Healthcare reform, specifically repeal and replace, was a major campaign promise of candidate Donald Trump along with most Congressional Republicans. The House passed a reform bill and the Senate is debating their own bill with few signs of progress given the difficultly of pleasing both conservatives and moderates in the Senate. America’s favorite socialist, Senator Bernie Sanders, despite being on the losing side of any Congressional vote, sings the praises of healthcare north of our border.
Bernie recently tweeted, “Somehow in Canada, they’ve managed to provide health care to everyone in their country at about half the cost per person than we do.” Well maybe not everyone. Newfoundland premier Danny Williams chose to have his heart valve replaced in Florida rather than at one of the hospitals in his province.
Not only heart surgery, but also stem cell transplants for cancer. Ontario resident Sharon Shamblaw didn’t want to wait eight months for treatment, instead traveling across the border to Buffalo. In fact, according to the Fraser Institute, a Canadian public policy think tank, “In 2014, more than 52,000 Canadians received non-emergency medical treatment outside Canada.”
So, no Bernie, Canada has not “managed to provide health care to everyone in their country.” They travel to the US for care because they can’t wait for treatment in their home country. Cancer doesn’t wait. A bad heart doesn’t wait. Pain from a bad knee or hip may be too unbearable to wait for treatment.
The commonality is the word “wait.” Waiting for specialist appointments. Waiting for diagnostic testing. Waiting for treatment including surgery. How long are Canadians waiting?
The same Fraser Institute cited above updated their annual report on wait times in Canada. When someone has a medical problem, their first point of contact is their general practitioner, or GP. If the GP can manage the problem, the story ends there. If the GP can’t, they refer their patient to a specialist. In my world, that would be for a cataract, diabetic retinopathy or macular degeneration, needing the care of an ophthalmologist.
The median time in 2015 from GP referral to specialist treatment was 20 weeks, or 5 months. There was variation between provinces, ranging from “quick” in Ontario, meaning only 16 weeks, to slow in New Brunswick at 39 weeks. Also, variation between specialists, neurosurgery referrals taking 47 weeks with oncology only 4 weeks. Good luck waiting close to a year to have that brain tumor or herniated disc treated. Cancer, at least, was attended to in about a month.
Let’s slice the numbers a bit differently. You see the specialist, receiving a diagnosis and treatment plan. How long until treatment starts? On average 11 weeks, almost twice as long as in 1993 when the wait was about 6 weeks. This is, “More than three weeks longer what physicians consider to be clinically reasonable.” Depends on the meaning of “reasonable.” Most patients with a newly diagnosed, potentially debilitating or life threatening condition want treatment to begin yesterday, not in a couple of months, even if the doctor thinks it’s “reasonable.”
What about diagnostic tests? Canadians wait 4 weeks for a CT scan, 11 weeks for an MRI scan and 4 weeks for an ultrasound. Who wants to be thinking about a cancerous tumor growing inside their body for a couple of months while waiting for a scan?
Waiting is not just an inconvenience. Instead it can have, as the Fraser Institute noted, “Serious consequences such as increased pain, suffering and mental anguish.” Not to mention “poorer medical outcomes.”
Despite Hillary Clinton, Bernie Sanders and other leftists singing the praises of Canadian healthcare delivery, reality tells a different story. About waiting. And waiting. Getting sicker. Maybe dying.
Which is why Republicans need to keep their campaign promise of repeal and replace, whether separately or together. Dithering and doing nothing will bring about the wrath of voters, eventually giving Democrats a Congressional majority — leaving America only one Congressional vote away from Canada exporting its healthcare system to her southern neighbor.
Brian C Joondeph, MD, MPS, a Denver based physician and writer. Follow him on Facebook, LinkedIn and Twitter.
