January 14, 2005
HIGH CRIMES AND MISDEMEANOURS
A boy's plight, a nation's problem (Lisa Priest, Globe and Mail, January 13th, 2005)
A four-year-old Newfoundland boy who has already lost one kidney to cancer is facing a staggering 21/2-year wait for a scan on the province's only magnetic-resonance-imaging machine.The scan was requested by a geneticist who suspects Ryan Oldford, a rambunctious, blue-eyed blond, has a rare syndrome that puts him at higher risk for leukemia and cancers of the kidney and liver, according to his mother, Brenda Oldford.
"I'm always very worried whether his other kidney is okay," Mrs. Oldford, who is a nurse, said in a telephone interview from the St. John's suburb of St. Philip's. "My heart has to believe he is okay, otherwise, I would not be able to survive."
As many as 100 children in Newfoundland face 30-month waits for the high-tech scans, said Geoffrey Higgins, clinical chief of diagnostic imaging at the Health Care Corporation of St. John's. While the wait is "less than ideal," he said patients' conditions are being investigated and followed by other medical means, and that anyone needing an emergency scan gets one.
Stories such as Ryan's are fuelling public demand for MRI services and sparking a boom in the private-clinic business, mostly in B.C., Alberta, Quebec and Nova Scotia.
On 36 private scanners across the country, patients can pay to have speedy access to MRIs, computed tomography machines, positron-emission tomography machines or the combination of a CT/PET scanner.
But federal representatives, concerned over the emergence of a private pay system, are meeting in Toronto today with officials from British Columbia, Alberta and Nova Scotia. "User charges and queue-jumping at diagnostic clinics" will be discussed, Health Canada spokeswoman Catherine Saunders said.
A separate meeting with Quebec on allowing patients to pay for medically necessary scans at private clinics will take place later.
Documents from 2004 obtained by The Globe and Mail under the Access to Information Act show that Health Canada is investigating every province over suspected Canada Health Act violations. The list includes patient charges at private high-tech diagnostic clinics, private surgery clinics, specialty referral centres, bone-density scans, surgical supplies and abortion services. Six provinces have also failed to pay the home rate for hospital care when patients are out of province and require care, according to the documents, which are marked "secret."
"The Canada Health Act is something we take very seriously," Ms. Saunders of Health Canada said in a telephone interview from Ottawa. "There is a concern that people are being charged for medically necessary services."
She is right. The Government takes the Canada Health Act very seriously. More seriously than the health of Canadians.
Posted by Peter Burnet at January 14, 2005 1:23 PMWow. One mri in an entire province. It doesn't say how many public ones but only 36 private ones for a population of 30 million. There are dozens in Cleveland which has about the same population as Newfoundland. What do Canadians get again for their tax dollars?
Posted by: Bob at January 14, 2005 1:57 PMAgain, why should this surprise anyone? If health care is a sacrament, and private transactions profane it, then why shouldn't priests like Mrs. Saunders do their best to hunt down heretics like Mrs. Olford?
Posted by: joe shropshire at January 14, 2005 2:02 PMFor anyone really interested in this subject, this book by a Canadian studying in California is getting good reviews. Non-dogmatic, accessible analysis of the problems in both countries, which she argues have both big problems coming.
Posted by: Peter B at January 14, 2005 2:17 PMAll very well to have a private plan. I have one and I'm very happy with it.
Problem is, most people want to jump on the public's back when their plan runs out.
Makes things hard to manage, no?
Peter, what percentage of Canada GNP is the public health?
Posted by: Harry Eagar at January 14, 2005 4:00 PMAll very well to have a private plan. I have one and I'm very happy with it.
Problem is, most people want to jump on the public's back when their plan runs out.
Makes things hard to manage, no?
Peter, what percentage of Canada GNP is the public health?
Posted by: Harry Eagar at January 14, 2005 4:00 PMGod forbid anyone be charged for medically necessary services.
Posted by: E Rey at January 14, 2005 4:28 PMHow long does one scan take? How many people are on the waiting list? I somehow doubt the machines are running 24 hours/day, which they should be under these circumstances.
Posted by: PapayaSF at January 14, 2005 7:53 PMI've been scanned several times. Takes 15 minutes, and only 3 or 4 in the actual machine.
10%, all other things being equal, means about one-quarter less health care than us.
So, if they were willing to pay as much as we are, they'd presumably wait less long.
Down here, you can get a CT scan, for a non-emergency situation such as this boy is in, within a few days, perhaps a couple weeks.
Or, not at all, depending.
Posted by: Harry Eagar at January 14, 2005 8:11 PMThanks, Harry. So let's round that down and figure they can do 3 an hour. If they ran the machine 24 hours/day, that's be 72 people per day. At 30.4 days per month, that's 2188.8 scans per month. So a 30-month waiting list would be about 65,664 people waiting for scans in Newfoundland. Doesn't that seem rather high? I suspect they are not running their machine at full capacity, and using the waiting list to demand more funding.
Posted by: PapayaSF at January 14, 2005 8:40 PMOr, not at all, depending.
Which holds just as true for a ration-by-queuing system, unless you believe that (a) every last person hanging on the end of that 30-month line eventually gets treated, and (2) that that person's primary-care physician is stubborn enough to prescribe proper care for their next patient. Try a little harder, Harry.
I have no idea what the downtime for a mri machine is, but I suspect the wait has much to do with a surrounding, almost Kakfkaesque bureaucracy. A friend of mine (of decidedly libertarian, anti-medicare views)recently had fairly commonplace, but painful and debilitating, surgery on his foot. He told me that the operation itself was first class and he was extremely impressed and confident about what went on in the operating room. A satisfied customer.
But the story of the eight months it took him to get there was chilling. Endless calls, booked and cancelled appointments, paper confusion, etc. He was told he was free to look for another hospital with shorter wait times elsewhere in the province, but when he called them he discovered there was no "procedure" to cover such requests and therefore it couldn't be done. He spent a whole day gowned in the hall of the hospital "with my butt hanging out", only to be told in late afternoon to go home because there was a shortage of nurses.
So, arguing that the care itself or the doctors and nurses are second-rate won't take you far--at least not for now. In some areas, like children's hospitals (supported by huge private fund-raising campaigns), it is cutting edge. The issues are ever-lengthening waiting times, hospital hygiene in some places (Quebec at the moment) and access to high-tech equipment.
BTW, it is interesting to note that, as these problems increase and become more and more in the public eye, the ideological ferver and determination to preserve the purity of the system is growing. Another proof of man, the rational animal. The damnable thing is that the situation could improve dramtically in the short term with some fairly minor tinkering---user fees, private supplemental services, etc. But the idealogues who lay awake at night caring for us all won't hear of it.
Posted by: Peter B at January 15, 2005 6:18 AMMy friend's cat had an MRI a couple of years ago. Took no more than a week or two from making the appointment to the procedure (cat is still going strong at 16). Sounds as if we provide better services for our pets than Canada does for its children.
Posted by: George at January 15, 2005 10:44 AM