A reader says that Canada's single-payer healthcare system is not right for the United States.
I completely agree with the views expressed by Craig M. Wax, DO, in his recent editorial. (“ACA: It’s not what the doctor [or voters] ordered, August 25, 2013). Anyone who favors a Canadian-style, single-payer healthcare system should read the latest annual report by the Fraser Institute, a Canadian think tank, titled “Waiting Your Turn: Wait Times for Medical Care in Canada.”
Their 2012 data shows that the median wait time for Canadian patients to see an orthopedist was 20 weeks, measured from the day of referral by their primary care physicians. Even then, patients had to wait an additional 19.6 weeks for the orthopedist to actually treat them, for a total median wait time of 39.6 weeks, from referral to treatment. That is a long time for a patient in pain.
Medical oncologists had the shortest delays; cancer patients had to wait a median of “only” 4.1 weeks to start chemotherapy, and 4.5 weeks for radiation therapy. For a cancer patient anxious to start treatment, a 1-month delay can seem a lot longer.
Canadian physicians, when surveyed, believed that their patients were forced to wait approximately 3 weeks longer than “clinically reasonable” for elective treatments. The Fraser Institute report estimates that at any one time, approximately 2.5% of Canadians are on a waiting list for treatment.
To prevent defections by delay-weary patients, Canada’s provinces have enacted regulations discouraging the private practice of medicine, except for non-covered services. So where do Canadians go when they want prompt care and have the ability to pay for it, despite their high income taxes? In 2012, an estimated 42,173 of them sought medical care in other countries, including the United States, according to another Fraser Institute report, “Leaving Canada for Medical Care 2012,” in the May/June 2013 issue of Fraser Forum.
Unfortunately, if the United States follows Canada’s lead by adopting a “single-payer” system, Americans will not have the convenience of being able to drive across a nearby friendly border to receive free-market medical care in a technologically advanced English-speaking country.
David L. Keller, MD
Redondo Beach, California