% The Flaming Right by paul murphy

Canadian health care costs

Canada's medicare industry is federally mandated but provincially administered with joint funding from both senior levels of government. In theory any Canadian can get any required medical service or procedure, except drugs, at no direct cost to the individual.

Canada's three richest provinces are British Columbia, Alberta, and Ontario. For fiscal 2009/10 their budgeted health care costs came to:

Province Health care budget (Billions of USD)) Population (in millions) Annual cost for a family of 5 (USD(@97.48 Oct 14/09))
British Columbia $16.3 4,381 $18,585
Alberta $12.6 3,585 $17,526
Ontario $46.2 12,929 $17,854

These budget numbers under-estimate real costs by an unknown amount, most probably in the 12 - 20 percent range for most provinces. Additional monies spent on health care come from sources such as: deficit operations; extra billing (particularly through the collection of health care costs from automobile insurance issuers); capital consumption (particularly through delayed maintenance); hidden subsidy (particularly through infrastructure development and government wide IT); third party payments and parallel systems (particularly Worker's Compensation); and, the separate health care systems maintained at the federal level for police, parliamentarians, natives, and the military.

So what do Canadians get for their money?

Almost no information about the effectiveness of health care in Canada is published and there is essentially no legal redress for harm caused by the medicare system or people working in it. As a result Canadians must base their trust in the system on their politics or on personal interactions with people and institutions whose professional records and credentials are opaque to them.

In contrast to data from within the system the public does, however, have access to an annual Fraser Institute study tracking the time Canadians spend waiting for "free" medical services.

The 2008 report: Waiting your Turn: Hospital Waiting Lists in Canada (PDF), includes a table showing the delays Canadians in the three richest provinces can expect between diagnosis by a general practitioner and action on that diagnosis in a hospital or other treatment center:

Table 2: Median Total Expected Waiting Time from Referral by GP to Treatment, by Specialty, 2008 (weeks)
  B.C. Alberta Ontario
Plastic Surgery34.943.422.4
General Surgery9.213.310.5
Orthopedic Surgery38.641.224.7
Cardiovascular Surgery (Elective)9.512.04.4
Internal Medicine11.115.410.7
Radiation Oncology6.97.26.2
Medical Oncology2.78.04.0
Weighted Median17.018.513.3

What this means is that about half of all BC residents who have managed to see a GP and been told that they need plastic surgery, then wait for more than 34.9 weeks (244 days) for the actual procedure - while those needing neurosurgery can expect to wait 29.7 weeks (208 days) between diagnosis and action.

Similarly what an Albertan with three kids and a GP who thinks he needs corrective surgery on a patella, gets for his 17,526 USD a year in medicare taxes is a warm feeling of Canadian moral superiority to Americans and the expectation of nine months of pain before exploratory surgery -done by someone with no stake in the outcome, no visible record, and inadequate nursing and diagnostic support- shows his GP to have been wrong.

Oh, and he also gets to hear people like me say that comprehensive American plans offer next day service for about a third less - and that he could get the diagnosis reviewed and any actually necessary corrective surgery done this week in any major American city for a few thousand dollars paid to people with known skills, at a fully staffed institution, and with available legal recourse if things go wrong.

Paul Murphy, a Canadian, wrote and published The Unix Guide to Defenestration. Murphy is a 25-year veteran of the I.T. consulting industry, specializing in Unix and Unix-related management issues.