BigGovHealth Improve and Strengthen Health Care for all Americans

Case Study: Canada

Denial of Care

Millions of Canadian patients are not getting the care they need from their government-controlled health care system

• More than half of Canadian adults (56 percent) sought routine or ongoing care in 2005 – of these, one in six said they had trouble getting routine care.¹
• Fourteen percent of Canadians - approximately five million people - are still without a family doctor. Within this group, more than two million (41 percent) have tried to find a family doctor and were not successful. ²

As wait times soar, physicians are giving up on their Canadian government-controlled health care system

• Eighty-five percent of doctors in Canada agree that private insurance for health services already covered under Medicare would result in shorter wait times. ³
• The Canadian Medical Association has openly expressed concerns regarding patient wait times and the strain of the system on providers.⁴
• Jacques Chaoulli, a Montreal doctor, launched a private, one-stop referral center for paying members. For a fee of $40, the Chaoulli Group will act as a brokerage firm to quickly match patients with family doctors and specialists, as well as diagnostic procedures and surgeries. Chaoulli says his motive is to help Quebec get rid of wait lists and reduce patients’ suffering. ⁵

Despite the claim of “universal coverage,” the main barrier to health care in Canada is access

• Approximately 875,000 Canadians are on waiting lists for medical treatment.⁶
• Desp ite a surge in spending during 2006 that represented a 5.8 percent increase from 2005 expenditures⁷, wait times for patients in Canada are at an all time high.⁸
• On average, Canadians have to wait:
  • Four weeks for access to CT scans or ultrasounds;
  • 17.8 weeks from general practitioners’ referrals to treatment by a specialist;
  • More than eight weeks for MRIs; and
  • Four or more months for surgeries deemed “elective,” such as hip replacements. ⁹
• Nearly three-quarters of the patients waiting to see a specialist reported that they experienced worry, anxiety and stress, as did 60 percent of patients waiting for non-emergency surgery and diagnostic tests. ¹⁰
• More than one-half of the people waiting for non-emergency surgery and diagnostic tests reported suffering pain because of the delay. ¹¹

Cost to Patients

Physicians cannot provide the best care for patients in Canada and overall care suffers under the government-run system

• Canada’s system is an excellent example of what happens to the quality of care when the government is the sole provider:
  • Patients have long waiting lines for critical procedures
  • There is a lack of access to current technology
  • Taxpayers and patients face increasing costs
  • Canada is facing a brain drain as one in nine doctors who trained in Canada has left to practice medicine in the United States ¹²
• Of men who are diagnosed with prostate cancer, less than one fifth die in the United States, compared to one fourth in Canada. ¹³
• Because of overworked, under-equipped hospitals and vast regions without any doctors at all, some Canadians are already being sent, at taxpayers’ expense, to American doctors and hospitals — or choose go at their own expense. ¹⁴
• In Canada, the federal government sets and administers the national standards for provincial health care. Since the rates are low, physicians perform more services, placing upward pressure on spending and leading many provincial governments to cap the total amount they can bill in a year. ¹⁵

Patients have to wait longer periods of time for any medical assistance

• In 2006, the median patient wait time from referral to treatment was 17.7 weeks. ¹⁶
• A 2005 survey found that just 23 percent of Canadians were able to see a physician the same day they needed one - placing Canada last among the six studied, including the U.S., Britain and Australia. ¹⁷
• The survey also reported that 12 percent of physicians and 4 percent of nurses believe they have had patients die specifically because of long waits for needed care. ¹⁸

1. ¹ Health Services Access Survey, 2003. Statistics Canada.
2. ² “Family doctors need more money, backup to improve patient care:study” CBC news (October 11, 2007) http://www.cbc.ca/health/story/2007/10/11/doctors-study.html
3. ³ “Health Care in Canada Survey,” Pollara, (2006)
4. ⁴ CMA Statement in response to the Chaoulli/Zeliotis Supreme Court case ruling (June 9, 2005)
5. ⁵ “Doctor launches medical brokering service; Charges $40” By Charlie Fidelman, Montreal Gazette (May 8,2007)
6. ⁶ “The rise of private care in Canada. All the health services money can buy” By Alexandra Shimo, Macleans (April 25, 2006)
7. ⁷ Canadian Institute for Health Information, National Health Expenditure Trends, 1975-2006 (Ottawa: CIHI, 2006).
8. ⁸ “How Good Is Canadian Health Care? An International Comparison of Health Care Systems” By Esmail, Nadeem and Walker Michael, The Fraser Institute (December 2006)
9. ⁹ Ibid.
10. ¹⁰ “The rise of private care in Canada. All the health services money can buy” By Alexandra Shimo, Macleans (April 25, 2006)
11. ¹¹ Ibid.
12. ¹² “Nearly 10 percent of doctors trained in Canada work in USA” Canadian Medical Association Journal, (April 2007) http://www.northernlife.ca/News/LocalNews/2007/04-18-07-docsUSA.asp?NLStory=04-18-07-docsUSA
13. ¹³ “Five Myths of Socialized Medicine” By John Goodman, Cato’s Letter: Quarterly Message on Liberty, Volume 3, Number 1 (Winter 2005).
14. ¹⁴ “Canada’s Health Care Shows Strains,” By Barbara Crossette, New York Times, (October 11, 2001).
15. ¹⁵ Ibid.
16. ¹⁶ “Long Waits for Health Care Plague Canada,” By Parnell, Sean, The Heartland Institute (January 2006).
17. ¹⁷ “Canada’s Doctor Shortage Worsening,” By Cathy Gulli and Kate Lunau, MacLean’s Magazine (January 14, 2008).
18. ¹⁸ Ipsos-Reid’s survey on behalf of the Canadian Medical Association and Canadian Nurses Association, 2004 http://www.heartland.org/policybot/results.html?artId=18276