November 2001
Canada’s Abysmal Health Technology Record
by Nadeem Esmail
The Credit Valley Hospital in Mississauga, Ontario has just added a new MRI unit, Alberta has committed itself to increasing the number of MRI units in the province by seven, and the Federal Government has allocated $1 billion of spending to increasing health technology. What is all this sudden fuss about MRI units?
The MRI machine is a relatively new device that became popular in the late 1980s. It creates images of the human body so that doctors can analyze fluid movements, search areas like the brain or spinal cord for abnormalities, and diagnose muscle or soft tissue injuries. Although the machines are not cheap, they are of great value to surgeons as none of these areas can be diagnosed with traditional xray based machines.
So now that Canada is investing heavily in these new, high-tech machines, will Canada be a health technology leader in the near future? Unfortunately, no. But this is not due to a lack of spending. Canada spends a lot of money on health care. In fact, when we consider the percentage of GDP spent on health care, Canada is the sixth highest spender in the OECD, and the fifth highest in actual dollars spent per person (table 1).
Despite our record for high spending, we still have relatively few health technologies available for Canadians. According to figure 1 and table 1, Canada currently ranks a depressing nineteenth in a comparison of 25 OECD countries for MRI availability. A number of countries that spend less than Canada rank higher in the availability of MRI scanners.
At present, Canada would have to add 161 MRI machines to place sixth on the chart, which would equal its rank in total spending (as a percent of GDP). That number leaps to an astonishing 327 MRIs if we wished to place second (leaving out Japan, which has a disproportionately high number of MRI machines). To add perspective to these numbers, Canada had 78 MRI machines per million inhabitants in 2000, to which we can add the new machine in Ontario for a rough total of 79. 1 These simple facts can go a long way towards explaining the alarming median waiting time of 12 weeks for an MRI scan (Walker and Wilson, p. 25). We simply don’t have the technology available to us in quantities comparable to the rest of the OECD.
Of course, there will be arguments that Canada may have chosen to substitute less expensive equipment for the very costly high-tech MRI machines. A computed tomography (CT) scanner can sometimes be used as a lower cost, albeit lower quality, alternative to an MRI scanner. It generates an xray of a cross-section of the body (as opposed to the usual lengthwise image), which allows doctors to diagnose far more than they can with a basic xray, but still less than they can with an MRI. Specifically, the CT scanner is less able to diagnose problems in soft tissue or muscles. But if Canada has been using CT scans in place of MRI scans to reduce costs, then Canada would rank relatively high on the CT scanner comparison (see figure 2) in order to compensate for a relatively low ranking on the MRI comparison.
Unfortunately for Canadians, this is not the case either. In a comparison of 23 OECD countries, Canada’s rank for the availability of CT scanners was similar to its rank for MRI scanners: a depressing eighteenth (see figure 2). There is no dispute: Canada does not have health technology available to its citizens in a quantity that compares favourably with other wealthy OECD countries.
Note
1 The problem is even worse than it looks.
Consider that the number of machines in
the majority of the countries in the ranking
was calculated in 1998 or 1999. Canada is in
the most recent data group (2000). This
means that according to table 1 we may
equal France, but France has actually had a
3year interim in which to increase its number
of MRIs.
References
Organisation for Economic Cooperation and
Development (2001). OECD Health Data
2001: A Comparative Analysis of 29 Countries.
CDROM. Paris: OECD.
Walker, Michael and Greg Wilson (2001).
Waiting Your Turn: Hospital Waiting Lists
in Canada (11 th ed). Critical Issues Bulletin.
Vancouver: The Fraser Institute.
Nadeem Esmail (nadeeme@fraserinstitute.ca) completed his B.A. in Economics at the University of Calgary, and his Masters in Economics at the University of British Columbia. He is Health Policy Analyst at The Fraser Institute.
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.