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Does It Work For The Canadian Government?

Posted Sep 23 2012 11:12am
Stanley Feld M.D.,FACP,MACE

In the last blog post I have discussed how a former Canadian physician (now a U.S. physician) felt about the Canadian system.

The next question is does the Canadian Healthcare System work for the Canadian government? 

The answer is No!

The Canadian deficit resulting from the Canadian healthcare system is mounting at a unsustainable rate in a country that is already overtaxed. The problem is the government is not admitting it and the U.S. government and media are ignoring it.  

I have discussed how patients I interviewed in Canada feel about their healthcare system. Some of Canadians are bitter about Canadian physicians immigrating to the U.S. because the practice conditions are better in the U.S. than in Canada.

The Canadians complained that physicians coming to Canada from India and China are not being licensed to practice medicine despite the severe physician shortage. Most of these physicians are driving taxicabs.  

 I included a You Tube of Canada patients raving about the Canada Healthcare system.

 The people interviewed looked healthy and probably did little interacting with the healthcare system.

Is the Canadian healthcare system good or a least better than the U.S. healthcare system?

There have been two recent articles in American newspapers that applaud the Canadian system.

  1. Debunking Canadian health care myths - The Denver Post                                                                                                                          http://www.denverpost.com/opinion/ci_12523427#ixzz25y9kuiVG

 2. Everything you ever wanted to know about Canadian health care in one post. Washington Post

Both articles are opinion articles and lack concrete evidence. The articles contain both misinformation and disinformation.  

  It reminded me of a Justice Scalia’s recent comment on 60 minutes .

“You should not believe what you read about the court in the newspapers,” Scalia said. “Because the information has either been made up or given to the newspapers by somebody who is violating a confidence, which means that person is not reliable.”

Scalia

The Fraser Institute is a well-respected Canadian think tank. Its research is accurate with a libertarian slant.

Its 2011 report contradicts the statistics in these articles concerning the Canadian government healthcare costs.

  Article 1. “Ten percent of Canada's GDP is spent on health care for 100 percent of the population. The U.S. spends 17 percent of its GDP but 15 percent of its population has no coverage whatsoever and millions of others have inadequate coverage. In essence, the U.S. system is considerably more expensive than Canada's.”

Article 2.  “In 2009, Canada spent 11.4 percent of its Gross Domestic Product on health care, which puts it on the slightly higher end of OECD countries.”

This is not true according to the Fraser report. Six of ten Canadian provinces are on track to spend half of their revenues on health care, according to the institute. To be specific, in 2011, health care spending consumed 50 percent of revenues in Canada’s two largest provinces, Ontario and Quebec.

According to the institute,

“B y 2017, four more provinces — Saskatchewan, Alberta, British Columbia and New Brunswick — will spend half of their revenues on health care.

These two articles are either copying other inaccurate articles or copying each other. It could be they are just reporting provincial (states) spending and not total costs. Healthcare costs in Canada are rising faster than the GDP.

“Total federal, provincial and territorial government health spending has grown by 8.1 percent annually, while the national GDP in Canada rose by only 6.7 percent during the same period.”

Article 1 states that the decision making for treatment and tests needed are made exclusively by the patients’ physicians. We know this is not true because of the rationing of care and the long wait times to see a physician.

“In Canada, the government has absolutely no say in who gets care or how they get it. Medical decisions are left entirely up to doctors, as they should be.”

There are no requirements for pre-authorization whatsoever. If your family doctor says you need an MRI, you get one.”

Article 2. states the opposite.  “The Canadian health care system was built around the principle that all citizens will receive all “ medically necessary and hospital physician services .” To that end, each of Canada’s 10 provinces and three territories finance and run a statewide health insurance program with federal aid. There is no cost-sharing for the health care services guaranteed under federal law.”

The Fraser report describes the actions the provincial governments have taken in response to the rapidly rising costs.

The provincial governments have raised taxes and rationed care, increasing patient wait times. This agrees with the reactions of the people I interviewed

“Provincial drug plans have also more often refused to pay for most of the drugs that are certified as “safe and effective” by Health Canada.”

“Unsustainable rates of growth in health care spending crowd out the resources available for other purposes including education, public safety, and economic growth-enhancing tax relief,”

Despite Canada’s increase in federal funding and rationing of care the cost of care increases. The federal government has encouraged the individual provinces to make the necessary reforms to increase their efficiency and decrease bureaucratic waste. The low overhead figures quoted by the two U.S. newspaper articles are wrong.

We conclude that Canada’s health system produces rates of growth in health spending that are not sustainable solely through redistributive public financing,” the report concluded.

“In 2011, health care spending consumed 50 percent of revenues in Canada’s two largest provinces, Ontario and Quebec.

By 2017, four more provinces — Saskatchewan, Alberta, British Columbia and New Brunswick — will spend half of their revenues on health care, according to the institute.”

“Federal funding is not a solution: the federal government has already transferred billions more in health funding to the provinces than the amounts needed to keep up with general price inflation or population growth.  

The study added that none of the government’s rationing efforts have made the growth of government spending on health care sustainable.

“The Fraser Institute concluded that Canada’s health care system is spending at an unsustainable rate. Six of ten Canadian provinces are on track to spend half of their revenues on health care , according to the institute.”

We conclude that Canada’s health sys tem produces rates of growth in health spending that are not sustainable solely through redistributive public financing.”

The media is the message. The message sent controls behavior.

All Canadians want a comfortable entitlement for healthcare. I do not blame them.

The problem is entitlements are too expensive for the government.  They don’t work because governments cannot legislate behavior by directives. Individuals must be responsible for their health and healthcare dollars. Using incentive programs government can help people be responsible to and for them.

  The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone

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