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To: koan who wrote (775843)

3/20/2014 12:05:08 PM

From: TideGlider

Respond to of 1578342

Waiting Your Turn: Wait Times for Health Care in Canada, 2012 Report
Type:	Research Studies
Date Published:	December 4, 2012
Authors:	Bacchus Barua Nadeem Esmail
Research Topics:	Health, Hospital Waiting Lists
This edition of Waiting Your Turn indicates that waiting times for elective medical treatment have decreased since last year. Specialist physicians surveyed across 12 specialties and 10 Canadian provinces report a total waiting time of 17.7 weeks between referral from a general practitioner and receipt of elective treatment. Wait times between 2011 and 2012 decreased in both the segment between referral by a general practitioner and consultation with a specialist (falling to 8.5 weeks from 9.5 weeks in 2011), and the segment between a consultation with a specialist and receipt of treatment (falling to 9.3 weeks from 9.5 weeks in 2011). While wait times have fallen over all, physicians themselves believe that Canadians wait approximately 3 weeks longer than what they consider is clinically “reasonable” for elective treatment after an appointment with a specialist. There is also a great deal of variation in the total waiting time faced by patients across the provinces. While Ontario reports the shortest total wait in 2012 (14.9 weeks); New Brunswick reports the longest at 35.1 weeks. The same is true of variation among specialties. Patients wait longest between a GP referral and orthopaedic surgery (39.6 weeks), while those waiting for medical oncology begin treatment in 4.1 weeks. It is estimated that in 2012, across all 10 provinces people are waiting for an estimated 870,462 procedures. This means that, assuming that each person waits for only one procedure, 2.5 percent of Canadians are waiting for treatment. Importantly, physicians report that only about 10.3 per cent of their patients are on a waiting list because they requested a delay or postponement. The results of this year’s survey indicate that despite provincial wait times reduction strategies and high levels of health expenditure, it is clear that patients in Canada continue to wait too long to receive medically necessary treatment.

To: koan who wrote (775843)	3/20/2014 12:10:42 PM
From: TideGlider	1 Recommendation Recommended By dave rose Read Replies (2) \| Respond to of 1578342

Winnipeg Free Press - PRINT EDITIONCanada's costly health care wait times By: Robert Ouellet and Nadeem Ismail Posted: 11/26/2013 3:16 AM \| Comments: 5 Tweet 53 Vancouver -- Waiting has become a defining characteristic of the Canadian health care experience, but the consequences imposed on patients by delayed access to universally accessible care are too often ignored in the health care debate. To be clear, some Canadians can wait (and wait...) with minimal consequence. Not so for others. Long delays can lead to a further deterioration in the untreated condition, meaning a more complex and difficult treatment at the end of the wait and possibly a poorer outcome. For some, long waits may condemn them to life-long disability or even death. The potentially fatal nature of waiting was not lost on the Supreme Court of Canada when it ruled against the public monopoly in health insurance in Quebec in 2005. And there are psychological consequences to waiting. Some may develop addiction to narcotics they take while waiting. Some will contend with loneliness imposed on them by the untreated medical condition, possibly from reduced mobility but also potentially because of a risk of deeply embarrassing events such as falls or incontinence. That embarrassment may also extend to increased reliance on others, even for the basics of life such as washing. And some may end up struggling with depression, despite the temporary nature of their situation. And, of course, there are economic consequences related to reduced productivity in the workplace, an increased need to take time off and possibly impacts on family income. What can governments in Canada say to Canadians whose lives have been harmed (if not destroyed) by long wait times for medically necessary care? They cannot, with any honesty, tell them the wait time was unavoidable in a universal access health care system. Nor can they honestly say they are on the path to meaningfully and permanently shortening wait times for those stricken with illness. The latest evidence on efforts to reduce wait times across Canada suggests failure: Spend-and-manage approaches simply don't work in reducing delay. Efforts that fail to deal with the underlying policies that created waiting lists in the first place will only leave provinces facing a larger bill for the same delays. So what does work? The evidence from Europe suggests fostering competition, where compensation follows patients, is a key approach to reductions in waiting. Broadly defined wait time targets, with clear and serious consequences for those who fail to meet them, also seem to work well. And, if the experiences of Belgium, France, Germany, Japan, Luxembourg, the Netherlands, and Switzerland are to be believed, a larger role for the private sector in financing and delivery can lead to universal access health care without queues for treatment. All this flies in the face of what we're constantly told about waiting and health care in Canada. We're told a public monopoly is the most efficient approach to universality, yet these other nations spend less and get more timely care with a private parallel system. We're told public provision and management are the keys to solving the wait times problem, yet these other nations have improved timeliness (and, in the case of the Netherlands, got rid of wait times problems) by embracing competition and activity-based funding. We're told public hospitals are the only way to have a good universal system, yet these other nations have more accessible and less expensive systems with the inclusion of private hospitals. We're told the answer can only be found in the "public" system, yet we know that competition, with money following the patient to the facility of their choice (private or public), means shorter wait times and more patient-focused care. Long wait times are causing Canadians significant harm. The solution is to step away from the wrong-headed, ideologically guided approach governments are taking today. Policy-makers should instead focus on how other, more successful, universal-access nations have improved the timeliness of health care for their citizens. Our health care problems aren't unique or different from anyone else's, and it's time we took a more pragmatic approach to reform with policies that actually work. Robert Ouellet is past president of the Canadian Medical Association and a Fraser Institute senior fellow. Nadeem Esmail is director of health policy studies at the Fraser Institute.