Where Does Canadian Health Care Fall With Health Care and Other OECD Countries?

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Many countries have universal health care but not all of them are run the same way.  Each year, the Fraser Institute monitors activity with the Canadian health care system tracking wait times and efficiency.  Canada, overall, spends more on health care than the majority of other high income countries with universal health care systems.  It ranks the second highest for expenditure on health care as a percentage of GDP and 8th highest for health care per capita.

Seeing the numbers for what they are can be incredibly disappointing.  The most recent study calculated a ‘value for money approach’ with 28 other high income countries.

The four categories studied were:

  1. Availability of resources
  2. Use of resources
  3. Access to resources
  4. Quality and clinical performance

Availability of resources

A basic requirement for a properly functioning health-care system is having availability of medical resources. Data suggests that Canada has substantially fewer human and capital medical resources than many peer jurisdictions that spend comparable amounts of money on health care. After adjustment for age, it has significantly fewer physicians, acute-care beds, and psychiatric beds per capita compared to the average of OECD countries included in the study. It ranks close to the average for nurses and ranked eighth for the number of long-term care beds (per 1,000 over the age of 65). While Canada has the third most Gamma cameras (per million population, age-adjusted), it has fewer other medical technologies than the average high-income OECD country with universal health care for which comparable inventory data are available.

Use of resources

Canada’s performance is mixed in terms of use of resources.  We ‘perform at higher rates than the average OECD country on under half the indicators examined (for example, cataract surgery and knee replacement), and average to lower rates on the rest. Canada reports the least degree of hospital activity (as measured by rates for curative-care discharges) in the group of countries studied.’

Access to resources

‘Canada ranked last (or close to last) on four indicators of timeliness of care; and ranked seventh (out of ten) on the indicator measuring the percentage of patients who reported that cost was a barrier to access.’

Quality and clinical performance

‘While Canada does well on five indicators of clinical performance and quality (such as rates of survival for breast, colon, and rectal cancers), its performance on the seven others examined in this study are either no different from the average or in some cases—particularly obstetric traumas and diabetes-related amputations—worse.’

Canadians spend a great deal of money in the way of taxes for their health care.  It is also one of the most expensive health care systems in the OECD.  Unfortunately, the research found shows that the performance for availability for access to resources is below the average OECD country.  The performance for use of resources, quality and clinical performance is mixed.

You can read the full report here.

 

Health Vantis

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So Many Delays

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We Are In Trouble

This pandemic has put so many strains and challenges in just about every aspect of our lives.  I don’t think there is one person world wide it has not affected.  In Canada, the health care system has taken a huge hit.  National health care can be great in theory, but when problems already exist and something like this happens, well, the light at the end of the tunnel doesn’t even seem possible.   

All of the provinces have been struggling to keep up but Ontario has really been hit.  The Financial Accountability Office (FAO) is estimating it will need $1.3 billion and 3.5 years just to clear the massive backlog for diagnostic procedures and elective surgeries.  The report also found a $3.7 billion hole in the health budget for 2023-24 which would grow to a cumulative $61.9 billion by 2023-2030 without additional spending.  Due to the halt to elective surgeries to open up critical care floors, it is projected to grow to 410,200 postponed elective surgeries and almost 2.5 million delayed diagnostic procedures by the end of September of this year.  

The FAO estimates the cost to clear the cancer surgery alone backlog to be $57 million and total surgery backlog to be $1.06 billion.   An additional $241 million is needed to eliminate the screenings such as CT and MRI scans.  

The budget for 2021 has already put $610 million into addressing the backlog.  There is a shortfall of another $700 million needed to get things caught back up.  

It’s not a position anyone wants to be placed in, especially if they have or are facing something like a cancer diagnosis.  The mental anguish that would have on a person not knowing if the cancer is spreading while they wait for treatment is a feeling I wouldn’t wish on anyone. 

If you have been subjected to another delay and would like to explore private options, give Health Vantis a call and we’d be happy to find a solution for you.  We can be reached at info@healthvantis.com or 877-344-3544.

Health Vantis

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877-344-3544

info@healthvantis.com

Wait Times Proving To Be Longer Than Expected

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Wait Times Proving To Be Longer Than Expected

We all knew, or highly suspected, that with the cancellation of non-urgent surgeries back when the pandemic broke, there would be consequences.  But how far deep has Canada dug a hole with regards to wait times?  According to the Canadian Constitution Foundation (CCF), it’s so far deep that it will take innovative thinking and more resources to mend the broken system.

Documents from the Ministry of Health show that between March 18 and July 27th, the number of surgeries and diagnostic procedures performed had dropped significantly when compared to the same time period in 2019.  Earlier reports for Ontario estimated 100,000 surgeries had been delayed, however, this was greatly underestimated.  Actual reports showed the number was 168,498 fewer surgeries done during that same 19-week period.  

If you look at it from a percentage point of view, this is where it faired:

– Pediatric surgeries dropped by over 75%

– Non-Oncology surgeries dropped by over 74%

– Oncology surgeries dropped by 24%

– Number of MRIs dropped by 43%

The numbers have not been evaluated since July 27th. To date, hospitals are still not performing surgeries at 100% capacity in anticipation of a second wave of COVID.  That means the backlog will grow even more.

The interesting thing in all of this, if you use Nova Scotia as an example, is that they cancelled 3,200 surgeries out of the 25,000 waiting to free up beds for COVID.  Since the pandemic began in NS, there were only 49 people who contracted the virus that were sick enough to need hospital care and only 12 of them needed ICU treatment.  So why were there 3,200 surgeries cancelled when the number of actual beds needed was so low?  

Per Gregory Hirsch, the senior medical director for surgical services network for NS, about 70% of the 3,200 cancelled surgeries have been caught up. That, however, doesn’t account for all of the postponed appointments with specialists and GP’s.  So the 3,200 number in reality is more like a back log of 12,000 as some of those cases have yet to emerge.  Even more discerning is that prior to COVID, only 60% of surgeries were being done within the standard amount of time it should take to begin with.

This pandemic has no doubt put the health care system in even more delays.  Were they necessary?  One could say yes, because they wanted to prepare for the unknowns to this virus.  But when you look at the actual numbers of how many people got postponed to free beds up to the number of people that actually needed them, were are still scratching our heads.

 

Health Vantis

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Ruling On Private Health Care In British Columbia

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Ruling On Private Health Care In British Columbia

What had been a decade long battle and litigated case came to a close in September.  Dr. Brian Day, owner of the private clinic Cambie Surgery Centre in Vancouver, unfortunately lost the constitutional challenge of public health care rules.

The Cambie Surgery Centre was legally opened in 1996 by Dr. Day to provide more OR time for surgeons that were unable to get it in the public hospitals. In 2009, he filed action against the B.C. government over sections of the Medicare Protection Act. This act requires doctors to opt out of billing the government for services provided for in the public system if they are also earning income in a private clinic.  According to the courts, Dr. Day’s facility has been in violation of this act since 2003.  He has maintained that under the Charter of Rights and Freedoms, patients who have waited too long in the public system for timely care should have the right to private treatment.

The argument has always been that by allowing a two-tier system, only wealthy patients would be able to pay out of pocket, therefore, allowing them to ‘queue jump’ for faster access.  This was thought to be unfair to those who didn’t have the means to pay for a quicker surgery or diagnostic test. 

In our experience, the customers that have come to us in search of private facilities have reached their tipping point of not being able to withstand the pain any further.  Their frustration levels are through the roof due to a system that was failing them.  Very few clients that have come to us over the past few years were weathly. In fact, the majority of them have been middle class or lower income earners who are willing to do anything just to feel better because the system has let them down.  In our experience, that argument is not validated.

It’s hard to say what will happen to the Cambie Clinic as Dr. Day did not comment on the ruling.  It is suspected he may try to appeal the decision.  In the meantime, Canadians will have one less option for access to private health care.

 

Health Vantis

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877-344-3544

info@healthvantis.com

Wait Time Updates – COVID-19

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Update On Wait Times During COVID-19

It is no secret Canada has some of the longest medical waits times out of all Universal Health Care countries.  Due to the COVID shutdowns and non-urgent surgeries being put on a temporary hold, you would think there would be significant increases in wait times. 

In Nova Scotia with a population of around 1MM province wide, about 25,000 people are waiting for surgical procedures.  Approximately 1,075 of those are cancer patients.  During the shut downs, about 3.600 surgeries were cancelled.  Some have suggested this will take an additional 2 years to catch up but Greg Hirsch, head of surgical services at the Nova Scotia Health Authority said that might be a little excessive.  

We have been monitoring the wait times on the Nova Scotia website for the past few months.  Here are the numbers that have been posted:

March 1, 2020-May 31,2020 April 1, 2020-June 30, 2020
# of Days for a Hip Replacement Consult 

189

143
# of Days for a Hip Replacement Surgery

466

363
# of Days for a Knee Replacement Consult 

167

161
# of Days for a Knee Replacement Surgery

539

626
# of Days for a Back Surgery Consult 

277

196
# of Days for a Back Surgery

115

191

As you can see, the number of days for surgery has increased by 14% for knee replacement surgery and by 40% for back surgery.  Hip replacement has decreased by 22%.  

Nova Scotia has done a great job at keeping the COVID-19 cases down, however, another wave of infections is projected to come which might result in more cancellations.  

Knowing your options of what you can do to get your surgery sooner or how to go about getting in a private manner can be overwhelming, especially with so many changes and restrictions placed on private facilities.  Contact Health Vantis is you have questions about your situation and what we can do to help you find the right private facility to address your needs at 877-344-3544 or info@healthvantis.com.

 

Health Vantis

877-344-3544

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info@healthvantis.com

To Mask or Not to Mask?

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To Mask or Not to Mask?

Back on May 20th, Chief Public Health Officer Dr. Theresa Tam made the announcement that she was recommending Canadians wear a face mask/covering where physical distancing wasn’t possible.  Wearing face masks is not something Westerners are used to.  It’s almost a stigma to have one on, however, in East Asia and China, there is no shame in wearing a face mask.  In fact, it has been going on there since the pneumonic plague in 1910 and is seen as a sign of civic responsibility to do so.  If someone is seen not wearing a face mask during a public health emergency, it is greatly frowned upon and people are actually afraid of that person because they would be considered to have low civic responsibility and disrespect.  

Now that things have opened up, we will be exposed to more human contact than we’ve had in the past several months.  Social distancing is a new term for us and we are still trying to understand what is acceptable and what is not.  Based on what Dr. Tam has suggested, if you are not able to distance yourself in a situation where you will have 2 meters space, then the recommendation is to wear a non-surgical face mask.  An example would be if you routinely take the train to work.  You cannot guarantee you will be able to keep a 2 meter distance with someone else.  In a situation like this, it makes sense to wear a covering.  If you take your own car to work, you would not need to wear your mask as you were driving.

COVID-19 is a new virus.  We are learning more and more about it each day.  We already know you can be asymptomatic.  Even though you feel well, you may be a carrier without even realizing it.  By wearing a face mask in situations where there will be close contact with others, the chances of spreading it are decreased significantly on both ends.  Many states in the US and provinces here in Canada have already enforced a mandate to wear one.  Not only are you protecting yourself, you are also protecting the more vulnerable such as a senior or immunosuppressed individual.  This shows that you are willing to make a difference in combating this virus and are respectful of others around you.  Plus, it is a temporary inconvenience and there are some pretty cool looking face masks being made out there!

Health Vantis

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What Creates Canadian Wait Lists?

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What Creates Canadian Wait Lists?  We are at the conclusion of our blogs this month for the 2017 wait times.  But what actually creates these wait lists and wait times?

Reasons That Might Suggest Why

There is a plethora of reasons why they occur across the country but here are a few possibilities that might support reasons as to why.

  1.   All physicians will see patients in the manner they see fit.  It can be based on their patient case loads, comparison to their other patients or simply triaged.  As much as we don’t want to believe it, some physicians will help fellow colleagues or friends/family out ahead of their actual patients.
  2. Lack of resources in a given province.  When this happens, the patient may be referred to another province for treatment.  If this happens, you become part of their wait list
  3. Rationing.  By this, we mean that there may be a doctor available to do another surgery and OR time available, however, each province sets the amount of patients seen or surgeries done in a given day.  If they have already met that quota, then they cannot treat any further patients until the next day.  This can create a back log that just keeps compounding on each other.
  4. Lack of available General Practitioner (GP) and Specialists. [ctt template=”3″ link=”Siu77″ via=”yes” ]Per a 2014 CBC Health News article, 4.4MM Canadians do not have a GP.(1) [/ctt]When you don’t have access to a GP or Specialist, people tend to utilize the ER for minor things as opposed to true emergencies.  This then creates long waits in the ER and takes valuable time away from those individuals who truly have an emergency.
  5. Lack of money.  Each province has their own budget of how much they spend on heath care resources.  Many of them have traditionally been fiscally conservative in how the money is spent.
  6. The aging Baby Boomer population.  As the Baby Boomers age, the need for more services are required that come with that aging process.  ‘The number of beds available for them may not be enough or may be blocked for budget reasons.  Community care is also limited.’(1)

Conclusion

Some experts have argued that changes need to be made to model other single payor systems in going to a 2-Tiered system which allows for privatization, using a cost sharing model for certain treatments or having to pay a co-pay for utilizing your GP or visiting the ER.  The Fraser Institute reported wait times the highest they’ve been in the 26 years they have been tracking it. Bacchus Barua(2) from the Frasier Institute has said [ctt template=”3″ link=”MDpxc” via=”yes” ]‘Canada is one of the highest spenders on health care in the developing world, but still has some of the longest wait times for treatment’.[/ctt] Although there are probably many other theories on where the medical wait lists began and most likely a combination of things there is no denying they exit.

We are experts at finding alternate, affordable, options if you are on a wait list.   Contact Health Vantis to see how we can help you find them!  877-344-3544 or info@healthvantis.com

Resources:

  1. CBC News/Health: http://www.cbc.ca/news/health/medical-wait-times-up-to-3-times-longer-in-canada-1.2663013
  2. Bacchus Barua: https://www.winnipegfreepress.com/local/hospital-wait-times-costing-national-economy-more-than-1b-375463401.html

Health Vantis

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2017 Canadian Wait Lists: Broken Down By Province

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2017 Canadian Wait Lists: Broken Down By Province…

In the 2 previous blogs this month, we gave a general overview of wait times for 2017 as well as a breakdown per specialty.  This week we’d like to provide the breakdown for each province.  The graph below indicates the wait time for each province broken down into: general practitioner (GP) to specialist, specialist to treatment and the total amount of time combined with these 2 factors.

Some of the changes in the first segment for a referral from a general practitioner (GP) to a specialist has risen from 9.4 weeks in 2016 to 10.2 weeks in 2017.  This is 177% higher than what it was in 1993.   The provinces where this increase has occurred are Manitoba, Ontario and Newfoundland & Labrador.

In the second segment of seeing a specialist and actual treatment has also increased from 10.6 weeks in 2016 to 10.9 weeks in 2017.  This is 95% higher than it was in 1993.

The overall wait time has increased in all provinces with the exclusion of British Columbia, New Brunswick, Nova Scotia and Newfoundland & Labrador where the wait time decreased slightly.  Despite the decreases for these provinces, New Brunswick and Nova Scotia are still leading the provinces with the longest wait times.

What causes these wait times?  Come back next week for more information on likely reasons the wait lists have existed and continue to rise.

For more information about Health Vantis and how we can help if you are on a wait list, contact us at 877-344-3544 or info@healthvantis.com.

Health Vantis

www.healthvantis.ca

877-344-3544

info@healthvantis.com

2017 Canadian Wait Lists: Broken Down By Specialty

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2017 Canadian Wait Lists: Broken Down By Specialty:

Last week we discussed the new numbers for the 2017 Canadian wait lists.  This week we are going to break this down by speciality, how long it takes to see a specialist and point of treatment.  They are as follows:

 

 

 

 

 

 

 

The largest INCREASES and DECREASES from 2016 to 2017 are as follows:

 

Keep in mind, these are averages across Canada. Many provinces have much lower wait times, however, there are some that have even higher wait times.  Come back next week as we will break each down by province.

For more information or if you are someone on this list being affected by these wait times, please give Health Vantis a call to see how we can help assist!  info@healthvantis.com  or Toll-Free 877-344-3544

Health Vantis

www.healthvantis.ca

877-344-3544

info@healthvantis.com

2017 Canadian Wait Lists and Wait Times

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2017 Canadian Wait Lists and Wait Times

Waiting for medical treatment in Canada has been an issue in the health care system for many years.  The Fraser Institute has been studying and reporting the statistics for these wait times for over 2 decades.  This month we will be breaking these findings down in our weekly Wednesday blog.  The 2017 findings are out and are as follows presented by weeks:

 

 

 

 

 

 

 

 

 

 

 

 

 

  • The number of Canadians on a wait list went from 973,505 in 2016 to 1,040,791 for 2017.
  • Average Total wait from referral to specialist to point of treatment is now 21.2 weeks 2017 which is 128% higher than in 1993.

What does this translate to outside of the obvious?  With prolonged wait times for your health, it can also affect many other aspects in your life.  Lengthy waits have consequences such as increased pain that may be treated with narcotics.  These have the potential to develop addiction which is a whole other set of issues.  It may also cause mental anguish, lost wages from the inability to work, or poorer medical outcomes potentially transforming reversible illness or injuries in to chronic, irreversible conditions that may result in permanent disabilities.

While Health Vantis supports the health care system, we also support making your health a priority.  If the system has put you on a wait list, please contact us to see what we can do to help.  Something as simple as having a private diagnostic test can make things move much faster for you.  Call us toll-free at 877-344-3544 for a complimentary 1-hour consultation to discuss how.  You can also reach us at info@healthvantis.com or by visiting our website www.healthvantis.ca

Check back each Wednesday this month for a break down to the 2017 findings.  These are the next topics to look forward to:

Week 2:  Wait List Broken Down By Specialty

Week 3:  Wait List Broken Down By Province

Week 4:  Why Do Wait Lists Exist?

Health Vantis

www.healthvantis.ca

877-344-3544

info@healthvantis.com