The Canadian Health Care Edge

About 41,000 Canadians a year go south for medical care; a tiny fraction of the millions who stay in Canada.

Courtesy: Michael Moore's movie "Sicko"

(CALGARY, Alberta) - Danny Williams, conservative Premier of Newfoundland and Labrador, is a multi-millionaire who used his wealth to fly to an unknown U.S. location for an unknown cardiac procedure done on February 4.

The populist Newfoundland and Labrador premier has been a vigorous defender of the public system so it’s not known why he went to the U.S. More advanced procedures are probably not available in his home province, but they almost certainly are in Ottawa or Toronto and other locations in Canada.

Fox news as well as the Fraser Institute in Canada have predictably jumped on the Williams’ case as an example of an ailing or failing public health system in Canada. “This should be a wake-up call to Congress and the administration,” said a Fox News medical commentator, in a report by John Geddes in Maclean’s “It is a fact beyond dispute that the United States remains the global destination for patients from all over the world.”

The Fraser Institute has estimated that about 41,000 Canadians go south for medical care which is obviously a miniscule fraction of the millions of medical procedures that occur every year across Canada. "Think about the absurdity about Canadians spending their income on medical treatment outside the country because it's not provided here at home," said Brett Skinner, president of the Fraser Institute, in a Vancouver Sun report By Mike De Souza and Sharon Kirkey.

Fox’s “fact beyond dispute” and Skinner's "absurdity" apply to the rest of the world but not necessarily to Canada or other developed countries. Dr. Bryce Taylor, surgeon-in-chief at Toronto’s prestigious University Health Network, said Ontario’s heart centres offer the latest techniques with virtually no waiting lists. “They were impugning our ability to give patients good access,” reports Geddes. I suspect that it was a particular surgeon that took Williams south.

Canadian hospitals match American cutting-edge procedures but Americans don’t go north for care because Canadian hospitals and physicians are not insured for malpractice suits that might be brought in the U.S. Dr. Jack Tu, senior scientist at Toronto’s Institute for Clinical Evaluative Sciences, has researched outcomes for heart patients in the two countries concluding that there’s little difference, reports Geddes. Within a month of heart surgery, about a quarter of U.S. patients are back in hospital compared to about a fifth in Canada. This is probably because of the pressure that U.S. insurance companies put on hospitals to get patients out the door as quickly as possible.

“In fact, the issue of readmissions has prompted the American College of Cardiology and the U.S. Institute for Healthcare Improvement to launch a program called Hospital to Home, in a bid to find ways to lower that troubling readmission rate,” writes Geddes. “Even the elite U.S. hospitals are seized by the issue. Last year, the Cleveland Clinic appointed a task force to study the problem. Broadly speaking, Tu said American hospitals tend to have the edge in technology and intensive care facilities, but Canada’s health system is better at caring for patients over longer periods, including after they leave hospital, and in making sure they get the prescription drugs they need.”

The Canadian health care system is as good as the U.S. system across the board. At the same time, it’s less expensive and accessible to all, regardless of their economic circumstances, and with most procedures, there is a lower re-admission rate because patients tend to be treated completely at the outset.

One thing not mentioned are the number of so called “snow birds”, well off Canadians who retire to the southern U.S. They keep their Canadian citizenship so they can readily return to Canada for medical care. This is something not availableto Americans.

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Daniel Johnson was born near the midpoint of the twentieth century in Calgary, Alberta. In his teens he knew he was going to be a writer, which is why he was one of only a handful of boys in his high school typing class — a skill he knew was going to be necessary. He defines himself as a social reformer, not a left winger, the latter being an ideological label which, he says, is why he is not an ideologue. From 1975 to 1981 he was reporter, photographer, then editor of the weekly Airdrie Echo. For more than ten years after that he worked with Peter C. Newman, Canada’s top business writer (notably on a series of books, The Canadian Establishment). Through this period Daniel also did some national radio and TV broadcasting. He gave up journalism in the early 1980s because he had no interest in being a hack writer for the mainstream media and became a software developer and programmer. He retired from computers last year and is now back to doing what he loves — writing and trying to make the world a better place