Canadians are one in a million -- while waiting for medical treatment

[Dashinka 23,234]

      

Sally Pipes , Contributor I cover health policy as President of the Pacific Research Institute

 

Canada's single-payer healthcare system forced over 1 million patients to wait for necessary medical treatments last year. That's an all-time record.

Those long wait times were more than just a nuisance; they cost patients $1.9 billion in lost wages, according to a new report by the Fraser Institute, a Vancouver-based think-tank.

Lengthy treatment delays are the norm in Canada and other single-payer nations, which ration care to keep costs down. Yet more and more Democratic leaders are pushing for a single-payer system -- and more and more voters are clamoring for one.

 

 

Indeed, three in four Americans now support a national health plan -- and a new NBC/Wall Street Journal poll finds that health care is the most important issue for voters in the coming election.

The leading proponent of transitioning the United States to a single-payer system is Sen. Bernie Sanders, Vermont's firebrand independent. If Sanders and his allies succeed, Americans will face the same delays and low-quality care as their neighbors to the north.

 

By his own admission, Sen. Sanders' "Medicare for All" bill is modeled on Canada's healthcare system. On a fact-finding trip to Canada last fall, Sanders praised the country for "guaranteeing health care to all people," noting that "there is so much to be learned" from the Canadian system.

The only thing Canadian patients are "guaranteed" is a spot on a waitlist. As the Fraser report notes, in 2017, more than 173,000 patients waited for an ophthalmology procedure. Another 91,000 lined up for some form of general surgery, while more than 40,000 waited for a urology procedure.

All told, nearly 3 percent of Canada's population was waiting for some kind of medical care at the end of last year.

 

https://www.forbes.com/sites/sallypipes/2018/06/11/canadians-are-one-in-a-million-while-waiting-for-medical-treatment/#6f6acd483e7d

[bcking 3,157]

There are 44 million Americans without health insurance.

 

How many of those Americans wait indefinitely for treatment because they have no access to it?

 

"The only thing Canadian patients are "guaranteed" is a spot on a waitlist. As the Fraser report notes, in 2017, more than 173,000 patients waited for an ophthalmology procedure. Another 91,000 lined up for some form of general surgery, while more than 40,000 waited for a urology procedure."

 

Those procedures are going to be non-emergent, elective procedures. Otherwise they would have shown up in an ER and been treated (just like in the USA).

 

You think the 44 million Americans that don't have health insurance ALL don't need those procedures? A spot on a waitlist is better then no spot at all.

[bcking 3,157]

https://www.kff.org/uninsured/fact-sheet/key-facts-about-the-uninsured-population/

 

"One in five uninsured adults in 2016 went without needed medical care due to cost."

 

So that means in American we have about 8.8 million people who "went without needed medical care" - Not just "waited for 10 weeks". 

 

Unfortunately it's a hard one to study. If many uninsured people don't seek even a regular doctor, how can you determine what medical care they need? I'm sure many of them are walking around with undiagnosed conditions and have "needed medical care" that they don't even know about. 

[Boiler 43,425]

No Doctor in my County so a bit moot.

 

We do have a vet and quite a few pot shops.

 

 

[bcking 3,157]

4 minutes ago, Boiler said:

No Doctor in my County so a bit moot.

 

We do have a vet and quite a few pot shops.

 

 

Can't you just cure everything with the pot?

[Boiler 43,425]

Dunno

 

The local Brewery does not seem to do that. But then not something they promise.

[bcking 3,157]

Direct comparisons of the "insured" population to the "entire" population in countries with universal healthcare is seriously flawed. It basically just ignores the vast number of people in America that don't even have the opportunity to get in a line. Just because they don't have insurance doesn't mean they don't have health needs. Many just aren't presenting for care until it's an emergency (why bother seeing the doctor when you have to pay out of pocket for that visit, and you know that any treatment he/she suggests will be unaffordable?). 

 

That also ignores the people who have "health insurance" but it is so bad it is deemed inadequate. I believe that's another 20+ million last I checked. 

[bcking 3,157]

Also, if you want to compare them to our system you have to take into account wait times in the USA. Many orthopedic procrdured have wait times of around 3 weeks. Yes it's a lot less, but the difference is more important than the absolute wait time in another country.

 

Also, just on wait times more generally - it's hard to make comparisons.

 

https://www.sciencedirect.com/science/article/pii/S0168851013001759

[Boiler 43,425]

Perhaps we can just all just praise Obama for the ACA.

[bcking 3,157]

Just now, Boiler said:

Perhaps we can just all just praise Obama for the ACA.

It's a very difficult problem to solve.

 

Decreasing the number of uninsured was definitely a good thing if you care about access to care, and people going without medically necessary treatments (people like the person writing the Forbes article seem to care). Unfortunately that increased the cost of insurance.

 

Bottom line no matter which system you use, healthcare is requiring more money. We either increase the funding (either publicly or privately) or we look at ways to decrease the cost. 

 

As I've always said though - I'd rather START with every citizen having access to healthcare, and then try to make it as efficient and affordable. Feeling good about relatively low cost of insurance while millions of people go without it is not a good solution. We can't just ignore the people who lack insurance.

[Dashinka 23,234]

56 minutes ago, bcking said:

There are 44 million Americans without health insurance.

 

How many of those Americans wait indefinitely for treatment because they have no access to it?

 

"The only thing Canadian patients are "guaranteed" is a spot on a waitlist. As the Fraser report notes, in 2017, more than 173,000 patients waited for an ophthalmology procedure. Another 91,000 lined up for some form of general surgery, while more than 40,000 waited for a urology procedure."

 

Those procedures are going to be non-emergent, elective procedures. Otherwise they would have shown up in an ER and been treated (just like in the USA).

 

You think the 44 million Americans that don't have health insurance ALL don't need those procedures? A spot on a waitlist is better then no spot at all.

Wondering about your 44 million number, do you have a reference for that?  Also didn't you read the part about patients in the UK waiting in ambulances in the UK due to no space in the A&Es? 

 

 

Edited June 14, 2018 by Bill & Katya

[bcking 3,157]

Just now, Bill & Katya said:

Wondering about your 44 million number, do you have a reference for that?  Also didn't you read the part about patients in the UK waiting in ambulances in the UK due to no space in the A&Es? 

 

 

We are talking about wait numbers for "medically necessary treatments" in Canada. The study in the original article was looking at non-emergent care.

 

Yes obviously the UKs problems with their A&Es is unacceptable. Regardless of how we manage general health of our population, we need to be able to efficiently manage emergency care as a priority. I'll never defend the issues going on in A&Es in the UK. They are understaffed and underfunded.

 

Source for uninsured population is below. I admit I was wrong as I accidentally used 2013 numbers from prior to the ACA. We are now at 28 million.

 

https://www.google.com/amp/s/www.kff.org/uninsured/fact-sheet/key-facts-about-the-uninsured-population/amp/

[Steeleballz 7,550]

1 hour ago, bcking said:

There are 44 million Americans without health insurance.

 

How many of those Americans wait indefinitely for treatment because they have no access to it?

 

"The only thing Canadian patients are "guaranteed" is a spot on a waitlist. As the Fraser report notes, in 2017, more than 173,000 patients waited for an ophthalmology procedure. Another 91,000 lined up for some form of general surgery, while more than 40,000 waited for a urology procedure."

 

Those procedures are going to be non-emergent, elective procedures. Otherwise they would have shown up in an ER and been treated (just like in the USA).

 

You think the 44 million Americans that don't have health insurance ALL don't need those procedures? A spot on a waitlist is better then no spot at all.

 

   Wait times for elective procedures are built into the Canadian system to a certain extent. Certainly people could pay more and have access expanded for everyone. This "rationing" is just the way the system is set up. If you need to see an ophthalmologist for an emergency or critical procedure, you will get in just as fast as you would in the USA.

 

  In the US, we also have rationing. It's based on cost, not necessity. Even with insurance, more and more physicians in the USA want the patient's share of the deductible/copay payed up front or they won't even see you. It doesn't matter if it's a critical/necessary procedure or elective procedure. If you can't pay, you don't get treatment. The system is driven by having your share of the costs. 

 

  Both countries also have wait times due to a shortage of health care workers, primarily doctors in specialty fields. This is often cyclical, and it's misleading when articles or "think tanks" portray this as built in rationing because it's not. If there are not enough ophthalmologists where you live (for example), everyone who needs an ophthalmologist will wait slightly longer. This shortage is not rationing, it's reality and I expect it to get worse in both countries. 

Edited June 14, 2018 by Steeleballz

[bcking 3,157]

1 minute ago, Steeleballz said:

 

   Wait times for elective procedures are built into the Canadian system to a certain extent. Certainly people could pay more and have access expanded for everyone. This "rationing" is just the way the system is set up. If you need to see an ophthalmologist for an emergency or critical procedure, you will get in just as fast as you would in the USA.

 

  In the US, we also have rationing. It's based on cost, not necessity. Even with insurance, more and more physicians in the USA want the patient's share of the deductible/copay payed up front or they won't even see you. It doesn't matter if it's a critical/necessary procedure or elective procedure. If you can't pay, you don't get treatment. The system is driven by having your share of the costs. 

 

  Both countries also have wait times due to a shortage of health care workers, primarily doctors in specialty fields. This is often cyclical, and it's misleading when articles or "think tanks" portray this as built in rationing because it's not. If there are not enough ophthalmologists where you live (for example), everyone who needs an ophthalmologist will wait slightly longer. This shortage is not rationing, it's reality and I expect it to get worse in both countries. 

Well said. Essentially what I was trying to say.

 

Healthcare in the US is incredibly rationed. As you said, it's rationed based on money. Healthcare in Canada and the UK is also rationed, but it is rationed based on a combination of need and "first come, first serve". Which system is better is up for debate (I have my opinion, but I'm sure others would disagree). Even among Doctor's that is an incredibly common misconception. They compare our system to those countries and think "Oh my god, I would never want to ration the care patients receive, that is just evil". The reality is we do it implicitly every single day. At least "wait lists" are explicit, with clear methodology for how the line is created and who gets in line.

[Dashinka 23,234]

4 minutes ago, Steeleballz said:

 

   Wait times for elective procedures are built into the Canadian system to a certain extent. Certainly people could pay more and have access expanded for everyone. This "rationing" is just the way the system is set up. If you need to see an ophthalmologist for an emergency or critical procedure, you will get in just as fast as you would in the USA.

 

  In the US, we also have rationing. It's based on cost, not necessity. Even with insurance, more and more physicians in the USA want the patient's share of the deductible/copay payed up front or they won't even see you. It doesn't matter if it's a critical/necessary procedure or elective procedure. If you can't pay, you don't get treatment. The system is driven by having your share of the costs. 

 

  Both countries also have wait times due to a shortage of health care workers, primarily doctors in specialty fields. This is often cyclical, and it's misleading when articles or "think tanks" portray this as built in rationing because it's not. If there are not enough ophthalmologists where you live (for example), everyone who needs an ophthalmologist will wait slightly longer. This shortage is not rationing, it's reality and I expect it to get worse in both countries. 

Why don't more doctors offer a cash price option?