Talk:Healthcare in Canada/Archive 1

Archive 1

Merger

I disagree with the merger proposal. Medicare is a distinct program that handles only a minority of Canadian's healthcare. - SimonP 18:38, 7 June 2006 (UTC)

Health care observations

I hope to introduce some of these observations into the topic.

Canada's Health care system has been called a public system, a socilized heath care system but in fact it is merely pulically funded, although many politicians and reports refer incorrectly to this system as a public one. ( this a good example of a half-truth - half-truth)

It was a very famous socialist politician Tommy Douglas the son of a preacher who instituted government funded health care.

Canadians receive 'free' health care paid for by a provincially funded tax supported fund. Some provinces employ a monthly insurance premium, Ontario does not. Some limited services are not covered.

Most doctors are in reality 'corporations' and clinics are privately owmed by doctor consortiums. Doctors, family doctors receive a fee per visit from the Government. A system that rewards repeat visits, referrals, and testing. Doctors in Canada, except for some hospital doctors do not receive a yearly salary.

The College of Physicians and Surgeons is a self regulating department that handles physician complaints.

Canadians are currently experiencing a doctor shortage due to the market forces at play and the fee structure, that penalizes doctors income relative to the supply of doctors.

A recent comparative report on Health Systems in the World, 'Wyatt/Watson' ranked Canada's Health system 20th in the world, better than that in the USA, ranked 24th. France and Italy were ranked in the top two.

I noted that I had forgotten to sign this one...the name is correct, the date is wrong...(half-truth.

--Caesar J. B. Squitti  : Son of Maryann Rosso and Arthur Natale Squitti 18:01, 18 January 2007 (UTC)

I don't understand what you mean in the lead when you say "it is not a true public system, even though the government and others have called it so". You seem to be referring to the fact that doctors are not employed by the government, as they are in most other systems. If that's what you mean, that's what you should say, but the word "true" seems POV. I've heard people say that it's not a "true socialist system," which seems clear to me, but other people might not think it's neutral enough. Nbauman

Canada has a genetic advantage in longevity?

The last paragraph where it seems to state that Canada does have a genetic pre-disposition to living longer seems over the top. What kinds of evidence do we have for this?207.236.24.133 16:16, 27 November 2006 (UTC)

I agree, it seems anecdotal at best. They're basically saying that black people are "genetically predisposed" to live shorter lives, while Asian people are predisposed to live longer, which is complete and utter bullshit. It's like saying women are genetically predisposed to earning less than men are. Correlation != causation.

The statements in that paragraph has no proper reference so it has been removed. TimL 01:11, 3 December 2006 (UTC)

How statistics can lie, all about half-truths.

Many Canadians, have the distinct situation of not being from Canada. That is a great many people came to Canada after the 1st world war, and have diets, and culture that is not Canadian, that may contribute to their longevity. So to say that statistically Canadians live longer, some do, some don't, which are which.

I see that Italian Canadians appear to live longer that Canadian Italians, they seem to live longer, and healthier, as to those born here; just an observation, with a conclusion that complicates the statistical conclusion.

--Caesar J. B. Squitti  : Son of Maryann Rosso and Arthur Natale Squitti 15:16, 27 January 2007 (UTC)

Observations on the observations

The article now notes that 99% of complaints to the College in Ontario are dismissed, most without making it the College's complaint committee. The sources for this information present it in a negative light, but it occurs to me that an investigation into the nature of the complaints might reveal that this rate is not in the least negligent; it may be that 99% of complaints are indeed insubstantial, which seems plausible enough to me. 霊村 11:23, 12 February 2007 (UTC)

Cancer research funding

In a section titled Doctor Shortage there is a paragraph long digression on the difficulty of funding clinical trials on non-patented drugs. This is surely an interesting and important topic, but it seems a little bit out of place in this section. Could there be a separate section for criticsm of the Canadian health research model? And is this concern specific to Canadian health research? 霊村 11:34, 12 February 2007 (UTC)

Mis-Citing the Fraser Institute

The last table on this page purports to present data from WHO, but the link is dead. The table presents the startling statistic that the Canadian "median waiting time to receive a critical procedure" is 124 days. That number is almost certainly derived from the Fraser Institute ( http://www.fraserinstitute.ca/shared/readmore.asp?sNav=pb&id=801 ) which states that the "total waiting time from referral to treatment" is 17.7 weeks (note that 17.7 x 7 = 123.9 days). It is bad enough that Fraser data is being passed off as WHO data, it is inexcusable that the "total time from referral to treatment" is then presented as "median waiting time to receive a critical procedure". If the table cannot be documented, it should be stricken.

For the best recent information on Canadian wait times, please see the latest Canadian Institute for Health Information data. CIHI is a Canadian government-funded watchdog agency. http://secure.cihi.ca/cihiweb/en/downloads/aib_provincial_wait_times_e.pdf

- Donald Loritz 19:16 (UTC), 5 March 2007, updated 6 March 2007 15:15 (UTC)

Sadly, that data is sloppy. For example, for radiation therapy wait times in Newfoundland and Labrador the number is "within 30 days." Does that mean most do it within 30 days, or does that mean most are actually 20 days with a few exceptions? For some things, the 124-day wait times are way off (Manitoba has 13 days for bypass surgery) but sometimes it's quite good (Newfoundland and Labrador has 98.6% within 182 days; note that means 1.4% are taking longer than six months).

In addition, sometimes there are wide ranges (in Nova Scotia CT and MRI scans can take anywhere from 34-177 days). And then, is that "critical care?" I don't know. Quebec cites its Cardiovascular/Cardiac Surgery wait times as "57-100%" What does that mean? Why are there no average numbers in this data? Why are there such wide ranges? How is "100%" a wait time? The problem is there is no aggregate data nor are the patient population numbers so we can't do aggregate data. They closest they get to that is: "The most commonly reported time periods are 1 month for 4 provinces, 3 months for 3 provinces, 6 months for 2 and 12 months for 1." Note they don't say if this is critical or general care.

I have no idea why you call this "the best recent information" in a way that suggests it's any good. I'll make a note that this data exists but I don't see how we can incorporate it into the table. However, you are correct about the WHO. I can't find the data either but it also looks like they are redoing their methods. But to be sure, we don't know if the cited number is the Fraser Institute or the WHO.--David Youngberg 20:30, 8 March 2007 (UTC)

Update: After examining the report in closer detail, I finaly figured out what they meant by "benchmark," as in they assign a target wait time for each priority level and this represents the percent that hits that level. 57-100% is a tremendous range and we have no data on which priority levels were achieved and which were not and how often each occurred. Thus the data is equally useless as I intially thought, just in a different way. -David Youngberg 20:52, 8 March 2007 (UTC)

Persistently Mis-Citing the Fraser Institute

We should thank Mr. Youngberg for supplying the WHO reference to the "Comparison" table on this page. Future editors should periodically check the WHO data and keep the table updated. Mr. Youngberg says above he doesn't "know if the cited number is the Fraser Institute or the WHO", but who, if not he, assigned the footnote attributing the 124 days to the Fraser Institute during the 22 minutes he spent "examining the CIHI report in closer detail"? Would he had spent the same amount of time reading the Fraser report.

The Fraser report ("Waiting Your Turn", p. 19 et passim, emphasis added) says:

The crucial difference between the two measures, however, is the inclusion of urgent surgeries. The SSCN web site measures waiting times for all non-emergent surgeries (i.e., urgent and elective surgery waits are measured), while Waiting Your Turn measures waiting times for only elective surgeries. This means that urgent wait times (which are significantly shorter than elective wait times) are included in the wait time measures available on the SSCN web site but not in those measured by The Fraser Institute.

In other words, 124 days emphatically does not measure "waiting times for critical procedures".

I have not yet found a source for the "1.2 day" waiting time the suspect column reports for the United States, nor have I found a source for the other countries' statistics in that column.

Accordingly, I have applied a disclaimer to the Comparison Table. Given that this Wikipedia page and the 124 vs 1.2 day "waiting time for a critical procedure" statistic has been widely cited on the web in the two months since it was originally posted, I believe it is proper and ethical to leave the disclaimer in place for an equal period of time or until the statistics in the "waiting time" column can be rectified and verified. 71.64.159.174 19:19, 18 March 2007 (UTC) Donald Loritz

I agree with your comments. I've updated the table, and left out that column. - SimonP 19:48, 18 March 2007 (UTC)

This article is too political and biased

This article uses stats produced by a private political strategist organization that's not open to public scrutiny. All statistics about Canadian Healthcare should be from recognized Canadian government statistics or the WHO/UN. Their scientific methods and research is open for peer review and is public record. 216.232.219.24 01:19, 19 June 2007 (UTC)S.Rothman

Citing the Fraser Institute

I've got a concern, and it is that this page does not mention the fact that the Fraser Institute is a hard-line neo-liberal economics supportive (or conservative) institute. If you don't believe me just look at their website. Shouldn't this page make a note about the politics of the critics of the Canadian system? Or in the case of the Heritage Institute, say that they are aligned in the North American conservative movement before just going ahead and citing away? It's all well and good to cite them, but they should never be unidentified by their ideological alignment, am I right? Thoughts anyone? I think that going forward it ought to be known what an institution's political alignment is before you cite on this page. Otherwise all sorts of political institutions are going to be put on here as experts in the field and readers will not know that many of them have an agenda. Drakeguy 22:56, 26 February 2007 (UTC)

The Fraser Institute is wikified on the page. If people want to know more about the source, that's how they can find out. Prefacing it with a descriptor of their politics runs the risk of turning that sentance/section into POV. -David Youngberg 19:13, 27 February 2007 (UTC)

If the Fraser Institute's studies are not peer reviewed, they're not a reliable source. There are many peer-reviewed studies and statistics of Canadian medicine, so it's easy to use peer-reviewed studies instead. I'm interested in what the Fraser Institute has to say, but when their claims and statistics are not peer-reviewed, it's important to point that out, and also to point out what the peer-reviewed data say. Nbauman 16:50, 4 July 2007 (UTC)

Doctor shortage caused by monopoly situation.

Original research lead:

It should be noted that most all doctors in Canada are paid a fee per visit, and with no guaranteed salary, the competitive environment tends to promote a shortage of doctors to guarantee an income; simple supply and demand economics.

--Caesar J. B. Squitti  : Son of Maryann Rosso and Arthur Natale Squitti 20:27, 23 July 2007 (UTC)

• You added: "In 1991, the OMA agreed to become a province-wide closedshop, making the OMA union a total monopoly. Restricting an oversupply of doctors would gurantee its members incomes. ONTARIO DOCTORS SOLD OUT AGAIN November 6th National Post Article byTerence Corcoran"
• This letter is a reprint of a newspaper column. But there's no indication that the association obtained copyright. I think WP policies say to avoid that and to reference (and link if possible) to the actual article.
• Corcoran is a very good writer (and may very well be right), but his column is a work of opinion. Rather than stating his opinion as fact, it should be attributed to him in the article. And if we are going to rely on opinion, then we need include the opposing opinions to balance. Canuckle 16:02, 26 July 2007 (UTC)

Quality level

Should this article be reclassified as a "stub"? Perhaps it is longer than the usual stub, but the quality of the article as an encyclopedia entry seems low. Consider a few examples from the current text:

(Regarding charitable and religiously-affiliated hospitals) "They were generally for the poor; wealthier citizens would be cared for in their homes by expensive doctors." Well perhaps, but isn't this just speculation? Define expensive, etc.

"Doctors who had long feared such an idea reconsidered hoping a government system could provide some stability as the depression had badly affected the medical community." Again, lots of speculation on what people may or may not have been thinking many decades ago. Why not leave speculation on people's motives to authors like Pierre Berton? This is supposed to be an encyclopedia entry, and the writing style seems to be like an editorial.

"It is also important to note that the doctors are self regulating through the Royal College of Physicians and Surgeons of Canada." This is completely false, and reflects a poor understanding of the responsibilities of various bodies. It is listed under the heading "Doctors [sic] Associations". The RCPSC is not a doctors' association, and it is not a "regulatory" (in a broad sense at least) or licensing body. Physicians are self-regulating through their provincial and territorial colleges, which are completely separate in mandate and organization from the RCPSC. The RCPSC accredits the certification of specialists. The only thing it regulates is the manner in which medical education of specialists is undertaken.

"The British North America Act did not give either the federal or provincial governments responsibility for health care, as it was then a minor concern." A minor concern for whom? How do we know? Again, a reasonable thought, but why bog down an encyclopedia entry with details like that. If the BNAA said nothing about health care, why not just say so? It would convey roughly the same meaning to the reader, without straying from fact into opinion and speculation. (24.137.84.65 05:21, 12 November 2007 (UTC))

"Delivered by private entitities"?

Yes GP's offices are private, but most Hospitals are not! How do you know that "most" healthcare is delivered by private entities? Kevlar67 16:03, 20 October 2007 (UTC)

This is a tricky definitional point. Legally, hospitals are private. (Compare to Ontario's provincial psychiatric institutions, which were public, although almost all of these have been closed or otherwise transferred to private not-for-profit management.) They operate under their own legislation; their employees are not classified as civil servants, and governments have difficulty in telling them what to do. (Compare this to public schools, which are public.) In recent years, many provinces have moved to regional health authorities, and abolished individual hospital boards. Note that there is considerable variation across provinces in what is included in these authorities, and how they are governed (or indeed whether certain boards - particularly for Catholic hospitals - were allowed to remain). Also, some provinces - notably Ontario - have retained individual boards. The legal status of these regional authorities is thus ambiguous - strictly speaking, they are not part of the provincial government, but there is certainly more control than was the case with the individual hospital boards. Quasi-private? Physicians are almost all private (even those working in hospitals). So are rehab clinics. Pharmacies. Labs. Home care agencies. In brief, Canada is indeed classified as having public financing (for ca 70% of care), but private delivery - albeit often not-for-profit - for almost everything (except public health). Hope this helps.R2SBD (talk) 16:18, 28 December 2007 (UTC)

Suggested revisions

I share the concerns about this entry. I have been doing some edits on the page about the Canada Health Act, and suggest that some of that material might be incorporated here. I would be happy to help edit this page as well, if that is deemed appropriate. There are some factual problems. For example, there is no such thing as the "Canadian health care system" - it is under provincial jurisdiction. I also have some questions about the point of view, which does not appear to meet Wikipedia guidelines.R2SBD (talk) 21:50, 24 December 2007 (UTC)

I've added a few sentences which are on related pages, and which I think improve the clarity. Is it appropriate to copy from one Wikipedia page to another if the pages are cross-referenced?R2SBD (talk) 04:36, 29 December 2007 (UTC)

Canadians "coming to" U.S. is POV

I have reverted a section heading about Canadians "coming to" the U.S. to seek health care. The POV problem is that this implies all readers of Wikipedia are in the U.S. A more neutral verb needs to be used. Canadians may "travel to" or "go to" the U.S. to seek health care, but "come to" should not be used. --Sfmammamia (talk) 17:10, 16 January 2008 (UTC)

OK. "Travel" is just as good a word. Grundle2600 (talk) 17:51, 16 January 2008 (UTC)

Brian Day quote

This article does not need Brian Day's quote about dog and human hip replacements in two places. I have left it under "wait times" as the most relevant and deleted the second appearance. --Sfmammamia (talk) 17:32, 16 January 2008 (UTC)

OK. Grundle2600 (talk) 17:54, 16 January 2008 (UTC)

Merge with History of medicine in Canada

History of medicine in Canada is really a subset of the topic health care in Canada. It is a short article and could easily be inserted into this one as a new section. It should be merged into this article.

Neelix (talk) 23:40, 25 February 2008 (UTC)

Support. Looks like an excellent idea to me, although the merged content could use some judicious editing -- it's currently a bit choppy. --Sfmammamia (talk) 02:08, 26 February 2008 (UTC)

Benefits Section

Why is half of the page about criticisms of the Canadian system and nothing is written about benefits of the Canadian system? For example, that Canadians spend half the amount of money as a % of GDP than the U.S. but have both have relatively equal life expectancy etc. Canking (talk) 15:44, 27 February 2008 (UTC)

But what about Mr. Big Chin?

Nowhere in this article does it say that Mulrooney changed the cost sharing scheme between the federal government and the provinces to 15%-85% from 50%-50% respectively. That is pretty much the root of our Health Care Crisis 99.241.140.96 (talk) 22:03, 14 April 2008 (UTC)

Graph of health care expenditure

We currently have three years of data. I am sure there are more. A graph of this would be nice ( Health care expenditure by year per person ).Doc James (talk · contribs · email) 22:57, 19 November 2009 (UTC)

600,000 procedures outside Canada?

I find it dubious that there are that many yearly procedures done on Canadians engaged in medical tourism. That's a huge number, and the source attached to the claim doesn't elaborate on the number, where it came from, or how it was calculated. It simply offers that it's an estimate, and nothing more. Frankly, the "source" seems to be more of a promotional piece for the company mentioned at the end of the article. Mindmatrix 01:07, 24 November 2009 (UTC)

Agreed, though the number may be higher than expected. I know of immigrant co-workers who prefer doing just that, going back to their home country for serious procedures. - RoyBoy 05:27, 1 January 2010 (UTC)

References

A good general reference on the system is Shah,Chandrakant P (2003): Public health and preventive medicine in Canada. 5th ed. Elsevier Canada, Toronto. 5th edition. This is a general text which has been used in training medical students.

For the history of Medicare, the key reference is Taylor,Malcolm G (1987): Health insurance and Canadian public policy. The seven decisions that created the Canadian health insurance system and their outcomes. 2nd ed. McGill-Queen's University Press, Kingston, ON.R2SBD (talk) 15:28, 28 December 2007 (UTC)

In the "Public Opinion" section, there is a "CITATION NEEDED" - here is that citation: http://www.harrisinteractive.com/harris_poll/pubs/Harris_Poll_2009_08_12.pdf also here: http://www.pollingnumbers.com/canada/poll-of-polls/canada-health-care-system-poll.html —Preceding unsigned comment added by 209.169.27.195 (talk) 04:15, 1 February 2010 (UTC)

Problem in citations

CIHI is cited frequently without explicitly telling which report is cited. This organism produces hundreds of reports every years. "CIHI p.19" does not tell me the name of the report and there is no link to this report. What report is it? —Preceding unsigned comment added by 66.36.151.142 (talk) 16:00, 28 February 2010 (UTC)

dental/vision care

"Depending on the province, dental and vision care may not be covered but are often insured by employers through private companies."

Please check some facts and figures, this is too vague and optimistic. In fact the majority of those that need this coverage the most are not covered... "often" does not describe this reality.

Dental care is a HUGE problem in our health care system, is not covered, and it causes a lot of unnecessary suffering. —Preceding unsigned comment added by 24.244.67.40 (talk) 22:49, 12 November 2010 (UTC)

Private insurance?

Hi, I'm a bit confused by the fact that at one point this page states:

Increasingly, there are private clinics that offer some of the same services as the public system such as hip replacements and MRI scans. These are legal. Contrary to popular belief, selling private health insurance that could cover these procedures is legal in several provinces, but because they are available without charge in the public system, so far there has been no market for private insurance for what the Canada Health Act defines as "medically necessary services."

but then under criticisms, I find:

Canada also outlaws all purchases of health care services within its borders as well as the purchasing of health insurance, denying its citizens from opting out of the system.

Could someone please clarify if this is a mistake or if I am misreading? 15:00, 13 November 2006 (UTC)

There have been changes in legislation at the provincial level. In Québec, it is now permitted for private clinics to operate, even if the market is relatively small. If I recall correctly, there was a significant court case challenging the older legislation, where it was established that it was permissible to operate private clinics. Private care providers are slowly making inroads into the system. I will see if I can find the exact details.LeMALdemer (talk) 00:31, 2 March 2011 (UTC)

I wrote the criticisms section and I got the latter factoid from the On the Fence Film (also under links). However the film appears to be over a year old so I'm attempting to confirm or deny either statement. David Youngberg 01:40, 14 November 2006 (UTC)

"Much of the political discourse concerning the health care system, as it stands in the year 2006, appears to be politically motivated." -This sentence is stupid. Need I even say that it stands to reason that political discourse is politically motivated? I'd change it, but I don't even really know to what it's referring. Somebody think of something. 16 February 2007

I agree with the statement, although it was not adequately worded. What is meant is that the discourse around healthcare in Canada has been influenced more by political ideology and vested interests than hard facts. In my humble opinion, I believe that much of the problem has been manufactured by the media and politicians. It is commonplace to see in Québec; for example, mention of a "crisis in healthcare". Thing is that in Canada, as is most likely the case in other OECD countries, there has been a combination of factors that have led to a significant stress on the its ability to operate as a welfare state.

There is a demographic bubble that is moving upward as people get older, which means that there will be a lot more people needing more care than ever before (there is a graph on this subject in the article) where the older people get, the more costs they incur on the health system.

There has been a sharp decrease in Government tax revenue from the private sector, as well as lowering personal income taxes.

Basically, the Canadian Government, as well as the provincial ones have to care for an increasing number of aging patients. The money invested into healthcare is outpaced by the ammount that would be required to maintain the quality and availability of care. Provincial healthcare systems have to do more with less.

LeMALdemer (talk) 00:31, 2 March 2011 (UTC)

Japan

So what is Japan doing right?

It spends less of its GDP (public and private) on healthcare than the US or Canada, less of a % of tax revenue on healthcare than the US, and less % of private industry than anyone but the Brits.

What is it, the sushi? —The preceding unsigned comment was added by 69.2.124.11 (talk • contribs) 2006-05-11 20:59:54 (UTC).

—————

Actually Cuba is the real outlier in this department. — Preceding unsigned comment added by 174.1.196.57 (talk) 15:57, 28 March 2012 (UTC)

or maybe it has something to do with this...

"Socialized medicine"

• An article titled "Health Care in Canada" with one brief mention of Tommy Douglas. Come on. It should be Douglas' photo on the first page, not Pearson's. And an entire section should be devoted to him. Is it because Douglas is so associated with Socialism that he is almost completely absent from the article? Please keep your politics to yourself and write the truth. — Preceding unsigned comment added by 142.161.245.219 (talk) 12:26, 18 July 2012 (UTC)

• • While there is a certain mythology out there about Tommy Douglas and him being the "father of medicare," the facts don't necessarily back that up. If Douglas is the father of medicare in Saskatchewan, then Woodrow Lloyd is its mother. Douglas served as premier for 17 years and didn't bring in public healthcare during that time. Though he planted the seeds in his last term, it was his successor (Lloyd) who introduced and implemented it to the province. However, it was Pearson who prompted it to spread to the other 9 provinces. However, if you think the page is broken, fix it. - Nbpolitico (talk) 13:22, 18 July 2012 (UTC)

• Can anyone explain why the "it's not socialized medicine" claim in the lead is relying on a reference to a letter to the editor of an American newspaper that doesn't mention Canada in the part that's publicly available without a subscription? See:

Letters: For Children's Sake, This 'Schip' Needs to Be Relaunched, Wall Street Journal, July 11, 2007, Uwe E. Reinhardt and others. Canuckle 05:17, 12 July 2007 (UTC)

The claim in this article that the Canadian health care system is not "socialized medicine" is incorrect -- at least, if you go by what our own Wikipedia article on Socialized Medicine says. ("The term can refer to any system of medical care that is publicly financed, government administered, or both.") Accordingly, I'm deleting the statement. 24.6.66.193 (talk) 06:16, 7 June 2008 (UTC)

For you to delete that well-documented section because you personally believe that it is incorrect, because of your interpretation of Socialized Medicine, is WP:OR original research and violates WP:NPOV. You can't delete it under Wikipedia rules. This is a clear violation of the rules. I'm reverting the change, and if I didn't revert it, somebody else would.

The only way for you to delete it is to discuss it here first. If you can be convincing enough to get consensus among the people who have been working on the article, then you can delete it. Nbauman (talk) 13:39, 7 June 2008 (UTC)

BTW, I don't like that introduction myself. There are arguments for and against the claim that Canadian health care is "socialized medicine." The lead may be incorrect or POV. But the way to change it is to give both sides of the argument and let the reader decide. I'm reverting it because you didn't follow the Wikipedia process. Nbauman (talk) 13:51, 7 June 2008 (UTC)

NPOV Check

After thoroughly reading this article to try to find facts, the tone leans towards bias and POV. Much, too much possible is dedicated to criticisms and not enough to the facts. Request a review by the community, discussion, and cleanup. This a controversial and politically charged topic in North American, especially the United States, so it should be handled delicately. 0pen$0urce (talk) 10:44, 1 November 2010 (UTC)

Feel free to improve the article.Doc James (talk · contribs · email) 23:43, 25 November 2010 (UTC)

I also had a bit of a beef with NPOV here. The fact that Tommy Douglas' picture was the only one at the top directly next to the heading is definitely political. It's True that Douglas contributed, but it's hardly fair to say that he was the only one. That would be like putting Winston Churchill's picture at the top of the entry on WWII, as if he had personally, single-handedly won the war. Canadian history makes it clear that there were a LOT of people that contributed to the public health care system, and actually, in fairness, Diefenbaker and Trudeau ought to have their pictures up there too. Brendan.Oz (talk · contribs · email) 27 September 2011 —Preceding undated comment added 19:06, 27 September 2011 (UTC).

To this US reader, the article appears overly concerned with defending the Canadian model against the US model. See in particular the section on Public Opinion. Why not just state the facts about Canadian opinion and ignore what we in the US think? Who cares what we think about our model or the Canadian model? It doesn't seem relevant and makes the entire section come across as unnecessarily defensive. — Preceding unsigned comment added by 68.100.237.144 (talk) 14:52, 4 September 2012 (UTC)

I think this article is trying to summarize the approach taken by newspaper articles of Canada rather than provide a new neutral view from scratch. My concerns: Why the focus on Canada vs the U.S., but no useful comparisons of Canada vs Europe (Europe generally facilitates private healthcare more than Canada)? I also don't think this article properly highlights how uniquely restrictive the Canadian health care system is in the world context (unlike in Europe, thanks to the combination of rules in Canada you effectively can't spend your money to improve your health and buy a private hip replacement). The reference to the Quebec court case is a good section -- shows how liberty has been restricted in Canada (and shows how the governments wanted a delayed implementation of the court rules to keep it that way). — Preceding unsigned comment added by 216.58.6.133 (talk) 10:47, 20 September 2012 (UTC)

Section: Ban on privately funded health care

I have deleted the following quote from Sally Pipes, quoted in a Wall Street Journal editorial: "Canada is the only nation other than Cuba and North Korea that bans private health insurance." The quote is totally inaccurate. Canada does not ban private insurance. As this article states elsewhere, many Canadians have supplemental private insurance, many of them receive it through their employers. I believe that insisting on including an inaccurate quote gives a biased perspective undue weight.

I've also deleted the modifier "black market" from the discussion of the opening of private clinics sourced from the New York Times. This characterization was not in the source and therefore is POV. --Sfmammamia (talk) 20:38, 15 January 2008 (UTC)

I am allowed to quote the Wall St Journal, because it is a legitimate source. And if Canadians aren't banned from spending their own money on hip replacement surgery, then why do they come to the United States to get it? Grundle2600 (talk) 16:55, 16 January 2008 (UTC)

Reliability of sources is not the only consideration here. That's why I cited the concern of undue weight. I have left the quote but noted the source (Sally Pipes, who is clearly biased) and explained the inaccuracy of it in the article. --Sfmammamia (talk) 17:45, 16 January 2008 (UTC)

Yes. It is better to have both opinions, than to have no opinions. More is always better than less. Grundle2600 (talk) 17:52, 16 January 2008 (UTC)

"And if Canadians aren't banned from spending their own money on hip replacement surgery, then why do they come to the United States to get it?" The short answer to this is that Canadians are unable to spend their own money on, or obtain private insurance for, INSURED medical services. "Insured medical services" being medical services covered by provincial health insurance. Services covered by each province may vary however all services deemed to be "medically necessary" ( a somewhat ambiguous term)are covered by the provinces. This prevents "queue jumping", effectively making it difficult for wealthier citizens to obtain care ahead of poorer citizens. The system is based on the severity of the medical condition, not one's ability to pay for the treatment. So people who can pay go to the US for treatment. 69.156.97.18 (talk) 09:13, 5 February 2008 (UTC)JR

The article refers to a court decision in 2005 that was stayed for 18 months, but there is no update as to the status for the last six years. — Preceding unsigned comment added by 98.217.131.172 (talk) 18:03, 25 February 2013 (UTC)

Is "only" a POV in this instance? Re: within Cross Border Health Care

Is "only" a POV in this instance? Re: within CROSS BORDER HEALTH CARE

 Sub- Canadians Visiting the U.S. to Receive Heath Care
 
 It is stated from a paraphrase:

"...Despite the medically questionable nature of heart bypass for milder cases of chest pain and follow-up studies showing heart bypass recipients were only 25-40% more likely to be relieved of chest pain than people who stay on heart medicine..."

re: (only 5-10%, only 85-100%...) Suggested to drop the "only" in this case

108.86.230.152 (talk) 09:32, 21 May 2013 (UTC)

I've removed it, and several other instances of "only" within the text which appeared to impart a POV. Mindmatrix 12:36, 21 May 2013 (UTC)

Avoiding Edit War over Wait Times countercriticism

I don't lightly use the term, only because Hauskalainen threatened to "keep deleting" things he characterized "arguments" when they were cited, documented facts quoted from medical sources and referenced in footnotes.

From Hauskalainen's talk page, after his initial deletion:

Hauskalainen, I just added detail from 1991 In Health, to Health care in Canada...you have known me for a while from the Single Payer article...it was a bit rash to delete my addition and say "dubious unreferenced claim" when I had given a full (more detailed that most on Wikipedia) reference including page numbers, certainly not "unreferenced" Next time, Just like C45207 did above on your talk page about the statistics you added about Waiting Times, could you please ask first, before deleting? Thanks--Harel (talk) 03:53, 25 August 2009 (UTC)

Since I don't read my talk page every single day, a faster way to reach me is by email via http://en.wikipedia.org/wiki/Wikipedia:E-mailing_users#Enabling_and_disabling_user_e-mail (I have ENABLED being contacted by email) --Harel (talk) 03:59, 25 August 2009 (UTC)

It is not a very relevent or up-to-date argument. 1991 was 17 years ago!! At that time there were 721 people waiting for heart by-pass surgery alone in BC (allegedly). (http://ageconsearch.umn.edu/bitstream/17472/1/ar910141.pdf) Today the total waiting for ALL heart surgery in BC is 127 and the median wait time for that surgery is 3.7 weeks. http://www.health.gov.bc.ca/cpa/mediasite/waitlist/median.html.

We are writing about Canada today. You seem to be making the rather crazy argument that people waiting for surgery in 1991 would be better off waiting because some of them will otherwise die on the operating table. What about those dying because they did not then get the surgery? For that reason I deleted the text and I will continue to do so.

I do not use e-mail for Wikipedia.--Hauskalainen (talk) 04:54, 25 August 2009 (UTC)

Hauskalainen, I am sorry to see you take such a hostile attitude. If you want an edit war, you will get one; actually, worse than a war: if you delete things which are (a) facts, not my opinions (b) the facts are relevant and (c) they are relevant facts which are well-referenced, then you will be sanctioned or even blocked by wikipedia for inappropriate behavior because, you cannot "keep deleting" them just because you don't like things which are facts, relevant, and documented. I will try to reason with you one more time: of COURSE I don't want people dying. But I am not "making a crazy argument" because 1) I am not making an argument, I am quoting other people, in fact, medical professionals so the "I" part is not correct and also 2) it's not a crazy argument, it is merely statistical facts. If you have the choice between giving 1000 people surgery, and having A die on the operating table, or giving none of them surgery, and having B die, then if B is noticeably less than A, then those are the facts, and people will agree that number (B) is better, I don't have to make an argument to people, they will draw their conclusion.

Now, those are the facts, but just to help calm things down, Of COURSE I don't want anyone to die, but I do understand Probability 101 that if my chance is 1 in 100 of dying in the next 2 years without surgery and it is 2 in 100 of dying (right there on the operating table) then if it were I, would NOT want that operation! Of course this assumes I trust my doctor; I might get a second opinion, but once I'm convinced I have solid medical advice, the real "crazy" thing to do would be to chose the 2 in 100 chance of death (on the operating table; the total chance of death in the next 2 years would be higher since one can die after the operation as well) instead of the 1 in 100 chance. I am adding this background so you can realize this is not about trying to kill people, it's about saving lives (if we don't trust the doctors, that's a separate, and probably even bigger problem, that goes well beyond this or any other specific example. If we trust them, they would be putting ahead on the list those people with higher risk, to get the surgery ahead of those with lower risk. And those with very low risk, risk significantly lower than the operation's mortality, should be advised against the operation at all) Obviously there is the risk of not enough people getting the operation, whether due to budget cuts, bad doctor practices, or other reasons. The paragraph (which I have a saved copy of and which will be re-posted) directly states that. The numbers for the year 1990 do prove that at least sometimes, the opposite is true, and more people would have been alive if none of them had surgery. Does that mean we should have given none of them surgery? Of course not. That is not a logical conclusion, nor does the paragraph make that assertion. (the correct conclusion is also not that everyone on the waiting list didn't belong on it; but that some of the people on the waiting list (a subset of them) who were waiting for the risk-bearing surgery, the ones least-at-risk from death from heart disease, who nevertheless were on the waiting list to get the surgery, should not have been on the waiting list (or ok to be on the list and never reach surgery) since their risk of death was lower that way; notice the deleted paragraph did not make this logical conclusion either, this is just for clarification), So...Please, pause before you react, the cited paragraph is not anti-public-health or anti-Canada and certain this is not a Sarah Palin "Death Panel" this is doctors (not government) prioritizing more-at-risk versus less-at-risk patients and comparing it to the risk of death on the operating table.

Hopefully you now see there is no evil conspiracy, but if you don't, I repeat, these are documented facts cited with full reference and if you delete things which are (a) facts, not my opinions (b) the facts are relevant and (c) they are relevant facts which are well-referenced, then you will be sanctioned or even blocked by wikipedia for inappropriate behavior because, you cannot "keep deleting" them just because you don't like things which are relevant and documented facts.--Harel (talk) 23:05, 25 August 2009 (UTC)

Reverting inclusion of paragraphs in Waiting Lists section of criticisms.

Harel:I will double check what you said when I get a little more time, but the reason I characterised it as a crazy argument was because it seemed to imply that people had a worse chance of dying on the operating table as they did waiting for the operation. I can't think that many people would wait for an operation that sped up their chance of dying and I think few doctors would want it that way also! And it did seem to be a very old source. How did you find it?' Can you give me the source again? Maybe I was a bit rash by not examining the source and the argument more closely but in order to do so I will need rather more information than I think you provided. Please tell me how I can verify the source.--Hauskalainen (talk) 05:05, 26 August 2009 (UTC)

Unless you can give some additional information about this source (like how you found it and how I can verify it) and furthermore explain why the content is still releveant today, I do feel inclined to delete this again. Lack of verifiabilty and lack of general relevance or applicability) seem to me to be very good reasons to do so. More of my thoughts at your talk page. --Hauskalainen (talk) 18:30, 26 August 2009 (UTC)

For those who didn't follow it, full reply and (in 9/6/09) full PDF documenting the article's authenticity, are at http://en.wikipedia.org/wiki/User_talk:Harel#Bizarre_claim_regarding_.22benefits.22_of_NOT_getting_an_operation_in_a_timely_manner. --Harel (talk) 22:05, 10 September 2009 (UTC)

The current counter-criticism section should be removed for two reasons:

1) The figures cited as evidence are not part of any research, but are estimates given casually by a Canadian health official during an interview. There is nothing in the article indicating that these figures actually represent the state of the bypass surgery wait list. And the evidence certainly doesn't justify extrapolating the argument to the entirety of the health care system.

2) The argument doesn't make logical sense either. Regardless of the wait list length, the patient ultimately goes through surgery if he hasn't died. If 1% of the people on the waiting list die before their surgery and 2% die on the operating table, then a wait list patient's total chance of dying during wait+surgery is (1% || 2%) = 2.98%. In order for wait lists to have a positive effect on mortality they would need to reduce the chances of the dying in surgery, which no part of the source article claims or provides evidence for. So unless I am seriously misunderstanding the claim, it doesn't make logical sense.--Ian H. 1:29, 23 September, 2009 (UTC)

Ian, for 1), I believe they are presented as what they are: the statistics for one part of Canada and of course the government of any country/region is responsible for gathering and reporting such statistics, and this case is not different and no less legitimate unless there is evidence of errors/misrepresentations.

As for 2), I see where the confusion is in appearance. Think of it as a per year statistics: for the next period of time (lets say a year for simplicity, it could be another period) you have a certain chance of death if you don't get the surgery, and another if you do. If the surgery gives a higher chance of being dead, than your chances of dying (without surgery) in the next 12 months, what would I prefer, what would anyone prefer? To not have the surgery. Then what happens a year or two or more later? Well, either you are cured or better due to other things (drugs, or diet, or exercise or some combination) or else, you're not cured or better but the same, but the surgery skills have improved so your operation now has a lower chance of death so you have it; or, you're of the same health and the operation of the same risk (so again you choose to not have the operation if you are rational: higher chance of being alive 12 months from now if I DON'T have the surgery)

...or else, your condition is worse. In this last case, maybe it's sufficiently worse that your chances of death in the next 12 months from no surgery (whether with or without medications) is higher, than the chance of death from surgery. At this point, it DOES make sense to "take a chance" and have the surgery since chances of death are lower with surgery than without. But earlier when you were healthier, your chances of not dying were better without the surgery.. Harel (talk) 02:22, 12 January 2011 (UTC)

Good god, why even have a counter-criticism section when the criticism section devotes more time trying to rebut criticisms than actually presenting criticisms. — Preceding unsigned comment added by 74.141.152.197 (talk) 17:56, 10 August 2011 (UTC)

The last sentence in the paragraph should be deleted since it is not relevant; it is about a different "phenomenon". Anyway it undercuts the paragraph's point by stating that "delayed" access to care could result in "worse health care" (author probably meant worse health outcomes, but the point still stands).

Instead of using percentages to support the idea of beneficial wait times we could state that the mortality rate for some risky operations and treatments may be higher than the rate associated with living with the condition and having no treatment. Still cite the same reference, but not give the small sample so much weight. Anyway the key is how well the risky treatment is predicted to work, when it does, i.e., is it curative or only likely to slightly improve the situation? If when the treatment works you get back to full health then you may take a risk on a treatment with a high mortality rate: .5*1=.5 However if it's only predicted to get you to a 75% quality of life score then you may be less likely to proceed: .5*.75=.375

Of course it also depends on where you start, e.g., are you going from .8 to 1 or .5 to .75? The is a key issue in public health care. Who should pay to make a person slightly more comfortable, when their life is not in danger?3dward.3ggins (talk) 19:44, 1 October 2015 (UTC)

Adding information that is not MEDRS

I know I am not supposed to add non-wp:MEDRS compliant information to articles that display the wp:Medicine banner on their talkpage. However, I decided to be bold and add information from the G&M to this article. Feel free to revert if you feel it should not be added. Thanks in advance, Ottawahitech (talk) 19:02, 31 December 2016 (UTC)please ping me

Single source on the "counter argument" to wait times

The so-called "counter argument" under the wait times section relies only on a 1990-era news article. C-GAUN (talk) 23:35, 11 August 2017 (UTC)

Source or opinion ?

"Canada's provincially based Medicare systems are cost-effective because of their administrative simplicity. In each province, each doctor handles the insurance claim against the provincial insurer."

Observations and many sources suggest this is NOT TRUE.

https://www.thestar.com/opinion/contributors/2019/01/09/what-many-canadians-dont-know-about-the-canada-health-act.html — Preceding unsigned comment added by 24.79.147.13 (talk) 03:33, 24 March 2019 (UTC)

"Gender gap in healthcare" significant revision

Hi,

I found this article on the “articles needing copy edit[ing]” page. I’m posting below a significant revision of the flagged "Gender gap in healthcare" section under "Criticisms" to allow for comment. I've extracted the main points, placed them logically at the start, removed repetition, and edited for clarity. I've had to rearrange footnotes, but have not edited them: the "Women and Private Health Insurance" document has page numbers, which therefore need to be integrated into the footnotes. General comment: the sources are underutilized -- this section could be expanded.

Disparities between men and women’s access to healthcare in Canada has led to criticism, especially of healthcare privatization. While most healthcare expenses remain covered by Medicare, privatization has shifted payment for some medical services previously paid for publicly to individuals and employer based supplemental insurance. ection This shift has negatively affected women economically for two reasons; first, because women are disproportionately poor and poorer than men, individual payments are a greater burden; [73] second, because women disproportionately work part-time jobs and in fields that do not offer supplemental insurance, in particular as homemakers, they are less likely to have private insurance to cover the costs of “services such as drugs."[75]

The shift from public to private financing has also meant additional labor for women to the extent that families disproportionately rely on them to be caregivers. Less public financing has shifted care to women, leaving “them with more support to provide at home.”[74]

Women’s additional healthcare requirements further exacerbate the gender gap. Although women make up approximately half of Canada's population, they “receive the majority of healthcare in Canada."[73] One reason for this extra care is due to gender specific healthcare needs, such as pregnancy.[73]

Differences in wait times for diagnostic tests for women and men also demonstrate a potentially harmful difference in healthcare. One Canadian study reports, "mean wait times are significantly lower for men than for women pertaining to overall diagnostic tests: for MRI, 70.3 days for women compared to 29.1 days for men."[76] Longer wait times have been associated with a higher risk of health complications.

Adjprofe (talk) 20:25, 1 May 2019 (UTC)

Clairfy; Publicly funded system of private-for-profit systems ?

"Canadians strongly support the health system's public rather than for-profit private basis,"

This point has to be clarified, amidst the confusion as the reality of the system.

Canada's system is a publicly funded system, where doctors bill 'per visit' in the case of family doctors, or per visit, or per procedure for specialists.

Problems caused ? Some might argue this is one reason the Canadian model ranks so low. In some cases doctors have posted signs, saying that only one question, or one problem can be discussed per visit.

The problem is compounded by 'self-regulation', and a 'doctor shortage' caused in part by the self governance of the Medical body, and the need to restrict doctors to maintain incomes. MOST DOCTORS ARE NOT ON A PAID SALARY, they COMPETE with each other in the market, paid by the government. Again the issue is a collection of private systems paid for by the public government taxes; a half-truth, half this and half that.

There is a great deal of confusion by the people based on years of misinformation.

https://www.theglobeandmail.com/opinion/five-things-canadians-get-wrong-about-the-health-system/article20360452/

Research by Capital T Consultants.

Blatant Engineering

It is pretty obvious when the History section has been removed to another article and all the other derp clogging this article up that this has been messed around by some right wing douchenozzles. — Preceding unsigned comment added by 46.7.188.106 (talk) 18:36, 9 October 2020 (UTC)

Out-dated content on wait times

I removed these statements which are out of date. I will find more recent data. "The median wait time for diagnostic services such as MRI and CAT scans is two weeks with 86.4% waiting fewer than 90 days. The median wait time for elective or non-urgent surgery is four weeks with 82.2% waiting fewer than 90 days. Urgent cases requiring MRI and CT scans are prioritized, and the wait time for those patients is not included in the above statistics. In Ontario, urgent MRI and CT scans are performed almost immediately.

This refers to the 1990s. Too much detail for 2020? "Surveys on waiting times for elective surgery show that the percentage of patients who reported waiting a long time for elective surgery increased greatly in the 1990s, suggesting that waiting times were much shorter before then. Anecdotal (and therefore weak) evidence suggests that waiting times were not perceived as a major problem by the public before cutbacks in the 1990s at a time of greatly increased demand for health care. Another issue is the total waiting time. Ontario knee replacement recipients waited an average of 72 days to see an orthopedic surgeon (2 months 11 days), giving a total average waiting time of 177 days (about 5 months and 4 weeks) from referral to treatment.

This content has no RS and appears to be anecdotal and from the early 2000s: "Sometimes, waiting times can be affected by temporary specialist shortages relative to demand rather than urgency, although patients waiting on the same list are often triaged; the author of this paragraph waited for only a little over 3 months to see a dermatologist because of a skin problem that itched slightly once a week and was not at all urgent (in the early 2000s) in Halifax, Nova Scotia, while cumulative waiting times (including referral to a medical test to appointment with a surgeon to radiation or cancer surgery) for cancer patients can be 2–3 months in areas with long waiting times. Waiting lists for cancer treatment are prioritized by level of urgency, but the triage process (while generally accurate) can occasionally assign a low priority to what turned out to be an urgent case."

References

Outdated references in further reading section

These should be integrated into the content—in sections reflecting history perhaps—including publication dates for clarification, or simple excluded.

• Caulfield, Timothy A; Von Tigerstrom, Barbara (2002). Health care reform & the law in Canada: meeting the challenge. University of Alberta Press. p. 37. ISBN 978-0-88864-366-7. Canada Health Act.
• Fierlbeck, Katherine (2011). Health Care in Canada: A Citizen's Guide to Policy and Politics. University of Toronto Press. ISBN 978-1-4426-0983-9.
• Jacobs, Philip; Jonsson, Egon; Rapoport, John (2008). Cost Containment and Efficiency in National Health Systems : A Global Comparison. Wiley-VCH. ISBN 978-3-527-32110-0.
• Institute, John Deutsch (2006). Study of Economic Policy Health Services Restructuring in Canada Conference. Economic Policy, Queen's University. ISBN 978-1-55339-075-6.
• Marchildon, Gregory P (2006). Health systems in transition : Canada. University of Toronto Press. ISBN 978-0-8020-9400-1. Health care in Canada.
• Raphael, Dennis (2007). Poverty and Policy in Canada: Implications for Health and Quality of Life. Canadian Scholars' Press. ISBN 978-1-55130-323-9.
• Mullner, Ross M (2009). Encyclopedia of health services research. SAGE. pp. 559–562. ISBN 978-1-4129-7194-2.

This article in its current layout needs constant updating to clarify decades-old statements that imply current actualities.Oceanflynn (talk) 20:38, 8 January 2021 (UTC)

Sidebar Logo Confusion with Canadian Ski Patrol?

The logo in the "Healthcare in Canada" sidebar seems very similar to the Canadian Ski Patrol logo, enough that I'm worried about trademark issues.

This is the logo on the sidebar: File:Red leaf with white cross.jpg

And here's the CSP logo:

There's a slight difference in the colour of red (#AE0E38 vs #A7192F), and the CSP's maple leaf is a 15-point variant rather than the eleven-point variant taken from the Canadian flag, but it still seems like there's a lot of potential for confusion here.

157.52.13.33 (talk) 03:35, 11 January 2021 (UTC)

 Fixed thumb.Moxy- 05:20, 4 March 2021 (UTC)

Knee surgery wait time citation?

In 2014, wait times for knee replacements were much longer in Nova Scotia,[159] compared to Denmark, Germany, the Netherlands and Switzerland.[citation needed]

Has a citation for this been located? I tried to find one but was unsuccessful. I will continue to look, but if anyone else knows of one please update!

Kyletong29 (talk) 20:12, 7 November 2021 (UTC)

Editing the Healthcare in Canada Article

Hey everyone! My name is Kyle and I am currently completing a university class that is working on editing healthcare information on Wikipedia. Another student and myself will be working on editing this page and adding a section discussing the inequality and barriers to healthcare access for subpopulations in Canada, including: immigrant communities, BIPOC communities, Northern communities, LGBTQ2S+ communities and others. We are looking forward to collaborating with you all, feel free to provide any feedback or comments on our work! Thanks so much! — Preceding unsigned comment added by Kyletong29 (talk • contribs) 00:40, 16 November 2021 (UTC)

Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 7 April 2020 and 27 June 2020. Further details are available on the course page. Student editor(s): Vmstiles.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 23:13, 16 January 2022 (UTC)

Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 7 September 2021 and 8 December 2021. Further details are available on the course page. Student editor(s): Kyletong29, EnricoRescigno.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 22:14, 17 January 2022 (UTC)