Does It Work For The Canadian Government?

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

http://www.washingtonpost.com/blogs/ezra-klein/wp/2012/07/01/everything-you-ever-wanted-to-know-about-canadian-health-care-in-one-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,

“By 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 system
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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