Canadians Embrace American Medicine

NOTE: Below is the second part of the Gazette editorial/opinion department's short series about Canadians living under government-run health care, and a law that forbids them to pay for better health care.

The pain in Christina Woodkey's legs became so severe she could barely get around, much less enjoy the hikes that had become a key part of life with her husband.

As a citizen of Calgary, Canada, Woodkey is covered under the Canadian health care plan. Canadian law forbids her to pay for treatments in Canada. She's at the mercy of a health care program that cannot keep up with demand.

Woodkey spoke with The Gazette and journalists from other American news organizations Sept. 27, as part of a health care conference in Vancouver, B.C., sponsored by Colorado's Independence Institute, a citizen's advocacy organization.

"What we have in Canada is access to a government, state-mandated wait list," said Brian Day, a former Canadian Medical Association director, as quoted in a recent Los Angeles Times news story about Canada's move toward a private health care option.

Woodkey was placed on the waiting list to see a hip specialist, and she waited for a year. The hip specialist told Woodkey she had a condition involving spinal compression, which would require an examination by a neurologist. Her general practitioner made a referral in January, and an appointment to see the neurologist was set for Sept. 30 — nine months later. The hip specialist told her the neurologist would recommend surgery. Woodkey inquired about the wait for surgery, and learned it would be approximately 18 months after seeing the neurologist. Her condition was getting worse by the day, yet Woodkey was looking at a 27-month wait, if all went well, for any kind of relief to begin.

Woodkey's story isn't rare. These types of stories are the norm for Canadians in need of more than basic, routine health care. Doctors and nurses in Canada receive uniform compensation rates by the government. Pay has no connection to performance. Because work as a physician carries no promise of wealth or prominence in the community, Canada suffers a physician shortage.

Canada's Fraser Institute keeps a constant watch on the effectiveness of Canadian health care and reports the average wait time, between referral and an appointment with a specialist, averaged 28.8 weeks in Saskatchewan.

British Columbia had the lowest wait times, averaging 17 weeks. The average wait for orthopedic surgery, in all Canadian provinces, was 19.8 weeks in 2008. Though this series tells anecdotal stories of Canadian patients, the Fraser Institute's numbers are the average — reflecting the common experience of Canadians.

Nadeem Esmail, an economist with the Fraser Institute, told the Gazette the covenants that govern Canadian health care enable some Canadians to jump queue and avoid long waits. Those favored in queue-jumping are members of the Royal Canadian Mounted Police, prisoners, workers compensation patients, and anyone who manages to buy health care abroad — people known as health care tourists.

None of the health care tourists The Gazette spoke with is wealthy. Most afforded treatment by mortgaging homes, raiding retirement savings, or borrowing.

Unable to bear the prospect of 27 months of pain and incapacity, Woodkey scrounged together $50,000 in financing she needed for surgery in the United States. She crossed the border into Montana and received surgery in two days.

As Americans have toyed with the prospect of a public option, in which the government would provide health care, Canada has been moving in the direction of privatization. The Times reports that government officials throughout Canada find the prospect of a private health care system, like the American system, alluring. That's because the government system is failing. British Columbia faces a $360 million shortfall in its $15.7 billion fiscal year medical budget, which only means fewer surgeries and even longer waits.

Market needs have a tendency to overpower laws that work against the common good. Immigration laws, for example, go ignored and unenforced in countries that need more laborers than domestic couples have produced.

Likewise, private clinics and surgical centers have begun springing up in British Columbia in violation of Canadian law. The need is mightier than the law. This month, A Canadian court plans to decide whether to allow the private facilities. If the court says yes?

"We would have a system of U.S.-style healthcare — along with a public system that is decimated," Leslie Dickout, of the British Columbia Health Coalition, told the Times.

Be thankful the public option idea, proposed by President Barack Obama, appears to have died.

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