... healthcare thoughts from Canada

     While at meetings in Canada, I took advantage of the situation and asked the individuals with whom I met about Canadian healthcare. I got two basic responses: 1) It works well for the most part, but serious diseases or illnesses are sometimes treated with less speed than they would wish, and 2) What are you Yanks thinking? Please understand that these responses are from lay people and not from medical, insurance or government officials.

     The slightly longer answers are that in general things work well for most uncomplicated illnesses. More complicated illnesses or diseases may be a different story. There is a perceived lack of specialists, and things take longer to be treated in Canada than they do in the US. In some rare situations, they are not treated at all but are managed on an end of life basis. A friend of one associate was diagnosed with liver disease and given six months to live. As he could afford it, he came to the US and received treatment from one of the best hospitals for that type of disease. That was six years ago. He was told if he stayed with the treatment proscribed in Canada that he would most likely have died in the six months he had been previously given.

     On the plus side, most believe that truly immediate life threatening situations are taken care of "stat". However, I was told that treatment for serious illnesses is done pursuant to a protocol based on the time an illness takes to advance (e.g. prostate cancer care is treated with less urgency and initial care could be delayed for months as it is thought of as a slowly advancing disease), as well as on a triage basis. Care of the elderly is not withheld, but is reviewed on the basis of return vs. life extension. I asked if this is perceived as rationing, and the answers were split between yes and no.

     Specialist shortages and highly trained healthcare technician shortages seem to grab the attention of some Canadians. Canada subsidizes the education of a physician (at present the student pays about $15,000 per year in tuition). Medical school entry requirements are stringent as the government wants to be sure students finish, and indeed, most do. While that sounds as if it would take care of any doctor shortage, it does not, as specialists are tempted by the higher incomes they can have in the US. While a true exception to the norm, one person mentioned that a doctor friend of his left the field and became a veterinarian as he could make more in that profession than under the government regulated healthcare system.

     The Canadian system depends on the US to take care of the serious case "overflow". The Canadian healthcare system pays to have patients transported to a US facility for operations and treatment. Additionally, some Canadians who are unwilling to wait for an operation in Canada (either because they want to get better sooner or because they or their primary care doctor believe more immediate care is necessary) will come to the US and pay for the operation on their own. Some Canadian insurance carriers offer healthcare policies that will mitigate this additional cost, but the premiums are entirely the responsibility of the individual policy holder.

     While at the Buffalo airport, I asked the manager of the general aviation facility how they are weathering the recession. He volunteered that business has returned to normal levels, but there has been an increase over the last year in medivac flights from Canada clearing Customs at Buffalo. They are now getting up to five or six such medivac flights a day on their way to various hospitals in the US. A friend who recently had open heart surgery at the Cleveland Clinic told me that almost half of the patients were from Canada.

     Some Canadians fear that if the US adopts a health care system that is similar to Canada's, that this safety valve will disappear.

If you have not already done so, please write your Congressperson and Senators and express your thoughts, recommendations and concerns about our path to National Healthcare. There are so many things that all of us are concerned about that seem to go unheard. It is amazing that 1,000 pages would leave so many wondering and in fear. I would be pleased to discuss this with you.

Best Regards,
    Mike