Healthcare in Canada and the U. S. Compared—One Physician’s Perspective

I thought that this little anecdotal first-hand report from a physician who practiced on both sides of the border was illuminating. In my view culture does count and the best comparison available for what a fully socialized system would look like in the U. S. is Canada’s and, well, the prospect isn’t particularly attractive. Here’s a few snippets:

As I have spent more time in Canada, I have started to appreciate the way its system affects doctors and their patients. The revelations have been nothing short of astonishing.

We hear a great deal about how much less Canadians spend on health care and what a wonderful system they have where everyone has access to “universal health care.” But how they accomplish this is not exactly as advertised.

According to no less a source than the World Health Organization, Canadians, for the price they pay, now have the worst health care system in the world. WHO ranks Canada’s health system as the third-most expensive system in the world, and rates it 30th in efficiency and 18th in access to care.

and

Surgeons are “controlled” by limiting access to operating rooms. In British Columbia, all elective operating rooms shut down at 3 p.m., except at Vancouver Hospital (the tertiary care center for all of the province), which shuts down at 5 p.m. except for emergencies.

Surgeons are given a very limited number of surgical “block times” in which to do their work. Younger surgeons get less time, and senior surgeons get the prime slots, just as in Britain. Each surgeon has a waiting list or “queue.” When a surgeon does an emergency case, the patients on his waiting list are pushed back by one slot for each emergency he does. That way the hospital’s budget for the number of surgeries it must pay for is not impacted by unexpected additions to the schedule

and

Internists and primary care physicians have another set of issues. The government limits how many patients each doctor can see and bill for each day. If you exceed the government’s quota, you simply won’t get paid for the additional work.

However, there is a work-around. Many physicians do their office practice and quit when they see their “limit.” They then travel to another community and work in an urgent care or after-hours clinic. As long as it is in another municipality (an outlying community with a health care need) they can bill additionally and get paid. This often means traveling 50 miles or more to work in a clinic distant enough to circumvent the quota rules.

Read the whole thing.

1 comment… add one
  • Larry Link

    Seems to me that the Canadian system is working just fine..according to the aritcle below, it cost the good folks from the north about $14.00 and some change a week for thier health care…something I think most Americans could afford quite easily!!

    When and only when we get politics out of the way and clear the air of all the spin on our own health care system will we realize that in the long run, having universal medical coverage for all of our people, only when this occurs will we begin to stop the rising cost of health care itself.

    http://ca.news.yahoo.com/s/capress/071217/health/health_health_tax_review

    By Chinta Puxley, The Canadian Press
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    TORONTO

    “The review will look at “fine-tuning” the tax – which costs every eligible taxpayer in the province as much as $900 a year-rather than phasing it out, McGuinty said in September.”

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