Op-Ed Article

17.  Canadian Health Care - Low Tech in a High Tech World

Discussions of problems with Canada's socialized health care system often focus on the lack of access to physicians and the long wait times to see specialists and to have surgery, routinely measured in months and sometimes years. Equally important, governments are also failing Canadians when it comes to providing access to high-tech health care. It is time to start paying more attention to the shortage of advanced medical technologies in Canada.

Our health care system's over-reliance on a small inventory of often outdated and unsophisticated technologies has important consequences for all Canadians.

Consider some of the benefits that arise from new medical technologies. New technologies can increase patient comfort, and reduce pain, and recovery times after treatment. New technologies can increase patient safety. Some new technologies also offer patients a new option for treatment where none previously existed.

In other words, a lack of access to technology can have important consequences for how comfortable a patient's treatment will be, how long and how well he or she can expect to live after treatment.

It should come as no surprise then that medical technologies are becoming increasingly important in the diagnosis and treatment of disease in the developed world.

Sadly, both federal and provincial governments across Canada are failing when it comes to providing Canadians with easy access to advanced medical technology.

Consider what the Organization for Economic Co-operation and Development (OECD) found when looking at access to MRI machines and CT scanners, both of which might be considered basic tools of health care today. According to a recent OECD publication, Canada has about 60% as many MRI machines and CT scanners per capita as the average OECD nation and lags well behind some of the leaders in this regard. It should come as no surprise then that Canadians often endure long wait times for access to the services these machines offer.

Medicare is equally poor at delivering access to more advanced and cutting-edge technologies. Consider that Canada lags behind the average developed country in terms of its inventory of PET scanners; it ranks last among developed countries in providing interventional radiology services (which offer a less invasive option for patients as compared to surgery). Canada is outpaced by a number of nations in the expansion of access to inventories of select medical technologies and it falls well behind the United States in access to a number of advanced technologies including, gamma knives (which provide a minimally invasive alternative to open-skull surgery) and implantable defibrillators (which allow patients at risk of sudden cardiac arrest to live independently and not to be under constant surveillance).

A lack of access to medical technologies is not the only technology-related failure of Canada's government monopoly health care system. It performs poorly also in keeping our current stock of technologies up to date. Specifically, the limited inventory of technology that is in place in Canada is often old, outdated, and unsophisticated.

Consider that, at the start of 2007, 30% of Canada's hospital-based MRI scanners, 46% of Canada's angiography suites, 42% of Canada's cardiac catheterization labs, and 42% of Canada's lithotriptors were past their recommended lifecycles according to guidelines published by the Canadian Association of Radiologists.

Furthermore, a number of Canada's CT scanners are basic and unsophisticated models that are incapable of providing the higher quality images, broader range of services and less-invasive screening options that their newer and more sophisticated counterparts provide. And a significant proportion of Canada's medical technologies - between 20% and 60% depending on the type of machine, according to the Canadian Institute for Health Information-were operating without the ability to digitally store images. Put simply, Canadians are often unable to access the latest advances in care-even from the technologies that are available to them.

The rarity of advanced medical technology in Canada is not the result of a lack of spending. To the contrary, Canada maintains one of the developed world's most expensive universal access health care programs. In addition, between 2000 and 2004, the federal government gave provinces $3 billion to improve access to medical technologies.

Canada's health care model is clearly failing Canadians. It tells patients to endure long waits for access to medical services. It requires them to undergo more invasive, more painful, and less comfortable treatments than those that are available to their counterparts in other nations. It sometimes requires them to forego life-saving and life-improving or life-lengthening care. And at the same time it forces Canadians to foot the bill for a world-class system that is anything but.

It's time we stopped accepting proclamations from the political class that Canada's health care system is great, and start asking our ideologically driven so-called leaders why exactly our socialist model cost so much and provides so little. Perhaps now that the United States may begin to socialize its medical system, it may become politically acceptable for us here in Canada to finally begin to privatize ours.

Nadeem Esmail - Fraser Foundation