Report's denial of healthcare crisis prevents true reform: Fraser Institute

Contact:

Martin Zelder, Director of Health Policy Research
The Fraser Institute
Telephone: (604) 714-4548
Email: martinz@fraserinstitute.ca

Release Date: 25 January 2001

VANCOUVER, BC — A recent report does not acknowledge the clear problems with Canada's current healthcare system and is based on largely anecdotal findings, says The Fraser Institute in response to a healthcare report issued today by the Tommy Douglas Research Institute.

"This report does a great disservice to Canadians who want our healthcare system to provide the care they need," says Martin Zelder, director of health policy research. "Their hopeful anecdotes are no substitute for relevant evidence."

Waiting list data, presented annually by The Fraser Institute, and verified against estimates published in peer-reviewed academic medical journals such as the Journal of the American Medical Association and the Ontario Medical Review, indicates that patients are waiting longer than ever — almost four months — between visiting a general practitioner (GP) and receiving treatment.

Averaged across all 12 medical specialties and 10 provinces surveyed, total waiting time rose from 13.3 weeks in 1998 to 14 weeks in 1999, a 5.3 percent increase. Waiting times have increased a dramatic 51 percent since 1993, when the median total wait for Canadian patients to receive treatment was 9.3 weeks.

"How can these authors say there is no crisis?" asks Zelder.

The evidence also shows that Canadians are being deprived of access to vital high-technology medical equipment and procedures. In terms of technology per capita, Canada is clearly not a world leader. The country is generally ranked among the bottom third of countries in the Organisation for Economic Cooperation and Development (OECD) for availability of medical technology.

The report by the Tommy Douglas Institute claims that doctor outflow is not a serious problem, but recent research by Statistics Canada shows that for every one doctor permanently migrating from the U.S. to Canada, there are 18 Canadian doctors who are leaving permanently for the U.S. (and the migration to the US, across all occupations, is grossly disproportionately found among those earning $150,000 or more — the most highly-skilled).

Current data (again from the OECD) shows that Canada has one of the lowest ranks in terms of number of doctors per capita, 23rd out of 29, better only than countries like Mexico, Turkey, and Korea. Further, the OECD data combines general practitioners and specialists, understating Canada's true problem: few specialists per capita.

The Douglas Institute's report also recommends less use of prescription drugs. Fraser Institute research on government health spending finds, however, that while higher overall government health spending (per person) does not reduce waiting time, spending on pharmaceuticals does. The efficacy of drug spending is further supported by recent research which finds that OECD countries with higher drug spending in 1985 had longer life expectancy in 1993.

"To reduce waiting times, to provide adequate access to doctors, to use resources like drugs to the extent they are valuable, substantive reforms are necessary. This report doesn't advocate such reforms; rather, it supports shuffling deck chairs on the Titanic," says Zelder.

Substantive reforms would include individual financial out-of-pocket responsibility for use of the system, such as modest user fees or medical savings accounts; greater use of private sector hospitals, who have demonstrated records of providing services at lower cost than government-run hospitals; and dismantling of government-negotiated collective bargaining for doctors, nurses, and non-medical workers, which underpays doctors and nurses (especially the highly-skilled), and overpays public union non-medical workers.

Established in 1974, The Fraser Institute is an independent public policy organization based in Vancouver, with offices in Calgary and Toronto.

Fraser Institute studies on waiting lists, the effect of increased spending on waiting times, and the availability of medical technology can be found on the web site at www.fraserinstitute.ca.

Relevant links:

Waiting Your Turn: Hospital Waiting Lists in Canada (10th Edition)
http://www.fraserinstitute.ca/publications/critical_issues/2000/waitingyourturn/index.html

Spend More, Wait Less? The Myth of Underfunded Medicare in Canada
http://www.fraserinstitute.ca/publications/forum/2000/08/

The Availability of Medical Technology in Canada: An International Comparative Study
http://www.fraserinstitute.ca/publications/pps/28/

How Private Hospital Competition Can Improve Canadian Health Care
http://www.fraserinstitute.ca/publications/pps/35/

Labour Costs in the Hospital Sector (Fraser Forum, November 1995)
http://www.fraserinstitute.ca/publications/forum/1995/november/

info@fraserinstitute.ca
4th Floor, 1770 Burrard Street, Vancouver, BC, Canada, V6J 3G7
Tel: (604) 688-0221 Fax: (604) 688-8539 Book Orders: 1-800-665-3558 ext. 580

You can contact us at the above email address for any comments or information requests. Please report any dead links or technical problems.