicines. Based on the experiences of countries like New Zealand , cutting edge drugs won’t be introduced into the Canadian market at all, because a universal plan would deem them too costly. A 2019 report commissioned by Medicines New Zealand ranked the country last for access to medicines and pharmaceutical investment among 20 OECD nations. Of 304 medicines introduced between 2011 and 2017, New Zealand funded only 17. Life-saving cancer therapies and other innovative medicines were rendered unavailable. In other words, national single-payer pharmacare will consign Canadians to the same problems as national single-payer medicare: lack of choice, rationing of care, and worse outcomes. Instead of keeping what works and fixing what’s broken, the NDP chose to score political points, and the Liberals bought themselves another year in power. So kudos to Alberta and Quebec for standing up and opting out. Let’s hope other provinces join them and expose this deal for what it is: a political game that leaves patients in the cold."
1 in 4 Ontarians could be without a family doctor in 3 years due to 'worsening crisis': survey - "The Ontario College of Family Physicians (OCFP) revealed in its survey that the province could see a mass exodus of family doctors leaving their clinics – or reducing their hours – with about 65 per cent planning to do so within in the next five years. In the survey, 94 per cent of family physicians said they “overwhelmed” by the administrative work as it can take up to 40 per cent of their time each week."
Damn conservative governments underfunding healthcare! Clearly this cannot be linked to high administrative costs in the system
We fled to the U.S. after long waits, misdiagnosis in Canada - "For months we’d been struggling to get Zena an MRI in the Toronto area, the scan obligatory to obtain an appointment with one of Canada’s chronically overburdened spinal surgeons. As she waited, Zena’s ability to walk grew progressively weaker and her hands burned with a constant tingling sensation. The best our family doctor could obtain was a scan on Sept. 29, three months after the physician submitted a requisition. I finally persuaded a radiologist I got to know during my years as a National Post health reporter to wrangle Zena a somewhat expedited MRI slot at his Toronto-area hospital — only for her problem to be misdiagnosed there. Meanwhile, a sit-down with a spine specialist still seemed a far-off, uncertain prospect. Frustrated and increasingly worried, we arranged for 62-year-old Zena — an accomplished print and broadcast journalist — to see Stoffman after first undergoing an MRI at a Buffalo clinic, all at our own expense, of course... He finished the appointment by grabbing my phone and urging our family doctor’s office to urgently find Zena help in Toronto. The message got through. A day and a half later, she underwent emergency, 10-hour-long surgery at Toronto Western Hospital, led by one of the world’s leading experts in the field. Most of the tumour was excised and several of her vertebrae were essentially rebuilt with titanium implants, launching Zena on a treatment journey that has been encouragingly successful. That was Sept. 9. The MRI appointment our family doctor had arranged through regular channels was still three weeks away. Three weeks in which the expanding tumour could well have wreaked even more havoc. Untreated, such growths impinging on the spinal cord can lead to permanent paralysis or death, says the Mayo Clinic. Zena, thank God, avoided that fate. But what about patients less fortunate than us, those who lack the means to pay for care in the United States, or the connections to work the system here? And what if Zena had been properly diagnosed earlier, possibly negating the need for risky surgery? I spent over 10 years covering health care for the Post, often reporting on medicine’s failings. But even I’ve been conditioned as a good Canadian to believe our system always comes through when truly needed. Once Zena finally made it into the system, her care was indeed prompt, compassionate and high-quality. But her experience until that point was a rude awakening, a reminder of what can and often does go wrong. My wife did well in the end. She’s back to walking normally, the burning-tingling is much better and oncologists are on top of the cancer. But I believe her case was a near miss. This is the story of the particular health-care shortcomings Zena encountered — just one part of a broader, troubled picture — and how they might be fixed. Doctors and another patient I interviewed for this story all expressed dismay at what happened to my wife. None of them was surprised. Wait times for MRIs, CT scans and other medical imaging, always bad, are becoming a “crisis,” say radiologists. The shortage of spinal surgeons and the hospital infrastructure they need to operate has led to waits for elective procedures of up to two years, even as some surgeons, remarkably, go unemployed. From his perch across the border, Stoffman said the situation in Canada seems to be growing ever more dire... Patients dealing with third-party payors — workers compensation, insurance companies, employers, NHL teams and the like — can access private imaging clinics that work surprisingly fast. Most claim to offer a scan within a couple of business days — yes, days, not months. But they were out of bounds for us: it’s against the law for the clinics to serve patients suffering a condition that’s covered by medicare... Bizarrely, much of the medical system still relies on facsimile transmissions... Canada ranks 12th among 16 higher-income countries in the number of MRI machines per capita, the Commonwealth Fund reported in 2020. The United States had almost four times as many MRI systems for each million citizens as Canada; Japan five times more. The most pressing problem, though, is a shortage of technologists, the professionals who actually operate the equipment, their ranks thinned by an all-time-high job vacancy rate. There are too few programs to train them, and those schools that do exist struggle to achieve full enrolment... Six provinces — British Columbia, Alberta, Saskatchewan, Quebec, Nova Scotia and New Brunswick — already allow anyone to purchase private CT or MRI scans out of pocket, sometimes in violation of federal health laws. Saskatchewan requires private clinics to offer a free scan to a patient in the public system for each one it sells outside it. British Columbia’s NDP government has recently limited its private tier of medical imaging. For Vancouver’s Snyman, however, it has been a Godsend... A fascinating 2019 study co-authored by Rampersaud found that New York state performed three times as many elective spine operations per capita as Ontario. The paper suggests the American system does too many surgeries — risking either no benefit or actual harm for some patients — and Canada too few."
Canada Healthcare Funding Not Based on Patient Services - "Virtually every other developed country with universal healthcare has moved to funding hospitals based on services provided to patients, while Canada remains one of only a handful of countries that funds hospitals primarily with lump sum payments, regardless of how many patients they treat"
Rohana Rezel 🐘 @rohanarezel@vindi.ca on X - "Canada's population has grown by 6 million over the past 10 years. In that time, Canada added 50 medical residency spots. Why are we acting all surprised that our healthcare system is collapsing? #cdnpoli [Source: Canadian Resident Matching Service (CaRMS)]
TBC: They have only added 50 extra spots for Canadian medical graduates (CMGs). They've added 120 or so more spots for international medical graduates (IMGs) and US Medical Graduates (USMGs)."
Clearly, Conservatives have been in power all across the country for 10 years
Would you cross the border for health care? 42% Canadians say yes in poll - "42 per cent of respondents would go to the United States and personally pay for more routine health care if needed. That is up 10 percentage points compared with January 2023. And 38 per cent of respondents said they would travel to the U.S. and personally pay for emergency care (up nine points from a year ago). “I think the increase is happening because of the increasing level of frustration that Canadians have in the health-care system,” Sean Simpson, vice-president of Ipsos Public Affairs, told Global News. “It’s not the quality of care that that people are upset about, it is the timely access to care, meaning wait times in emergency rooms, wait times to see specialists, to get appointments, for screening. As a result, we have a significant chunk of the population say if they can get that service elsewhere, such as the United States, they may consider doing so.”... 58 per cent of respondents suggested that provinces ought to present a detailed plan to the federal government outlining their strategies for improving health-care delivery in exchange for increased funding. “Canadians increasingly believe that more money simply isn’t the solution,” Simpson said. “We’ve been throwing more money at the health-care system … and yet Canadians aren’t receiving any improvement as a result of those investments.”... The Ipsos poll also examined Canadians’ attitudes towards the privatization of health care, a concept that Ontario, has been increasingly exploring. In the poll, 63 per cent of respondents said they would support private health care for those who can afford it. And 60 per cent said they would support private delivery of publicly funded health services."
The Weekly Wrap: It’s time to have the private health-care conversation - "nearly two-thirds of Canadians say that they’re in favour of “two-tier” health care which no politician is actively proposing. It signals that the political class is well behind the public and represents the conditions for an enterprising politician to advance a more ambitious agenda. We certainly need it. Not only are general wait times at an all-time high, but we’re now increasingly encountering on a daily basis excruciating stories of 20-hour emergency room waits, large-scale hospital overoccupancy, and adverse health consequences, including avoidable deaths. The facts overwhelming point in the direction of some kind of market-based reform. Polls show that Canadians instinctively understand it. Yet too many politicians dogmatically cling to the status quo even as the system collapses around them. Federal health minister Mark Holland for instance recently said that “we’re not going to allow that [greater private delivery] to happen.” This isn’t an expression of evidence-based policy. It’s a quasi-religious statement. Holland and to be fair a lot of politicians—including some conservatives—are seemingly prepared to trade off worse health-care outcomes in exchange for a false fidelity to the principle of equality—even if it ultimately means equal misery and suffering. Conservatives often get accused of being ideologues in today’s political climate. But is there anything more hyper-ideological than defending a system that’s self-evidently producing such bad outcomes and that a majority of Canadians say requires fundamental reform? It’s like persisting in the view that the earth is flat long after it had been proven otherwise. Some day people will no doubt look back on the past 30 years of health policy debates in Canada and think that we were crazy. We’ve collectively accepted an egalitarianism of poor outcomes even though various other jurisdictions have matched our commitment to equality without people dying because of rationing and scarcity. The Ipsos poll tells us that this attachment to a failed system isn’t an example of the public wagging the dog. It’s a case of elite failure. Hard-core ideologues in politics and universities (including law deans and medical school chairs) have substituted their own political preferences for the rest of us. The outcomes have been tragic in some cases."
Meme - Rupa Subramanya @rupasubramanya: "A microcosm of the current dysfunction in Canada."
The Ottawa Hospital: "To better meet the diverse needs of the community we serve, our hospital now provides all patients with adhesive bandages that complement a variety of skin tones. mm We've got you covered:"
Denyse O'Leary @itsdesign: "My ears ring with complaints like 1) My doctor is retiring and I can't find a new one 2) I have to wait two months to begin cancer treatments 3) I go to the ER every week but can't get a pacemaker. And THIS is a priority?! A classic in luxury beliefs."
Damn conservative premiers underfunding healthcare!
Opinion: The failure of Canada’s health care system is a disgrace – and a deadly one - The Globe and Mail - "you don’t get to claim a purportedly universal system is working when more than one in five Canadians don’t have a family doctor, which renders Canada dead last among wealthy nations in terms of access to primary care. You can’t claim a system is working when we spend more per capita than our peers and receive less (so let’s drop the lazy refrain that our system is struggling because we don’t fund it enough). And you can’t claim a system is working when an infant having a bad allergic reaction has to wait 11 hours to be seen, or a teen has to wait 19 hours for an emergency appendectomy. If your “universal” system is routinely subjecting vulnerable people to extreme forms of suffering, then the system itself is a failure. Indeed, it’s more than that: it’s a disgrace that is having deadly consequences. For years, experts have proposed various ways to overhaul the system. Former health minister Jane Philpott just released a book proposing we treat primary care as we do education: as a legal right, where access is assigned by postal code. Susan Martinuk from the Frontier Centre for Public Policy suggests a hybrid private/public system modelled after those in other developed nations. Experts with the C.D. Howe Institute released a 13-point plan for health care reform last year. But instead, our government is announcing plans for free birth control pills and a new dental care scheme that dentists don’t seem to want to partake in. We can’t even get the basics right, and we’re adding new programs on top. This is insane."
The failure of Canada’s health care system is a disgrace – and a deadly one : r/canada - "Health care has been deteriorating in Canada for at least 30 years, in all ten provinces. Throughout that period, every province has undergone changes of government. Yes, even Alberta. There have been blue, red, and orange governments take kicks at the can everywhere across the country. There have been both blue & red federal governments as well. The one common denominator is that health care keeps getting steadily worse. It's an emergent property of the system as a whole and cannot be laid at the feet of any one government in any one province in any one time period."
The failure of Canada’s health care system is a disgrace – and a deadly one : r/canada - "Provinces also devote nearly 50% of their budgets to healthcare and that number is growing. It’s why there’s poor long term planning and why other areas are underfunded (education, infrastructure, justice). It’s both too much and not enough and unfortunately no one likes the answer to this paradox."
The failure of Canada’s health care system is a disgrace – and a deadly one : r/canada - "Imposing a temporary pause in government worker wage increase isn't "breaking a system". Many of us in the private sector do not get automatic wage increases every year, like government employees. Governments all over the world cap public servant wages in times of austerity. Besides, as I've mentioned, Bill 124 expired last year and no longer applies, I don't know why you keep on referencing a bill that expired? If Liberals/NDP think yelling out about bill 124 will somehow get them elected they have another thing coming - they tried that in 2022 and lost big time. Both health care and education are well funded in Canada, across the provinces. I'll happily cite the data to you but it's clear that you are only interested in misleading information and half truths supplied by the unions. You also inadvertently proved my point, since parents can opt to pay for private education for schooling, why shouldn't they be able to pay for private health care? Europeans look at health care like this, and so should Canadians. And I hate to break this to you, but reposting the sources you did previously doesn't prove your point. Your article cites data from Quebec, not Ontario, so it's not even relevant anyways."
The failure of Canada’s health care system is a disgrace – and a deadly one : r/canada - "I'm not proposing anything. I'm just saying that simply throwing funding at the system won't solve anything. As far as I am concerned the issue lies with gatekeeping, rent- and profit seeking within the medical fraternity itself. No amount of outside managerial help will solve anything in that case. https://www.ibisworld.com/canada/industry-trends/industries-highest-profit-margin/ Don't get me wrong, I think medical companies and professionals should be allowed to make profits, but they shouldn't be allowed to do it on the back of a government enforced monopoly. You should get to choose one: Either the government funds critical aspects of your industry or the government enforces a monopoly powers for it. But having monopoly power and then expecting to extract limitless social funding on your say-so (no outside experts are allowed to comment) is not a sustainable solution for any problem. Worse when society makes or breaks political careers based on how much your industry says it needs or deserves to provide the monopoly service."
The failure of Canada’s health care system is a disgrace – and a deadly one : r/canada - "The problem is in trying to govern things that shouldn't be governed and not governing things that should. The healthcare problem in Canada is a function of the monopoly problem in Canada. Both, in turn are the result of a marriage between a conviction that government action is the solution for all problems and a government that is largely unaccountable and incapable of anything but putting a pretty convincing spin on siphoning more money to their buddies. Spin is a great skill, don't get me wrong. But it's not the sort of thinking that solves problems in service provision."
The failure of Canada’s health care system is a disgrace – and a deadly one : r/canada - "Dishonest rubbish like that headline is why journalists are now correctly hated as much as politicians themselves. "Ford government allocating $21B less to fund health care" What the report actually says: "the Province has allocated $21.3 billion less than will be needed to fund current health sector programs and deliver on its program expansion commitments in hospitals, home care and long-term care." Emphasis my own. More from that report: "The Province has committed to make significant investments to expand capacity in hospitals, home care and long-term care. However, these increases in capacity will be more than offset by increases in demand for these services from Ontario’s growing and aging population. Relative to projected growth in demand, by 2027-28, Ontario will have less hospital capacity, similar home-care capacity and less long-term care capacity compared to what it had in 2019-20." Ontario's healthcare budget is and has been going up. Some of the increases in recent years were the largest percentage increases in the province's history. The health care budget is still going to be $21 billion short of what would be needed despite those increases, because demand is exploding faster than the budget can possibly keep up with. This is yet another consequence of liberals treating immigration like a form of charity toward poor third worlders, where more is always better."
The failure of Canada’s health care system is a disgrace – and a deadly one : r/canada - "We have 10 times the number of admin positions in our healthcare system compared to Germany, per capita."
Naturally, someone tried to dismiss this with an unsubstantiated ad hominem
The failure of Canada’s health care system is a disgrace – and a deadly one : r/canada - "Yes. I work in "healing" in government funded agencies. 98% of the money is spent having lunches, photo ops, SM managers posting "inspirational" messages, lavish AGMs, etc. Almost NOTHING goes to proving services. I worked at a local "neighborhood" charity with 20 employees. I had access to client reports going back 4 years. There was not a single individual helped. The totality of 4 years of "housing outreach" was a single ID request form filled out. I'd get 400 emails a day. All of them from other agencies calling us to "join them in their celebration" of whatever the fuck."
"Is there no one above monitoring results and demanding value out of the money invested? That seems like basic economic principles and yet our country just keeps throwing money at issues without doing the bare minimum of making sure that this funding is generating results. These organizations should be accountable for showing that every dollar spent has gone towards its intended purpose and created value for the community. Especially as the pool of taxpayers is set to shrink drastically with the retirement of the baby boomers getting the most value out of every taxpayer dollar should be a huge priority for the government. Instead we're seeing the opposite."
"We have a crisis? Let’s spend 5 billion! We have another crisis? Let’s spend 10 billion! Wait, those problems never get solved? That must be because of underfunding. Let’s double the money we spend!"
The failure of Canada’s health care system is a disgrace – and a deadly one : r/canada - "they were cutting positions essential to the ER last year, and admin came down saying they have no other solutions. I told them that the cuts should be happening to non-patient facing personnel first, "Primarily admin". She looked shocked. Admins, thank you for your work, but when there are 10 layers of personnel to one decision, that's a no. And when the baton of burden is passed onto those who actually do the work, infringing on that in any way, personnel, resources, psychic capacity, remuneration, is a travesty."
"No one in the history of management has ever looked in the mirror and said oh yeah we are the problem we should fire ourselves."
"In a private company, the problem solves itself when the company goes bankrupt. In a public system, it just keep getting worse and worse until the country fails."
Opinion: National pharmacare will reduce drug access for almost 26 million Canadians - "Granted, pharmacare will move all Canadians into a single system modelled on existing public drug plans. To examine how this might affect access to medicines, I compared the number of new drugs covered under public versus private drug plans and how long Canadians waited for insured access to those drugs. The analysis used data from the leading source of pharmaceuticals market information, IQVIA Inc., as well as provincial and federal formularies. The evidence is clear: coverage for innovative drugs is better and faster in private than public plans"
