Thursday, October 20, 2005

17.7 Weeks

This one needs no commentary, other than to note that the country being described below is commonly regarded by legislators in America as a role model in considering how to restructure our own highly flawed health care system:

Waits for Canadian Health Care Shorten a Bit

October 19, 2005; Page A11

TORONTO -- After a dozen years of lengthening durations, Canadians awaiting medical care got access to treatment a little faster in 2005 than in the prior year, according to a survey of medical specialists by a conservative think tank.

The study by the Fraser Institute, which supports introducing more private-sector health care in Canada, comes as provinces grapple with potential fallout from a Supreme Court of Canada ruling last summer. In a decision on a Quebec case that could open the door to more private health care across Canada, the court found that long waits under the current public system violate Quebecers' rights by preventing them from paying for private care. Each of the 10 provinces runs its own health-care system, funded partly by federal payments.

Canadians waited an average of 17.7 weeks for treatment after their first visit to a general practitioner during the first three months of 2005, compared with 17.9 weeks in the same period last year, the study by the Vancouver, British Columbia-based Fraser Institute found. One reason for the incremental improvement was that Saskatchewan improved its performance by 7.8 weeks to 25.5 weeks. The study looked at 12 kinds of treatment, including cardiovascular surgery, cancer care and plastic surgery.

What this means is that if you or I were diagnosed with a cardiovascular problem or cancer which required treatment today, we would be admitted to the hospital along around February 5th.

Quite a role model indeed.

Jeff Matthews
I Am Not Making This Up

© 2005 Jeff Matthews

The content contained in this blog represents the opinions of Mr. Matthews. Mr. Matthews also acts as an advisor and clients advised by Mr. Matthews may hold either long or short positions in securities of various companies discussed in the blog based upon Mr. Matthews' recommendations.


Project_Guru said...

I'm a Canadian now living in Texas. Back when I stilled lived in Canada (just a few years ago) I used to have to get MRIs every couple of years. It took 6 months usually to get booked in for one! Now when I need one in the US they ask what day next week I want to come in!!
Canada has definitely been losing doctors as well to the US. My wife and I had a husband/wife doctor team that up and left Canada because they could make so much more in the US by not having their rates capped by the government.
My father in law needed by-pass surgery but wasn't really in dire need so he waited, and waited and waited for months, more than a year. They only fit you in for that if you're basically about to die. Needless to say some people take a quick turn for the worse and do die while waiting.
I'm not saying I love the US system totally because if you're healthy in Canada it's a much simpler system (we don't have Open Enrollment, and HMO and other crap) but if you have a good employer in the US you can sleep a little easier knowing you'll have a better chance of being diagnosed and cured much faster than in Canada.

mamis said...

Jeff -

I knew a woman in upstate NY with Cystic Fibrosis. She needed a lung transplant. Cost between 300-500K. Family couldn't afford it. So what did they do?

Bake sales. Tag sales. Raffles. They tried to raise the money one cupcake at a time.

My point is that if you want to swap "lousy health care system" anecdotes, we can go back and forth all day. It's a subject I know a lot about (for the wrong reasons, unfortunately).

I have no idea if Canada, Sweden, etc. is any better for the chronically ill. I just get frustrated when free-market worshippers congratulate each other on how great the US health care system is, because I have so many anecdotes about (and experiences with) its failures.

Jeff Matthews said...

"mamis": when I said our own system was highly flawed, I wasn't being sarcastic.

The system is broken, unfair and works against the professionals who keep it going.

Most of us have a horror story similar to yours, unfortunatly.

A said...

Canada is just one, and not the best, example of a single-payer healthcare system. The reason it is continuously used and abused as a (bad) example is because of our peculiar problem - we only have borders with two countries, so most people have no clue about the rest of the world. I am an American by choice and I love this country, but if there's one probem here that drives me mad it is the most stupid, most expensive, most inefficient way in which we run our healthcare system. Every other developed nation in the world has public healthcare access for all, AS WELL AS great private care. They don't have to be mutually exclusive - that's Canada's mistake. Here, instead of the Govt. bureaucrat you have HMO bureaucrat, and don't tell me one is better than the other. And on this "choice" thing - why is it that my HMO has its list of doctors I can use, drugs I can take, how many times a year (2 years) for an eye exam, etc., etc?
Small Investor Chronicles

mamis said...

Jeff - Apologies if I read something into your post that wasn't there.

The health care market combines finite supply and inelastic demand. I don't have a good solution; there probably isn't one.

MD said...

I wonder when the backlash against large pharma broadens out to medical device, biotech companies, and managed care companies. Unlike large-cap pharma, these companies have produced good earnings growth of late.

I was surprised to see that UNH, MDT, and DNA all have higher market caps than Merck.

Its_strange said...

I know about CF and i know about lung transplants. Give me 2 % of the money we spend on grade / high school sports and i can see we have enough available organs and the money to do the job. The science is already done. But our culture is absurd . ...CF is not curable . The lack of available organs can be solved within 2 years...Its a serious battle that CAN BE WON !! Now !! Why it isn't is beyond words..

You know if Jim Cramers pal Senator Corzine becomes Gov of NJ i just might ask Cramer for some help...

Pedro said...

I can't help but think of Thomas Sowell's comment that for the "problem" of health care, there are no "solutions", only trade-offs.

padawancowboy said...


I am happy you brought this up. All of this banter about socialized medicine is proof that we need more economic education in this country.

Through a family member with cancer I have come to know how disastrous the European model of medical care can be.

To begin, medical care is scarce; therefore it is a good and not a right. Goods can be allocated through price- or non-price mechanisms. As Hayek made clear, prices are bits of information. Without prices, the only option is beauracracy, i.e. guys in a room making decisions. Kornai elegantly described why non-price markets almost always collapse. For example, the NHS in Britain continually struggles with problems like determining how many operating theatres should be kept open or how many syringes to order in a given month.

Unfortunately, prices in the US system are somewhat distorted for a number of reasons; it is not a pure market in any sense. But even if it was, you would still witness adverse selection among multiple insurers (i.e., good risks 'underinsuring'). For this reason, microeconomists are quick to point out that the most efficient insurance mechanism is a single-insurer that perfectly pools all risks. The "40 Million uninsured Americans" that the Left purports to defend are mostly young and healthy folks; their decision not to purchase insurance mainly hurts high-risk individuals by pushing up premiums.

But the problem with a single insurer--the Gov't--is that there is no competition and no way to ensure quality. Furthermore, there are no prices to provide information about scarcity and value. Nevertheless, I do not think Sowell is 100% correct on this issue. I think a decent solution does exist.

Consider a two-tiered system with public insurance but private care for the lower tier. Medical care contracts could be awarded by the Gov't to private providers through auction. Citizens would be permitted to shop among different providers, thus introducing an element of competition. Contracts could come up for review over the medium-term. And of course, those who wish to could purchase additional insurance in a private market.

Public choice economists will be quick to denounce this idea as prone to political favoritism. Perhaps, but no less so than the current system.


norcadiver said...

What this means really doesn't translate waits for cancer or cardiac patients. An average that includes plastic surgery and nine unnamed medical is a meaningless average. Pick the right ten categories and zero waits for critical care could/would/will yield unsettling averages. Kaiser Permanente has some very very long waits for optional, schedulable surgeries.