Canada’s healthcare – money alone does not ensure good healthcare

Canada’s healthcare – money alone does not ensure good healthcare

Eustace Davie, director of the Free Market Foundation, 6 March 2015,

Canada had a 2013 per capita GDP of US$51,962 (R613,152), SA’s was US$6618 (R78,092), according to the World Bank’s development indicators. So Canadians are on average 7.85 times wealthier than South Africans. Yet most people in this country would be horrified and become rebellious if they had to wait as long as Canadians do for medical treatment.

The Fraser Institute at has been documenting “the lengthy queues for visits to specialists and for diagnostic and surgical procedures in the country”, a crucial aspect of healthcare, which is reported in their 2014 publication, Waiting Your Turn. For instance, the median waiting time across Canada from the time a patient is referred to a specialist by a general practitioner (GP) to time of treatment was 18.2 weeks. Conditions are not improving. Back in 1993 the time between referral to a specialist and the patient receiving treatment was 9.3 weeks, so patients are now waiting 96% longer for treatment.

According to the report, which surveyed 12 specialities in 10 provinces of Canada, the waiting times differ substantially between provinces and between the various specialities. The shortest overall time of 14.1 weeks (3 ½ months) was in the province of Ontario and the longest was 37.3 weeks (9+ months) in the province of New Brunswick.

Waiting times between being referred by a general practitioner and seeing a specialist has deteriorated in the past two decades from 3.7 weeks in 1993 to 8.5 weeks in 2014. The shortest waits for consulting specialists is in Manitoba (6.4 weeks) and the longest is in New Brunswick (26.4 weeks).

After patients have seen a specialist they have to endure another wait to receive treatment. The waiting time for this part of the medical marathon has lengthened from 5.6 weeks in 1993 to 9.8 weeks in 2014. The shortest specialist-to-treatment waits are in Saskatchewan (7.0 weeks) and the longest in Prince Edward Island (17.6 weeks).

Variations between specialities differ markedly. The longest wait for patients is from referral by a GP to orthopaedic surgery (42.2 weeks) and from referral to medical oncology treatment 3.3 weeks.

There were an estimated 937,345 procedures for which people were waiting in 2014. Patients experience significant waiting times for various diagnostic technologies across the provinces. In 2014 Canadians could expect to wait 3.8 weeks for a CT scan, 8.7 weeks for an MRI scan, and 3.3 weeks for an ultrasound. I personally observed an SA patient in a private hospital on one day’s notice undergoing two such scans on the same day.

The Fraser Institute researchers point out “that wait times for medically necessary treatment are not benign inconveniences. Wait times can, and do, have serious consequences such as increased pain, suffering, and mental anguish. In certain instances, they can also result in poorer medical outcomes—transforming potentially reversible illnesses or injuries into chronic, irreversible conditions, or even permanent disabilities.” Other consequences are loss of income and other negative economic losses suffered by patients. The researchers conclude: “The results of this year’s survey indicate that despite provincial strategies to reduce wait times and high levels of health expenditure, it is clear that patients in Canada continue to wait too long to receive medically necessary treatment.”

How is it that patients in such a wealthy country have a non-functioning and apparently declining healthcare system by SA waiting standards? It is most unlikely that SA public hospitals and clinics make patients wait as long as patients have to wait in Canada. In the private sector, waiting times from GP to specialist to treatment are a fraction of the waiting times in Canada. It is no surprise to learn that Canada has a government-funded universal healthcare system – the kind of system that will come about with the introduction of NHI.

It would be helpful if SA’s government planners would take note of the deficiencies of the government dominated healthcare systems, such as Canada’s, and recognise that their NHI plans are likely to reduce and not improve the quality of SA’s healthcare, especially when considering the fact that high levels of expenditure in such systems do not translate into higher quality of care and efficiency in delivery.

The FMF’s Health Policy Unit consistently recommends that government should allow the private healthcare sector to grow as rapidly as possible so as to enable it to supply high quality competitive care to a steadily increasing percentage of the population. Government could then plan to purchase high quality care for government-funded patients from the private sector and eventually itself withdraw completely from the provision of healthcare.

Author: Eustace Davie is a director of the Free Market Foundation. This article may be republished without prior consent but with acknowledgement to the author. The views expressed in the article are the author’s and are not necessarily shared by the members of the Foundation.

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