It's Not Just the VA; Government Health System Waiting Lists Are Lethal in Canada, Too

Vermin Inc / Foter

At least 40 veterans may have died in Phoenix alone, while languishing on secret Veterans Administration waiting lists, according to CNN. Such delays are typical of government-controlled, single-payer systems, I wrote yesterday. They're such a regular feature that the U.K. National Health Service boasts "you have the legal right to start your NHS consultant-led treatment within a maximum of 18 weeks from referral."

And the deaths that go with such delays may also be a regular feature of single-payer systems.

"Canada's growing wait times for health care may have contributed to the deaths of 44,273 Canadian women between 1993 and 2009," that country's Fraser Institute announced just yesterday.

The estimated 44,273 deaths between 1993 and 2009 represent 2.5 per cent of all female deaths in Canada during that 16-year period, or 1.2 per cent of Canada's total mortality (male and female).

More specifically, during that same 16-year period, for every one-week increase in the post-referral wait time for medically necessary elective procedures, three female Canadians died (per 100,000 women).

The study reaching those conclusions found no such dramatic relationship between extended waits for care and male mortality, which is reassuring to those of us with a Y chromosome. For double-XXs, not so much.

Fraser reports that wait times for Canada's single-payer system have grown across 12 major medical specialties from 9.3 weeks in 1993 to 18.2 weeks in 2013. The extended delays grew so bad in Quebec that Canada's Supreme Court ruled laws banning private medical insurance unconstitutional in 2005.

Similar problems exist in other countries with government-dominated health care. Recently, in Wales, the Colchester Hospital University NHS Foundation Trust was investigated after a report suggested that delays in cancer treatment were being concealed by officials.

Comments

[RG]

Slightly OT, but Obamacare processing contractors apaprently sit around all day playing Pictionary due to lack of work.

http://www.philly.com/philly/h....._knew.html

[Certified Public Asskicker]

The study reaching those conclusions found no such dramatic relationship between extended waits for care and male mortality, which is reassuring to those of us with a Y chromosome.

WAR ON WOMEN.

[mad.casual]

The estimated 44,273 deaths between 1993 and 2009 represent 2.5 per cent of all female deaths in Canada during that 16-year period, or 1.2 per cent of Canada's total mortality (male and female).

Fuck the details, I need to know the important stuff... were they vaccinated?

[Certified Public Asskicker]

They might be dead, but they get free birth control.

[John]

And they never went bankrupt trying to pay their medical bills.

One thing about not getting any medical care, you don't leave any bills for your family to pay when you die. What are you racist tea baggers complaining about?

[Sevo]

John|5.21.14 @ 10:40AM|#
"And they never went bankrupt trying to pay their medical bills."

I'm amazed when this is used as some sort of criticism of medical care costs.
Bankruptcy is SUPPOSED to be last resort, and medical care is something you SHOULD spend you savings on.
What, is bankruptcy to be reserved for buying that 60" TV you can't afford?

[John]

And if you are "bankrupt", that means you get a fresh start. These people are just profoundly stupid to the point of being irrational.

[Torontonian]

I describe it like this to progressives:

"We should have a system where sick people can get the medical treatment they need, and if they're too poor to afford the bill, they can apply to have payment reduced or waived. However, to prevent rich people from scamming the system, an impartial government official should review the person's income and assets to determine whether they honestly lack the means to pay for it."

When they agree that the above system would be perfect, I explain that's exactly what bankruptcy court does.

[MonsoonMoon]

You did not even present an argument, just run of the mill deflection.

[John]

I wasn't intended as an "argument". It was intended as ridicule of a prog argument. Since the Prog argument, such as it is, is ridiculous and irrational, as Sevo points out above, ridicule is the best response to it.

[Sevo]

MonsoonMoon|5.21.14 @ 12:35PM|#
"You did not even present an argument, just run of the mill deflection."

And yours was even more 'run of the mill' lefty twaddle.

[Kreel Sarloo]

Actually, birth control is not included in Canadian Medicare although low income women can get it under separate means tested welfare programs.

Also dental care is also not included in Medicare although, again, some provinces have means tested programs for low income families.

It is interesting that many of the things Americans expect to get for free are not covered by other countries health plans.

[Kreel Sarloo]

Actually the above is not quite right. OHIP (Ontario's health plan*) pays for vasectomies and tubal ligations.

*Canada's Medicare is not "national". Each of the provinces and territories runs it own plans subject to federal legislation. The federal government pays for a substantial chunk of the costs through grants.

[John]

Funny how stories like Pussy Riot being jailed in Russia are front page news for weeks yet 44,000 people dying for lack of care IN CANADA doesn't warrant even a mention. If it doesn't fit the narrative, I guess it is just not a fact.

[RG]

Don't the citizens of these countries with socialized care still show strong support for the system? Until their citizens start to care about what is happening, I can't be bothered to.

[John]

You should be bothered when American Progs point to Canada as some kind of superior model to the USA.

[RG]

I know they are idiots, but iirc Canadiens give their own health care system high marks despite mounting evidence.

Its Stockholm syndrome all the way down.

[Dances-with-Trolls]

Mark Twain ? 'It's easier to fool people than to convince them that they have been fooled.'

[Bardas Phocas]

That's becuase, if the Government doesn't provide healthcare, they'll have to go without - like down south in Amerikkka!

[rts]

Hi, Canadian here.

Data suggest there is not strong support for the current system, but the "solution" is to do it harder and faster.

For example...:

- Overall ratings of the health care system have improved slightly in recent years, but a large majority of Canadians still believe that the system is unsustainable and urgently in need of substantive change.

- Both federal and provincial governments receive relatively low ratings for their performance on health care, though Canadians have slightly more confidence in their provincial governments to make positive changes in the future.

- There is overwhelming support for increased spending on health care, from both levels of government. There is a strong sense that the federal government should transfer more money to the provinces, but not without conditions ? there is also strong support for national standards in health care provision.

[John]

The patient isn't responding. More leeches!!!

[Eggs Benedict Cumberbund]

"You know, medicine is not an exact science, but we are learning all the time. Why, just fifty years ago, they thought a disease like your daughter's was caused by demonic possession or witchcraft. But nowadays we know that Isabelle is suffering from an imbalance of bodily humors, perhaps caused by a toad or a small dwarf living in her stomach."

[C. S. P. Schofield]

*snerk*

[mad.casual]

Funny how stories like Pussy Riot being jailed in Russia are front page news for weeks yet 44,000 people dying for lack of care IN CANADA doesn't warrant even a mention. If it doesn't fit the narrative, I guess it is just not a fact.

My point exactly. I hear news stories about people who weren't killed by virus-of-the-month, MERS. I hear news stories about people not dying from a measles 'outbreak'. But it's not until the bodies start piling up that anyone talks about people dying while waiting for their medical treatment rations.

[Jordan]

Let's not forget about the Stafford Hospital Scandal in the UK:

Hundreds of hospital patients died needlessly as a result of substandard care and staff failings at two hospitals in Mid Staffordshire between January 2005 and March 2009.
The Mid Staffordshire trust, which runs Stafford Hospital, lost sight of its responsibility to provide safe care. In the wards, people lay starving, thirsty and in soiled bedclothes. Patients' buzzers would drone endlessly, unanswered.
Some patients received the wrong medication; some, none at all.
Decisions about which patients to treat were left to receptionists, inexperienced junior doctors were put in charge of critically-ill patients, and nurses switched off equipment because they did not know how to use it.
Some relatives have told how patients were left so dehydrated that some began drinking from flower vases.

[...]

The scandal is thought to have occurred because managers attempted to cut costs and meet Labour's central targets, in order to achieve a coveted "foundation status" for the trust.

[John]

How much longer are the people in these countries going to put up with this?

[Dances-with-Trolls]

As long as nobody was drinking from a larger vase than anyone else, because that would be inequality.

[RG]

This. They are redistributionists, driven by petty envy, first and foremost.

[Bryan C]

Activating statist perception filters....

"because managers attempted to cut costs"

You murdering budget-cutting monsters!

[Almanian!]

This is unpossible, because FREE HEALTH CARE and EVERY CIVILIZED NATION EXCEPT THE US has it.

So....there.

[Drake]

Bug, feature, whatever...

[John]

Those people were just a drain on the system. How are we supposed to have a health care system if it is always full of sick people needing expensive care?

[Longtorso, Johnny]

I remember the good old days when Canada and the UK were the models for govt health care. I've been arguing this topic since USENET. The libs point to some foreign program as one to emulate because it works. That program is then investigated by those of us who oppose socialized medicine and the flaws are pointed out. The libs then move to some other foreign program until its flaws are laid out too explicitly to ignore, at which point they just move to another foreign healthcare system flavor of the month....

[C. S. P. Schofield]

Everything I feel I need to know about the British National Health system is summed up by the fact that the British cartoonist Giles was doing cartoons about its shabby facilities in the mid 1950's. The reason I find this significant is that Giles was (he died in 1994) a longtime socialist, having started his career doing cartoons for a Party paper before WWII.

Yet he was already disillusioned with the National Health by the mid-'50's.

[toolkien]

To be fair, a free market system for health care will have people die due to lack of care. It's not the net, collective result (we're all going to die) it's the notion that prior decisions and behaviors should impact the access to care versus some positive right.

People who make the best decisions in life probably have the means to pay in a market for care, and probably make better behavioral decisions and probably won't need expensive care until they get quite old. The next layer are people who might make certain sound economic/career decisions but make poor health decisions, and probably will have to dip into their equity sooner. People who make the poorest decisions across the board likely will have to rely on the kindness of strangers.

All a centralized, controlled system does is put everyone into line (except certain apparatchiks/nomenklatura of course) regardless of value judgments made. Regardless of your best decisions, you are placed into the same pool as everyone else. And, when the central command's treasury gets thinned out, they will have to mandate behavior.

Simply, we are all going to suffer pain and die regardless of economic systems, the idea is to provide mediation for yourself (and loved ones) to stave it off as best as possible. Fascism redistributes the pain and suffering to everyone regardless of how you behave or the value judgments you've forged.

[DJK]

These things are all true. However, a market system has another huge advantage - it's not subject to the socialist calculation problem. Markets will ALWAYS be more efficient than centrally planned systems.

[John]

In a free market system, you can buy your way out of things or you can get someone else to pay for it out of charity. In a government controlled system you can't do any of that. You are totally at the mercy of the government. You don't live or die because you have a family who loves you and mortgages their homes to pay for your care or because some rich guy starts a charity hospital and gives you the care you need but can't afford for free. You live and die based on the risk adverse and rule driven decision of some government bureaucrat.

Progs are so sick they see that as an improvement.

[Booker]

That's pretty unnecessarily black and white, there are are many different levels of government control in health care systems. I don't think anyone will argue that there is quite a bit of government control here and you can still buy yourself a procedure. The article even comments that you can do the same in Ontario.

[Booker]

*Sorry, Quebec.

[C. S. P. Schofield]

The issue is that in a free market, if somebody dies due to lack of care it's a tragedy. In a National Health system, if somebody dies due to lack of care, it is an outrage because the goddsdamned politicians have made me partially responsible. I am The Sovereign, or one of them. If it is made the responsibility of my Government, then it falls on ME.

Absent a National Health system there will be all KINDS of ways to obtain care. Get your sob-story out there and maybe you will get inundated with checks. Maybe you can create enough negative publicity that somebody gives you what you need to generate good PR. These things are still POSSIBLE if the Government is supposed to be the final arbiter, but you are much more likely to run into some well entrenched sphincter telling you "no" because he likes to exercise his petty authority.

[DJK]

Where the hell is Tony? I would have expected him to come out swinging on this one. Maybe something about how these results are tainted by the Fraser Institute's right-wing bias?

[Jackand Ace]

And how many deaths in the US are attributable to lack of health insurance? In 2009, Harvard said as many as 45,000. I guess for them the wait time for cancer treatment was infinite.

http://news.harvard.edu/gazett.....-coverage/

Regardless, Canada has had a problem with wait times, found that it varied from province to province, and is using that data to make improvements. More importantly what was the US experience in regard to wait times before the ACA? It wasn't any better than others, and yet we paid more for the privilege.

http://economy.money.cnn.com/2.....ealthcare/

[John]

In 2009, Harvard said as many as 45,000.

AS MANY AS 45,000, meaning 45,000 is the upper limit and likely a limit that won't be reached, otherwise they would have said 45,000 or "likely" or used a better word than the weaselly "as many as".

Moreover, what were the circumstances of those deaths? If I am a Christian Scientist who won't see a doctor and I die because of it, i died for "lack of medical care" and get counted on the list. If I go to the doctor but my doctor fucks up and misdiagnoses me and I don't get treatment for my actual ailment, I died for lack of medical care.

Moreover, what does "lack of health insurance" even mean? Insurance is not care you fucking half wit. That statistic is something they pulled out of their asses by comparing "our current system" to some idealized system "where everyone had care". How would you even do such a comparison? The best you could do is compare the results of people with health insurance crudely to those without. There are about a million variables that would make that comparison useless.

Take your talking points elsewhere. We are all full up on bullshit.

[Bryan C]

How many houses burn down because they don't have fire insurance?

[Booker]

"may have contributed to the deaths of 44,273 Canadian women"
Both studies are bullshit, they only point out correlation, not causation.

[Jackand Ace]

Exactly.

[Jackand Ace]

Not impressed by your anger.

Each one of the exceptions you list would apply in the case of deaths in Canada as well. Surely you should have understood that before you posted that answer.

[Sevo]

Jackand Ace|5.21.14 @ 1:51PM|#
"Not impressed by your anger."

Not impressed with your constant stream of bullshit.

[Sevo]

"Regardless, Canada has had a problem with wait times, found that it varied from province to province, and is using that data to make improvements."

Yes, JnA, the next quota of "3-tons of shoes" will be something other than one giant boot.
They'll fuck it up some new way, just like your fave idiocy does every time.

[Brian]

Jackhand Ace:

And how many deaths in the US are attributable to lack of health insurance? In 2009, Harvard said as many as 45,000. I guess for them the wait time for cancer treatment was infinite.

http://news.harvard.edu/gazett.....-coverage/

This really is your pet issue, isn't it?

This was deemed half-true, primarily because of problems people have cited. Namely, the study links health insurance to premature death, but doesn't show causality. It's really hard to say that someone died because they didn't have health insurance, just by studying insured and non-insured populations and estimating a different rate of premature death.

That's somewhat different from counting the people who die waiting for treatment for the very same illnesses they're trying to get treatment for.

Also, I love the citations backing up your second citation: the Commonwealth Fund. No data, no research. They took a phone survey, and these are the results.

Brilliant.

[Jackand Ace]

Its no more a pet issue for me than my comments seem to be for you.

Commonwealth is a very respected organization, they take surveys all the time about a wide range of issues.

Yesterday, opinion polls were all the rage for J.D. when they provided one or two answers that he agreed with. If you think surveys or polls are illegitimate, you may want to take that up with J.D.

[Jackand Ace]

By the way, you might find this one response from a healthcare official in Canada interesting:

"While the B.C. Ministry of Health still needs time to analyze the study properly, a spokeswoman said they are concerned about the "number of assumptions" made by the Fraser Institute? especially considering the study's wait time information comes from the think-tank's own SURVEY data, which the ministry called "opinion, not science."

Surveys...they just keep coming up...even from Fraser.

http://metronews.ca/news/vanco.....ath-rates/

[Juice]

More importantly what was the US experience in regard to wait times before the ACA?

You think the ACA is going to improve wait times?

[poloniusium]

Yes! Because people will stop trying to see doctors at all.

[Jackand Ace]

And that is exactly what people would do when they did not have insurance...they stopped trying to get treatment because they couldn't pay for it.

[steedamike]

...or didn't want to pay for it themselves.

[XM]

"And that is exactly what people would do when they did not have insurance"

Take advantage of local programs (like healthy way LA), free clinics, or buy catastrophic insurance. Many of which are not available post ACA.

If you have cancer in America and you don't have insurance, you have no choice but to live out the rest of your life at home? Dude, this isn't Japan. No one's afraid of invasive surgeries or imposing a burden someone to live even 3,4 additional months.

[Sevo]

Jackand Ace|5.21.14 @ 2:10PM|#
"And that is exactly what people would do when they did not have insurance...they stopped trying to get treatment because they couldn't pay for it."

Cite missing.
Lefty stupidity presumed.

[concerned cynic]

If you enter a hospital via the emergency room, and your body is in emergency, the law forbids your being turned away. At most, you will be shifted to the nearest county hospital. It is a felony to refuse medical care to an individual whose life and limb are at risk, merely because they may not be able to pay the bill.
If you qualify for Medicaid, you will be treated somewhere in your locality. The trick with the uninsured who are not downright poor, it to make them look poor by an administrative subterfuge, such as donating your assets to an irrevocable trust, or divorcing your spouse, and letting your spouse take the entire marital property. I am sure lawyers know other tricks to get people on Medicaid.

[Jibby2]

"And how many deaths in the US are attributable to lack of health insurance? In 2009, Harvard said as many as 45,000. I guess for them the wait time for cancer treatment was infinite."

Surprised nobody else mentioned this yet, but the system prior to the ACA wasn't a free market system either. Even if those statistics were valid and relevant, they would be an evaluation of the pre-ACA level of government intrusion, not an evaluation of actual market-based healthcare.

-M

[Booker]

Unfortunately we don't have any data for a market based system. It's never been done in modern times.

Market-based health care with modern technology is radical and un-tested but could be better than the current system. We don't know because no one currently does it.

[Booker]

The health care system we have (and had pre-ACA) was indisputably terrible. One side will argue that it was because there was too much government intervention, the other side will argue there was not enough.

What we need to do is get the laboratory of democracy going and cut one of the states loose. That way we will have some data as to what will happen. I vote New Hampshire, they might be up for it, being so libertarian leaning. Also their next door neighbor is going to do the opposite and go full single payer a-la Canada.

So lets cut New Hampshire off from medicare and medicaid, exempt them from the ACA and other national health regulations, refund them their contributions and see what happens.

[Sevo]

Booker|5.21.14 @ 2:13PM|#
"The health care system we have (and had pre-ACA) was indisputably terrible"

Please tell us how O-care is better.

[New West Republic]

Here's how it works in Canada when you have some particularly horrible form of cancer:

- If you have money, you go to a top Cancer Center in the US and pay out of pocket.
- If you don't have money, but lots of friends and family, you get a liquor license, rent a hall, sell drinks and get donations. With the money you raise you go to a top Cancer Center in the US and pay out of pocket.
- If you have some assets, and can't avail yourself of the second option above, you send your hospital records and imaging to a top US Cancer Center and hope you can figure out some way of paying for it later, for example, by selling your house and living in a refrigerator box, as I was prepared to do when my sweetheart was dying.
- Otherwise, you die, knowing the best healthcare system in the world did everything possible to preserve your life.

[Pinky]

"you have the legal right to start your NHS consultant-led treatment within a maximum of 18 weeks from referral."

This, of course, isn't a guarantee, it's the time one must wait before filing a formal complaint. Something akin to waiting 48 hours before one can file a missing person report.

Go away. Shut the fuck up. Come back in 18 weeks.

[Eric Bana]

Thank you for this info. I've heard a lot of close people mentioning Canada's "fantastic" health care system recently.

[ronalk77]

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[[e-mail]]

"The study reaching those conclusions found no such dramatic relationship between extended waits for care and male mortality, which is reassuring to those of us with a Y chromosome. For double-XXs, not so much."

No, most men die at a much younger age, they simply don't die of maladies that can be easily treated by doctors. Many more men work until they simply drop dead (93% of workplace deaths are men). Many more men than women die in die as victims of violence, accidents, suicide, etc.

So, no, it isn't reassuring. Men simply don't make it to the hospital.

[concerned cynic]

It has been my understanding for 40 years that socialised medicine around the world invariably has waiting lists, and that some people die while on waiting lists. So the VA is simply another case in point. Are Medicare and Medicaid truly untouched by waiting lists, or have de facto waiting lists been artfully covered up?

I live in a country with socialised medicine, and I, along with at least 30% of households, have private health insurance. This insurance buys me immediate treatment when a problem arises. It also pays for some treatments the public sector will not pay for.