MyFoxCleveland

The Health Care Quality Problem
So what has happened in Canada? Why is it that we've gone from being very bullish on this health care system to having great reservations? Part of it is that Canadians read newspapers, and it doesn't much matter whether you're on the west coast or the east coast; it doesn't much matter whether you're a Globe and Mail reader, or a National Post reader; every single day, there are stories describing the system.

I've just randomly chosen a few stories that have come to light recently.

The head of trauma care at Vancouver's largest hospital announces that they turn away more cases than any other center in North America. He's quoted as saying this would be unheard of in the United States.

In Manitoba, which is my former home province, the premier--the political equivalent of a governor--concedes that his pledge to end hallway medicine has fallen short. Hallway medicine is the phenomenon where the emergency rooms are so filled with patients that people are forced to lie on stretchers in hallways, often for days. Overcrowding is a periodic problem. In fact, the overcrowding is worse than last year. The community is rocked by the death of a 74-year old man who had waited in the emergency room for three hours and had not been seen.

New Brunswick announces that they will send cancer patients south to the United States for radiation therapy. New Brunswick, a small maritime province, is the seventh to publicly announce its plans to send patients south. In the best health care system in the world, the vast majority of provinces now rely on American health care to provide radiation therapy. Provinces do this because the clinically recommended waiting time for treatment is often badly exceeded. Ordinarily, oncologists suggest that there should be a two-week gap between the initial consult by the family doctor and the referral to the oncologist, and then two weeks more from the oncologist to the commencement of radiation therapy. In most Canadian provinces, we exceed that by one to two months, sometimes three.

In Alberta earlier this year, a young man dies because of the profound emergency room overcrowding. He is 23. On a winter's night, he develops pain in his flank and goes to the local emergency room. It is so crowded that he grows impatient and goes to another. There, he waits six hours. No one sees him. Exhausted and frustrated, he goes home. The pain continues, so he finally decides to go to the local community hospital. It's too late: His appendix ruptured. He dies from the complications hours later.

Those are some of the examples of the cruelty of what goes on in Canada. But they don't give you the flavor of the insanity--and I'll use that term in a nonprofessional sense--of the Canadian system.

MRI scanners are very difficult to get in Canada. There are long wait times. In my book, I talk about a political struggle on Vancouver Island where the wait time for a non-urgent MRI scan was over a year--"non-urgent" being defined by government officials, not by physicians. In the province I now live in, Ontario, there are long wait times for MRIs.

Part of the problem is that we have so few of these scanners. Canada per capita has as many MRI scanners as Colombia and Mexico. It wouldn't be fair to try and compare us to the United States or Western Europe. And the few MRIs that we have tend to run on bankers' hours. MRI scanners are expensive to operate. So if an MRI scanner stops dealing with humans at 5 p.m., there are still hours you could run the scanner.

What many MRI clinics now do to make a little bit of money is rent out their facilities to veterinarians. There was a story, which caused quite a scandal, that a London man was expected to wait seven months for an MRI but his dog could get one in just a couple of weeks. They, of course, addressed this discrepancy in a very Canadian way: by preventing veterinarians from booking the off hours.

They're still renting out in some parts of the country. Where I live now, Toronto, there's an MRI scanner that was renting out to vets. A patient came up with a clever idea: He tried to book himself for an appointment under the name of "Spot." Spot was a good name to choose, because Spot could be seen a hell of a lot faster than a person bearing a less canine name.

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canadian article on healthcare from a canadian

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