Heed the cautionary tale of Canadian health care

It’s a good thing Canadians are so polite; they spend an unbelievable amount of time waiting in line.

In 2018, the typical Canadian patient faced a median wait of almost 20 weeks for treatment from a specialist after referral from a general practitioner, according to a new report from the Vancouver-based Fraser Institute.

Patients in some provinces faced especially long delays. Albertans waited a median of more than half a year between referral from their general practitioner and specialist treatment. The median wait in New Brunswick was 45 weeks.

Canada is hardly unique. Long waits and rationed care are hallmarks of all government-run health care systems. The same would be true under a Medicare-for-all system in the United States.

How does America’s current system stack up to Canada’s?

Consider the wait for an appointment with a gynecologist. In Houston, patients waited an average of four weeks to schedule an appointment with a gynecologist in 2017, according to a study from Merritt Hawkins, a national physician search firm and a company of AMN Healthcare. The average wait time across 15 American cities was about the same — 26.4 days.

Meanwhile, the median Canadian wait for an appointment with a gynecology specialist following referral by a general practitioner was nearly 11 weeks last year.

Or look at orthopedic surgery. Merritt Hawkins reported an average wait for an appointment in Houston of 10 days in 2017. Nationwide, the average wait was 11.4 days.

The median Canadian wait for an appointment with an orthopedic surgeon following referral from a general practitioner? Nearly 15 weeks in 2018.

Canadian patients have been waiting longer and longer for treatment over the past quarter-century. Median wait times in 2018 were more than twice as long as in 1993, the first year the Fraser Institute published its report.

Canadians have no choice but to wait in line. The government bans private insurance coverage for medically necessary procedures. So ordinary Canadians can’t pay out of pocket for faster or better care — their only option is a lengthy wait for state-funded care.

As a Canadian native, I’ve witnessed the destructive impact of these waits firsthand. My own mother died from colon cancer after doctors delayed her colonoscopy so younger people on the waiting list could go first.

Waiting is a big problem on the other side of the Atlantic, too. About 4.1 million Britons were waiting for a non-urgent operation through the United Kingdom’s National Health Service as of September 30. That’s more than 6 percent of the country’s population.

To clear the backlog, the NHS would need surgeons to perform an additional 10,000 operations a week. That’s a nearly impossible target to meet. The NHS is short 10,000 doctors and 40,000 nurses. By 2030, the system could lack 350,000 medical professionals, according to The King’s Fund, a health policy think tank.

Things will likely get worse this winter. NHS facilities were so overburdened during last flu season that as many as 100,000 patients languished in ambulances for at least half an hour before they were admitted to emergency rooms.

This year, more than 300,000 patients may wait more than four hours on hospital trolleys before they receive care, according to predictions from the British Medical Association.

Delays of this sort aren’t merely inconvenient. They pose a serious threat to patients’ health. A previous Fraser Institute study found that long waits for necessary care caused up to 63,000 premature deaths among Canadian women between 1993 and 2009.

American proponents of Medicare for All ignore the failures of government-run health care abroad. On a recent trip to our northern neighbor, U.S. Sen. Bernie Sanders asked rhetorically, “How is it that here in Canada, they provide quality health care to all people?” The Democratic Party’s newest superstar, freshman Congresswoman Alexandria Ocasio-Cortez, D-N.Y., has said, “Every other developed nation in the world does this … Why can’t America?”

Both Sanders and Ocasio-Cortez support legislation that would import the Canadian model to the United States — and outlaw private insurance coverage for medically necessary procedures. That’s more radical than even the United Kingdom, Germany and other developed countries in Europe, all of which allow for private health coverage.

Voters ought to ask themselves a different set of questions than Sanders and Ocasio-Cortez offer. How could nations as wealthy as Canada and the United Kingdom subject their populations to such abysmal medical care? And how can we prevent such a system from taking root here?

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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