Canadian health care isn't perfect


If you are lamenting the cost and confusion of your Medicare or HMO health-care plan, just remember: It could be worse. You could be facing more difficulties in the Canadian health-care system. Its government-financed system is not the utopia it appears to be.

Granted, Canada provides basic care and pays for everyone, no matter each citizen's employment status or income level. However, as I found out during a recent international conference on aging there, problems abound.

An article in the National Post summed up the current struggle: "After five years of deep government cuts to health care that have affected every province and virtually every community, public confidence in government-financed medical care is faltering as more and more Canadians experience delays in receiving medical care and endure over-crowding in hospitals."

These problems are particularly burdensome on the elderly.

A 1998 report produced by Canada's National Advisory Council on Aging (NACA) describes long waits for hip, knee and cataract surgery, as well as nursing-home placement. A 1997 study of 209 patients awaiting hip and knee surgery shows 15.9 percent waited one to three weeks, 30.8 percent waited seven to 12 weeks, and 34.1 percent waited 13 or more weeks. In another study, 127 patients waited 8 1/2 weeks for just an initial consultation with a surgeon and nearly 16 weeks for actual surgery. A 1992 study of 366 hospitalized patients needing nursing-home placement revealed that 68 died in the hospital while waiting. The waits averaged from 115 days to 344 days.

Canadians are starting to demand changes in the system. There is growing support for a parallel private health-care system. A poll by COMPAS Inc. reports 41 percent of 1,000 people surveyed supported the right to buy their own medical services. In Quebec the numbers were higher: 52 percent. Conrad Winn, president of COMPAS, says, "a large majority believes that the system is sufficiently corroded that the law should be changed to facilitate more private medicine."

So thinks George Zeliotis, who, after waiting a painful year for hip surgery, has voiced his objections to the Quebec Superior Court. He and co-plaintiff Dr. Jacques Chaoulli, a medical activist, seek to invalidate Quebec law "that gives the government a virtual monopoly over the regulation of medically necessary health services inside and outside of hospitals."

With the addition of private doctors working within public hospitals and clinics and the development of private insurance, the two argue, "some patients would rather pay for immediate health care than live through daily grinding pain."

The day I left Canada the National Post ran a front page article on Claude Castonguay, "the father of Quebec medicine." Aware of Zeliotis' appeal, Castonguay supports some changes in the current system. He advocates "investing more money in the current public system and the regulated growth of a private system."

Mary B. Moorhead is a licensed family therapist and elder-care specialist.

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