Tuesday, October 16, 2007

Surgery Wait Times in Canada Hit Record High

Canadians waited longer than ever before (18.3 weeks) for non-emergency surgery in 2007, despite a multi-billion-dollar effort by government to speed up medical care, according to a report released yesterday by Canada's Fraser Institute. Highlights of the report include:

1. A typical Canadian seeking surgery had to wait 18.3 weeks in 2007 between referral from a general practitioner and treatment (averaged across all 12 specialties and 10 provinces surveyed), reaching an all-time record high, up from 17.8 weeks in 2006.

2. Ontario recorded the shortest waiting time overall at 15 weeks and Nova Scotia recorded the longest waits in Canada at almost 25 weeks.

3. The waiting time between referral by a GP and consultation with a specialist rose to 9.2 weeks from the 8.8 weeks recorded in 2006. The shortest waits for specialist consultations were in Ontario (7.6 weeks) and the longest waits for consultation with a specialist were recorded in Prince Edward Island (12.7 weeks).

4. The waiting time between specialist consultation and treatment—the second stage of waiting—increased to 9.1 weeks from 9 weeks in 2006. The shortest specialist-to-treatment waits were found in Ontario (7.3 weeks), while the longest waits were in Manitoba (12.0 weeks).

5. Between 2006 and 2007, large increases occurred in the waits for internal medicine (additional 4.9 weeks), gynaecology (additional 2.1 weeks), urology (additional 1.9 weeks), and otolaryngology (additional 1.8 weeks).

6. The median wait for a CT scan across Canada was 4.8 weeks. British Columbia, Alberta, Ontario, New Brunswick, and Nova Scotia had the shortest wait for CT scans (4 weeks), while the longest wait occurred in Manitoba (8 weeks).

7. The median wait for an MRI across Canada was 10.1 weeks (in other words, early 2008 if you call tomorrow). Patients in Ontario experienced the shortest wait for an MRI (7.8 weeks), while Newfoundland residents waited longest (20 weeks - in other words March 5, 2008 if you schedule tomorrow).

8. The median wait for ultrasound was 3.9 weeks across Canada. Alberta and Ontario displayed the shortest wait for ultrasound (2 weeks), while Prince Edward Island and Manitoba exhibited the longest ultrasound waiting time (10 weeks).

The Fraser Institute concludes that “The promise of the Canadian health care system is not being realized. The only way to solve the system’s most curable disease – lengthy wait times that are consistently and significantly longer than physicians feel is clinically reasonable – is for substantial reform of the Canadian health care system.”

MP: The disparity in wait times for surgery and other procedures like MRIs among Canadian provinces seems somewhat puzzling - isn't socialized medicine supposed to provide "free" and uniform medical care to all Canadians, regardless of which province they live in? Perhaps the significant geographical disparity in Canadian health care is because market prices and profits are suppressed under socialized medicine, resulting in an inefficient and uneven allocation of scarce medical resources?


At 10/16/2007 11:02 PM, Anonymous Anonymous said...

If I were a Canadian, the most terrifying prospect would be an America with the same universal health care: No escape would be possible then, even for the connected and rich.

At 10/17/2007 8:56 AM, Blogger Ironman said...

How funny - I dug into some numbers and posted this yesterday at Marginal Revolution:

Different Jeff asked:

How and why can Canada, for example, deliver equal or better health care outcomes for half the price?

First, consider this: the median amount of time Canadians wait to see a specialist after being referred to one by a general (or family) practitioner has gone from 3.7 weeks in 1993 to 8.8 weeks in 2006 [these figures are from the Fraser Institute (last year's data, before the release you cited!)]. This more than double increase in the time delay to receive treatment has come despite there being almost no change in the proportion of GPs and specialists with respect to the total Canadian population.

In other words, the increase in median wait time to receive medical treatment over these years is not driven by a shortage of specialists.

By contrast, the total number of doctors in the U.S. has increased with respect to the population from 1993 to 2006, including the number of both GPs and specialists.

Now consider this: the Canadian health care system has systematically underfunded investments in new medical technology for years, including for well-established devices such as MRIs, which have become a primary means for specialists to diagnose and monitor various medical conditions. According to OECD data, in 1993 Canada had 1 MRI for every one million Canadians. By 2005, the Canadian health care system had increased that to 5.5 MRIs for every one million Canadians.

By contrast, the U.S. had 11.5 MRIs for every one million Americans in 1993, which increased to 26.6 MRIs for every one million Americans in 2005.

The lack of investment in implementing medical technologies into the Canadian health care system acts as a bottleneck for Canadians in receiving treatment. This underinvestment keeps costs down, as nothing saves more money than not spending it, but these savings come at the price to patients of serious delays in receiving advanced medical treatment. Once Canadians make it to the specialist, the outcomes are similar to those in the U.S. for many conditions, but not for those conditions (such as cancer) for which early treatment is an essential element in obtaining substantially better outcomes.

We should note that the OECD indicates that U.S. patients do not have a significant wait time between getting a referral from a GP to receiving treatment from a specialist.

At 10/17/2007 1:20 PM, Anonymous Anonymous said...

As for the persistent crowds, many customers remain indifferent. "Our country's a country of lines," says Andrey Shatskiy, a 40-year-old soap-opera cinematographer, while eating lunch at the Pushkin Square restaurant. "We all got used to it."

The above is from your 10/16/07 post r.e. McDonald's in Moscow.

Seems like socialism breeds lines in Europe and North America; whether it's fast food or health care.

At 10/17/2007 4:05 PM, Anonymous Anonymous said...

I would like to know how Canada can deliver health care outcomes that are very similar to what we get here?

If our system is that much better than the Canadian system then our patient outcome statistics should be amazingly better than Canada's and they are not.

At 10/17/2007 4:46 PM, Blogger Mark J. Perry said...

Anonymous: "If our system is that much better than the Canadian system then our patient outcome statistics should be amazingly better than Canada's and they are not."

I got an MRI in one day in Michigan, and could have actually gotten one on the same day I made the appt. MRIs in the U.S. are often "same day service." In Canada, I could be waiting for 20 weeks in some parts of the country.

At 10/17/2007 5:08 PM, Anonymous Anonymous said...

What was the price for the one day MRI? If you had waited, could you have gotten a better price? Was there a need to have the MRI the next day? Or was it a demand by the "I must have this procedure right this minute or my patient might die" mentality?

At 10/17/2007 5:29 PM, Blogger Mark J. Perry said...

I still haven't gotten the bill for the MRI. It was a non-emergency situation for what ended up being a herniated cervical disk. Calling on a Friday morning for an appointment, they said they had openings the next Monday, and even had an opening that day. Getting the diagnosis immediately allowed me to proceed with treatment, which included 4 epideral injections and then physical therapy.

Waiting for 20 weeks for an MRI seems like a real burden, and potentially dangerous, or at least uncomfortable. In my case, I had a certain amount of pain, and the speedy MRI significantly speeded up the diagnosis and treatment process.

I'm thankful for non-socialized medicine in the U.S., despite many problems that have been discussed on this blog.

At 10/17/2007 8:08 PM, Anonymous Anonymous said...

Mark J. Perry:"I got an MRI in one day in Michigan, and could have actually gotten one on the same day I made the appt. MRIs in the U.S. are often "same day service." In Canada, I could be waiting for 20 weeks in some parts of the country."

I didn't ask for an anecdote I was asking why our system here in the U.S. does not produce dramatically different outcomes for patients vs what is found in Canada.

You don't know how long a patient with your symptoms would wait for an MRI in Canada. You pulled a number from some study and suggested that it might apply to you. That is a bad argument for or against any heath care system.

Show me how our system is so much better than the Canadian system. Show me with statistics and peer reviewed studies, published in respected journals how our system produces a significant difference in patients outcomes.

I'm not advocating the Canadian system, I think it has flaws but it isn't the boogeyman that it is being made out to be by private health insurance companies from this country.

At 10/18/2007 10:51 AM, Anonymous Anonymous said...


Why not turn the table and ask if the Canadian system doesn't produce amazingly better results than the American system, why are we having this discussion?

At 10/19/2007 1:03 AM, Blogger Logan said...


Help is on the way.

At 10/21/2007 1:30 PM, Anonymous Anonymous said...

bob wright:Anonymous:
Why not turn the table and ask if the Canadian system doesn't produce amazingly better results than the American system, why are we having this discussion?

bob wright...the Canadian system of health care (that I do not support) produces very nearly the same result that our system does (for all of it's citizens) for nearly half the cost of our system and that is pretty amazing.

At 11/02/2007 6:16 PM, Anonymous Anonymous said...

Giuliani's Bogus Diagnosis http://www.washingtonpost.com/wp-dyn/content/article/2007/11/01/AR2007110101991.html?hpid=opinionsbox1

Giuliani is getting slammed for using bad data regarding prostate cancer and socialized medicine. He sourced the info in a hurry from bad sources with agendas that don't include the truth.

Giuliani has lost his credibility as this goof up on his part was so easy to confirm as true or not but he had an agenda that didn't include the truth.

At 10/24/2008 10:39 AM, Blogger Unknown said...

1/2 the cost of our system??

Maybe an acct out there can help explain how Canada "hides" a good portion of its infrastructure overhead costs by booking them to the Balance Sheet as assets vs the Income Stmt as expenses.



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