A Tale Of Two Healthcare Systems

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In Canada, it doesn’t take a pandemic to overwhelm the healthcare system. It’s a routine occurrence.

The United States just reached an all-time high of over 100,000 coronavirus hospitalizations. Over 1,000 hospitals are critically short-staffed; about three-quarters of all hospital beds are full.

Some hospitals have stopped accepting new patients. In Idaho, St. Luke’s Magic Valley Hospital turned away patients seeking emergency care last month. Just a few weeks later, Elkhart General Hospital in Indiana diverted ambulances to other medical centers as staff rushed to treat people suffering from Covid-19. Over 90 hospitals nationwide have announced plans to cancel or postpone elective surgeries that require an overnight stay.

These stats are bleak. But it’s important to remember that the United States is facing its worst public health crisis in a century. And in many parts of the United States, the healthcare system is operating normally. According to the latest data from the Department of Health and Human Services, about 30% of inpatient beds are unoccupied. About 40% of intensive-care unit beds are currently free.

North of the border, in Canada, it doesn’t take a pandemic to overwhelm the healthcare system. It’s a routine occurrence.

That’s one of the key takeaways from a new report by the Fraser Institute, a Vancouver-based think tank. Canada has just two acute care beds per 1,000 people—the second-lowest figure among OECD nations. The United States, by contrast, has 2.5 acute care beds per 1,000 people—one-quarter more per capita.

Canada also underperforms when it comes to critical equipment like MRI machines. While the United States boasts over 40 per 1,000 people, Canada has one-fourth as many—just 10.4.

Fraser’s research ranks Canada either last or next-to-last on four out of five indicators of timely access to care. Nearly one in five patients had to wait four months or more for an elective surgery in 2016—the worst percentage among surveyed countries. Only 43% of patients can get a same-day doctor’s appointment when sick.

By comparison, over half of all U.S. adults can receive same-day or next-day care when required.

In 2019, over 1 million Canadians were waiting for medical treatment—nearly 3% of the entire population.

These delays are detrimental to Canadians’ well-being. One-third of them report that they’ve been living with some form of pain for longer than three months, according to a survey from the Angus Reid Institute, a Vancouver-based non-profit. More than 20% say that pain impacts their day-to-day activities. Of those experiencing chronic pain, 33% say they would likely have to wait six months or more for surgery.

I was born in Canada and have witnessed problems like these firsthand. My own mother lost her life to colon cancer after doctors delayed her colonoscopy, prioritizing younger people on the waiting list. Her life—and thousands of others—might have been saved if they’d been able to get the care they needed earlier.

What’s worse, Canadians pay an awful lot for this subpar care. Out of the 28 high-income countries with universal health care analyzed in the Fraser Institute report, Canada has the second-highest healthcare expenditure as a percentage of GDP after adjusting for age. It’s the seventh-highest spender per capita.

Those high costs mean high taxes. Last year, the average family of four paid $14,474 in taxes just to fund their broken healthcare system. The average single adult was on the hook for $4,894 in healthcare taxes.

That’s in addition to $690 in annual out-of-pocket costs. Shockingly, Canadians spend just $34 less per month on out-of-pocket healthcare costs than the average American despite facing annual tax burden that’s up to 51% greater, according to research from the Heritage Foundation.

Waiting for care has a significant cost, too. Wait times in Canada resulted in an estimated $6.3 billion in lost productivity in 2018—about $5,860 per person.

For much of this year, Canada has been spared from the worst of the coronavirus pandemic. But that’s changing. Given the Canadian healthcare system’s relative lack of capacity, that could present a big problem.

Sally C. Pipes is President, CEO, and Thomas W. Smith Fellow in Health Care Policy at the Pacific Research Institute. Her latest book is False Premise, False Promise: The Disastrous Reality of Medicare for All (Encounter 2020). Follow her on Twitter @sallypipes.

Nothing contained in this blog is to be construed as necessarily reflecting the views of the Pacific Research Institute or as an attempt to thwart or aid the passage of any legislation.

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