Tag Archives: Wait Times

New study: Angus Reid Institute analyzes Canada’s single payer healthcare system

Price of healthcare per Canadian household (Source: Fraser Institute)
The cost of healthcare for average Canadian households

I found two interesting studies from Canada’s Angus Reid Institute describing single payer health care in Canada. I’m very interested in find out what things are like in countries that have true government-run health care. A typical Canadian family pays $13,000+ per year per household for healthcare, or about $585,000 over their working lives. What are they getting for all that money?

Here is the first Angus Reid article:

The study finds more than 2 million Canadians aged 55 and older face significant barriers when accessing the health care system in their province, such as being unable to find a family doctor or experiencing lengthy wait-times for surgery, diagnostic tests, or specialist visits.

Moreover, most Canadians in this age group have at least some difficulty getting the care they want or need in a timely manner.

The study focuses on the health care experiences of older Canadians, as well as their assessments of the quality of care they receive.

According to the article, 31% of respondents (aged 55 and older) rated access to the government’s healthcare system as “easy”. 48% had “moderate” problems with access, and 21% had “major” problems with access.

Remember: in the Canadian system, you pay your money up front in taxes, and then they decide how much healthcare you will get later – and how soon you will get it. If you worked from ages 20 to age 65, then your household will have paid 45 x $13,000 = $585,000 into the system, in order to get “moderate” problems with accessing healthcare after you’re aged 55.

And the Canadian system DOES NOT cover prescription drugs.

The second Angus Reid article explains:

This second part of the study finds one-in-six Canadians (17%) in the 55-plus age group – a figure that represents upwards of 1.8 million people – say that they or someone else in their household have taken prescription drugs in a way other than prescribed because of cost.

One-in-ten (10%) have decided to simply not fill a prescription because it was too expensive, and a similar number (9%) have decided not to renew one for the same reason. One-in-eight (12%) have taken steps to stretch their prescriptions, such as cutting pills or skipping doses.

Some 17 per cent of Canadians 55 and older have done at least one of these things, and that proportion rises among those who have greater difficulty accessing other aspects of the health care system.

In a previous blog post, I reported on how Canadians have to wait in order to see their GP doctor. If that doctor refers them to a specialist, then they have to wait to see the specialist. And if that specialist schedules surgery, then they have to wait for their surgery appointment. The delays can easily go from weeks to months and even years. The MEDIAN delay from GP referral to treatment is 19.5 weeks.

But remember – they paid into the system FIRST. The decisions about when and if they will be treated are made later, by experts in the government. This is what it means for a government monopoly to run health care. There are no free exchanges of money for service in a competitive free market. Costs are controlled by delaying and withholding treatment. And no one knows this better than elderly Canadians themselves. But by the time they realize how badly they’ve been swindled, it’s too late to get their money back out. You can’t pull your tax money out of government if you are disappointed with the service you receive. There are no refunds. There are no returns.

Is Bernie Sanders correct to say that Canada has better, lower-cost health care?

Wall Street Journal calculates cost of Sanders spending plan
Wall Street Journal calculates cost of Sanders spending plan

He seems to be really passionate about raising taxes on working families, and then giving them “free” health care in return. Let’s see how that’s working out in Canada, where they do have a single-payer health care system.

The Washington Free Beacon reports:

Waiting times for medically necessary health care services under Canada’s single-payer system have hit a record high, according to a report from the Fraser Institute.

[…]The Fraser Institute found that patients under Canada’s single-payer system this year waited an average of 10.9 weeks—roughly two-and-a-half months—from the time they had a consultation with a specialist to the time at which they received treatment. Physicians consider 7.2 weeks to be a clinically reasonable wait time.

The report also found that patients’ wait for treatment after referral to a specialist by their general practitioner was 21.2 weeks, or longer than four months.

“This year’s wait time—the longest ever recorded in this survey’s history—is 128 percent longer than in 1993, when it was just 9.3 weeks,” the report states.

The report, which looks at 10 provinces in Canada, found that there are 1,040,791 patients waiting for procedures. There are also high wait times to receive scans and ultrasounds. Patients waited an average of 10.8 weeks for an MRI scan and 3.9 weeks for an ultrasound.

“Research has repeatedly indicated that wait times for medically necessary treatment are not benign inconveniences,” the report states. “Wait times can, and do, have serious consequences such as increased pain, suffering, and mental anguish.”

According to the report, patients experience long wait times for surgeries, waiting as long as 41.7 weeks for orthopedic surgery, 32.9 weeks for neurosurgery, and 31.4 weeks for ophthalmology.

“In certain instances, [wait times] can also result in poorer medical outcomes—transforming potentially reversible illnesses or injuries into chronic, irreversible conditions, or even permanent disabilities,” the report states. “In many instances, patients may also have to forgo their wages while they wait for treatment, resulting in an economic cost to the individuals themselves and the economy in general.”

Fraser points out that previous studies have found the lost economic output in waiting for joint replacement surgery, coronary artery bypass graft surgery, MRI scans, and cataract surgery totaled $14.8 billion in 2007.

The report also notes that 46.3 percent of patients would prefer to have their procedure performed within a week if they had the opportunity to do so.

The article also quotes Sally C. Pipes, a Canadian health care expert who knows how much Canadian taxpayers pay for “free” health care.

Pipes also refutes Sanders’s claim that Canada’s system offers relatively the same quality of care at a cheaper cost.

“It isn’t cheaper because Canadians pay for health care through their taxes,” Pipes explains. “The average Canadian family pays anywhere between $4,000 and $12,000 a year in taxes for a system where they have to wait over five months from seeing a primary care doctor to getting treatment by a specialist.”

“There’s fewer doctors relative to the population than in all but four other industrialized countries,” she said. “It’s last in terms of acute care hospital beds and there’s doctor shortages, residency spots are down, and waiting times—this is what happens when government controls the health care system, and this is what Bernie Sanders wants for the United States.”

Canadians are also paid less than Americans. Why? Because Canadian employers have to pay a percentage of their employee’s salary to the government for health care. Obviously, the employers are going to take that out of their employee’s salary without telling them.

Finally, it should be obvious that progressive Canadian politicians go South when they’re sick for healthcare. They know that when health care is free, you get the quality you’re paying for.

One thing you need to understand is that if you put health care in the hands of politicians, they they will use it for vote-buying, like they do with any government-run social program. So, if you are young and want an abortion or a sex change, you’re in luck. Because you have a lot of voting ahead of you, and they want to keep you happy with big government. But, if you’re old, and don’t have so much voting left to do, you’re expendable. That’s why countries with big government health care, like the Netherlands and Canada and the UK are always tinkering with euthanasia for the elderly.

Donald Trump would expand Obamacare into single-payer health care system

Let’s take a look at how well a policy he supports – single payer health care – is working in Canada, where it’s been the law of the land for decades.

First, let’s see Trump explain his view on single payer health care in his own words:

When government pays for all the health care provisioning, we call that a single-payer system. And Trump is for it – that clip is from September 27, 2015. In the Fox News debate in August, he said that single payer health care “works in Canada“.

So, let’s go and see what the Canadians are saying about their single payer system, by looking a wide variety of stories from last month from a wide variety of Canadian news sources, covering a wide variety of Canadian provinces.

First, let’s start on the west coast, and then work our way east.

The Vancouver Sun reports on British Columbia wait times:

Median waiting times from referral by family doctor to treatment are 22.4 weeks, or almost six months in B.C., longer than all provinces except those in Atlantic Canada, according to the 25th annual survey of 2,382 medical specialists.

And waits between the first appointment with a specialist and getting treatment are 14 weeks in B.C., the highest since the survey began. The doctors who take the survey are asked to give their best estimates of waits for care.

The government-run CBC, reporting on Manitoba health care:

Manitoba has been given a failing and a near-failing grade for prostate and breast cancer treatment wait times by Canada’s Wait Times Alliance.

The group released their annual wait time report card on Tuesday, giving Manitoba an F for wait times for radiation and curative care treatment for prostate cancer and a D for the same treatments for breast cancer.

Manitoba has received an F for prostate cancer treatment wait times for more than five years, and a D in breast cancer treatment wait times for the past four years.

The Globe and Mail reports on the city of Winnipeg:

New data shows Winnipeg hospitals still have the longest emergency room wait times in Canada.

The Canadian Institute for Health Information says Winnipeg’s six emergency rooms all came in below average on the time it takes 90 per cent of patients to see a doctor after they check into an emergency room.

The average for the Winnipeg Health Region as a whole is 5.7 hours compared to the Canadian average of 3.1 hours.

And the Montreal Gazette reports on the province of Quebec:

Quebec reported the steepest increase this year of any province in wait times for medical imaging scans in Canada — a finding that suggests the public system is being stretched to the limit, a national survey reveals.

The 25th annual survey by the Fraser Institute found that the median wait time in hospital for a magnetic resonance imaging (MRI) scan in Quebec jumped to 12 weeks this year from eight in 2014. By comparison, the median wait time for an MRI is five weeks in Ontario, unchanged from last year.

Wait times increased slightly for other medical imaging in Quebec, going up from four to five weeks for both ultrasounds and CT (computerized tomography) scans.

Investors Business Daily also wrote about this and had a helpful chart breaking down how long people are waiting for treatment:

Single-payer health care wait times in Canada
Single-payer health care wait times in Canada

Canada also has a well-known doctor shortage. Their way of controlling costs is to limit the number of people who can practice medicine, so less care can be billed to the government. Get in line, and if you die waiting for treatment, that’s great for them – less money to pay. After all, they get to keep all the taxes they took from you during your life, and now they don’t have to give you anything back since YOU’RE DEAD.

Trump says that single-payer “works in Canada”. Does this look like it is working to you? Would you be willing to have 45% of your income go to federal, provincial, municipal income and sales taxes so that you could get in line in a system like this? This is Trump’s ideal, is it your ideal?

If you want to see what Canadian health care is really like on the ground, check out this video of Steven Crowder trying to get health care in the province of Quebec:

That’s what Donald Trump thinks is working. His past statements about being “very pro-choice”, and about same-sex marriage being “the law of the land” and about single payer and amnesty make him out to be a Democrat. He has never put effort into any conservative initiative on any conservative issue since the day he was born. He has been a Democrat, has donated to Democrats, including many, many donations to the Clintons. Only a complete idiot could support a Democrat in the Republican primary, especially when there were so many conservatives who fought and suffered for conservative issues in the past, e.g. – Perry, Jindal, Walker and Cruz.

As for his experience with making money, he inherited all his money, and he is worth $10 billion less today than he would have been if he had just invested his silver spoon inheritance in index funds. He knows less about politics than you do. He has gone bankrupt more times than you have. He is less good at making money than you are. He was born wealthy. He has no idea what conservatives believe. He is not conservative now, never has been conservative, and never will be conservative. You cannot choose a candidate by listening to mere words, you have to look at evidence, you have to look at accomplishments.

We have single-payer health care already in the VA system – is it working?

VA health care wait times
VA health care wait times

This is health care policy expert Sally Pipes, writing in Investors Business Daily.

She writes:

new report from the Government Accountability Office has confirmed that the Department of Veterans Affairs can’t take care of those it’s supposed to serve.

The GAO has placed the VA’s health system on the “high risk” list of federal programs that are vulnerable to “fraud, waste, abuse, and mismanagement.” The agency is still struggling to recover from an 8-month-old internal audit that revealed that returning soldiers had to wait more than 90 days for care. Some patients died while waiting.

The GAO’s findings apply far beyond the VA. The agency’s problems — which include long wait-times and out-of-control costs — demonstrate what happens in any government-run, single-payer health care system.

The VA’s failings ought to give pause to the liberal politicians and policy analysts who would love to introduce single-payer health care for all Americans. But they don’t seem to have heeded the GAO report. Within a week of its release, Rep. John Conyers, D-Mich., called for “Medicare for All.”

Champions of socialized medicine used to point to the VA as proof that single-payer worked. In 2011, economist Paul Krugman called it “a huge policy success story, which offers important lessons for future health reform.” In a 2009 debate with me, Princeton professor Uwe Reinhardt said that there’s an example of a single-payer system in the U.S. that works — the VA.

The VA offers lessons about health reform — just not the ones single-payer’s proponents have in mind.

Defenders of government-run health care claim that it will control costs by cutting out middlemen such as insurance companies. The evidence shows otherwise. According to the GAO, the VA budget more than doubled between 2002 and 2013 even as enrollment increased by less than a third.

Single-payer’s “guarantee” of access to high-quality care is a myth, too.

“Despite these substantial budget increases,” the GAO report says, “for more than a decade there have been numerous reports … of VA facilities failing to provide timely health care.”

Over the last decade, more than 63,000 veterans have been unable to get a doctor’s appointment. At least 40 veterans have died because of long waits.

Things aren’t likely to get better anytime soon. The VA has yet to act on more than 100 GAO recommendations for improving care.

Last summer, lawmakers allocated $10 billion to a program intended to reduce wait times by permitting veterans to see private doctors outside the VA system. So far, the agency has only authorized 31,000 vets to seek private care — out of a possible 8.5 million.

That has to change — 88% of veterans say that they want the ability to choose where they receive their care.

However, there is one military person who is getting health care – convicted traitor Bradley Manning. He’s getting sex-change surgery while he is in jail for leaking national security secrets to our enemies. He won’t have to wait at all for his health care. This is what happens when you take money out of your wallet, give it to the government, and then hope that when you get sick, someone in the government will decide that you are worthy of treatment. Which you aren’t, unless they want your vote.

It’s not just the VA health care system – government-run health care doesn’t work in other places:

The United Kingdom’s National Health Service, for instance, is notorious for denying patients everything from certain cancer medications to hip replacements.

The program is also financially unsustainable. According to its own medical director, Bruce Keogh, “if the NHS continues to function as it does now, it’s going to really struggle to cope because the model of delivery and service that we have at the moment is not fit for the future.”

In Canada’s single-payer system, the average wait time between referral from a general practitioner and the actual receipt of treatment by a specialist was more than four months in 2014. That’s nearly double the wait time of two decades ago.

The Canadian system is the one that Democrats want to emulate – but Canada’s rich left-wing politicians come here when they want care. They don’t want to wait in line. Why should we want to wait in line? We need to prefer consumer-driven health care over government-controlled health care.

Top doctor: NHS is killing off 130,000 elderly patients a year

From the UK Daily Mail:

NHS doctors are prematurely ending the lives of thousands of elderly hospital patients because they are difficult to manage or to free up beds, a senior consultant claimed yesterday.

Professor Patrick Pullicino said doctors had turned the use of a controversial ‘death pathway’ into the equivalent of euthanasia of the elderly.

He claimed there was often a lack of clear evidence for initiating the Liverpool Care Pathway, a method of looking after terminally ill patients that is used in hospitals across the country.

It is designed to come into force when doctors believe it is impossible for a patient to recover and death is imminent.

It can include withdrawal of treatment – including the provision of water and nourishment by tube – and on average brings a patient to death in 33 hours.

There are around 450,000 deaths in Britain each year of people who are in hospital or under NHS care. Around 29 per cent – 130,000 – are of patients who were on the LCP.

Professor Pullicino claimed that far too often elderly patients who could live longer are placed on the LCP and it had now become an ‘assisted death pathway rather than a care pathway’.

He cited ‘pressure on beds and difficulty with nursing confused or difficult-to-manage elderly patients’ as factors.

Professor Pullicino revealed he had personally intervened to take a patient off the LCP who went on to be successfully treated.

[…]Professor Pullicino, a consultant neurologist for East Kent Hospitals and Professor of Clinical Neurosciences at the University of Kent, was speaking to the Royal Society of Medicine in London.

[…]He said: ‘The lack of evidence for initiating the Liverpool Care Pathway makes it an assisted death pathway rather than a care pathway.

‘Very likely many elderly patients who could live substantially longer are being killed by the LCP.

‘Patients are frequently put on the pathway without a proper analysis of their condition.

More from a different UK Daily Mail article:

The health service ‘looks like a supertanker heading for an iceberg’, the head of the NHS Confederation has warned.

His comment came as a survey revealed the squeeze on NHS finances is so serious that almost half of its leaders think it will reduce quality of care for patients over the next year.

The research, carried out before the confederation’s annual conference in Manchester, shows that NHS leaders fear that growing financial pressures will mean treatment rationing and longer waiting times.

Of the 252 chief executives and chairs of NHS organisations questioned, almost half believe the financial burden on the health service is ‘very serious’ and 47 per cent say this means quality of care will reduce over the next 12 months.

Mike Farrar, chief executive of the confederation which represents organisations providing NHS services, said: ‘Despite huge efforts to maintain standards of patient care in the current financial year, healthcare leaders are deeply concerned about the storm clouds that are gathering around the NHS.

‘Our survey shows that many NHS leaders see finances getting worse and that this is already having a growing impact on their patients. In response, they are cutting costs in the short term but they know that much more radical solutions are the only answer in the long run.

[…]Mr Farrar added that politicians had ‘consistently failed’ to put the long-term interests of the population’s health above their short-term electoral interests.

[…]Katherine Murphy, chief executive of the Patients Association said: ‘This survey confirms what everybody inside the health and social care system is already saying – the next decade is likely to be the most challenging one in the history of the NHS.

‘Treatments are being rationed, waiting times for elective procedures are going up and patients continue to be treated poorly on our hospital wards.

In a government-run system, whether you get treatment or not depends on a bureaucrat, whose only desire is to be re-elected. Sometimes, killing you is the best way for them to get re-elected, as seen in the euthanasia numbers. But, in a private health care system, it makes no sense to kill patients, because then the money stops coming in. Doctors actually care about you in a for profit system. They want to help you, and they want you to live.