Paying vs. Waiting — Comparing Health Care Systems
Monday, February 23, 2009
It's sophisticated medical technology that can pinpoint problems in the body from your brain...to your heart...to your limbs. Magnetic resonance imaging - or MRI - uses magnets and radio waves to take a closer look at soft tissue. And health officials say getting an MRI in Manitoba...has never been better.
Dr. Blake McClarty: I think we have improved things, and the volume of the diagnostic imaging procedures has gone up an awful lot over the years.
Compared to the United States, Canada has fewer MRI machines per capita, but does more scans per machine. And patients get the scans, free of charge. But there's a catch...if it's not an emergency...you'll have to wait.
Teresa Clifton: Extremely painful. It's hard to walk.
Teresa Clifton broke her foot last spring. But months after she got the cast off, she was still in pain. After CT scans and x-rays, doctors couldn't figure out why.
Teresa: They finally said, “Okay, we're gonna send you for an MRI. We think it's muscle or tissue damage.” But now I'm on a four month waiting list for it.
She knows others need scans more than she does. Still, that wait is too long. And if the price was right, she'd pay for one.
Teresa: I would really like to get this fixed - find out what's wrong with it - because the last thing I want to do is be taking medication for the rest of my life.
For non-urgent MRIs, the wait is typically five to eight weeks. But the provincial government's health department recently changed how doctors order them. And that's bumped wait times up to 14 weeks. Health officials say they're working on getting that back down.
A unit like this scans 29 patients a day. This clinic also recently expanded its operations to seven days a week to see more patients.
The regional health authority also has plans to add another MRI unit to another Winnipeg facility. Moves it hopes will reduce wait times.
Dr. McClarty: Historically we've done well on almost all of the wait list issues.
Still, health officials acknowledge that's little comfort for people who are in pain. And if their health issues escalate, they'll be bumped up for an MRI. So doctors are asking people on waiting lists, to be patient.
I'm not overly concerned that there's a major health risk in any of that, but it's more...should they have the right to buy that if they can buy a steak at the grocery store, can they buy an MR? That I think is just a controversy. I'm comfortable with the quality and availability of imaging services in Manitoba.
Teresa: I definitely prefer our Canadian medical system over the states. But if you do get an opportunity to pay a couple extra bucks to get down to the problem, I kind of like that as well.
For Jon Paintin it's simple. The more he runs, the longer he'll live. Just three years ago he weighed twice as much as he does today.
Jon Paintin: I took a look at myself in the mirror and thought, “Wow, look at me. I'm 400 lbs. I'm massively overweight.” I had to do something with myself. Otherwise I was going to be at risk of heart attack, diabetes, a whole range of different health problems.
Paintin managed to stave off diabetes as many Canadians have.
In Canada, only one in 17 has the disease, a far healthier percentage than exists south of the border, where it's one in 13.
And for anyone who's at risk in Canada, getting good health advice is as easy as a free trip to the doctor.
But for Canadians like Wendell Oigg, free healthcare wasn't enough to prevent his kidneys from failing five years ago. He says he never took the warning signs seriously.
Wendell Oigg , Type-2 Diabetic: Now I'm sick and it comes back to haunt you. Why did I not listen to that? I should have listened. I was stubborn.
Wendell was first diagnosed with type-2 diabetes in 1990 when he was
23 and 300 pounds.
He never took his doctor's advice to lose weight and eat healthier food.
Just a year after his kidneys failed, he slowly went blind.
Wendell: I would have listened and ate everything I was supposed to eat.
Wendell is Ojibway, one of the groups making up Canada's 1.1 million aboriginal people. And while diabetes was virtually unknown among them 50 years ago, today it's assumed epidemic proportions. One in four has the disease.
Dina Bruyere , Exec. Dir., National Aboriginal Diabetes Association: Today we live more of a sedentary lifestyle, and the food that we're able to access is not very good for our systems.
A half century of change to traditional lifestyles has meant less physical activity and less access to a healthy, natural diet, and a greater reliance on cheaper, processed foods.
Dina Bruyere: That's very concerning. It should be a priority health issue on
Canada's health agenda.
So while Bruyere feels government has to act, she also thinks individuals can improve their own situations too.
Winston Thompson has seen the disease tear through his family. Just a few years ago his brother died from complications of the disease.
Winston Thompson , Type 2 Diabetic: Not even less than two years after he passed away that I was diagnosed with diabetes. So I thought okay well, that doesn't sound like a good situation to be in.”
So he decided to get in shape. Now, he watches what he eats, and monitors his blood sugar regularly.
Dina Bruyere: I think people are starting to become aware of it now, because a lot
of our people are experiencing the complications.
Complications that people like Wendell can't get fixed, only treated. He's grateful he's able to access free treatments like dialysis, but that's little solace when he only has himself to blame for suffering through this new epidemic.
Wendell: Take a look at what happened to me. I didn't listen. Do you want what
I'm going through?
Ron Leibl is Geoff's dad.
He knows staying active plays a huge role in staying healthy.
So he meets twice a week with his buddies at this Winnipeg curling
club, a game with its roots in Scotland.
And for Ron Leibl, curling has become as Canadian as universal healthcare. He and his wife Anne have lived on the Prairies their whole lives. And they see access to health care as one of the big advantages.
Ron Leibl: Everyone gets it. That's the big virtue.
Anne Leibl: What makes me happy about it is that everybody is covered.
Outside of a few minor procedures.
The Leibls haven't had to rely too much on the health care system in recent years. But as they get older, they know they're covered. Regardless of their pensions or other insurance plans.
Ron: We wouldn't dare go to the States without having coverage over and above what we have here. But that's exactly what their son Geoff did when he moved to San Diego 15 years ago.
Ron: He went down with not that much money at the time, so we didn't know
how he'd be able to afford it. So yes, there was a concern, obviously.
Geoff eventually got a good job and health care coverage along with it. And his parents now believe he's in good hands if he or his family gets hurt or sick.
Ron: It's wonderful. And they get terrific coverage. They use the system to their advantage, and it works out well for them.
So well, in fact, that even though the Leibls are big supporters of Canadian healthcare, they wouldn't rule out someday going south for specific treatments.
And it's all because of where they see Canada falling short, long wait times for different services.
Ron: I think it should be enhanced, quite frankly. I think there should be other schemes too that should be outside the universal system.
In Manitoba, you could wait up to seven weeks for a CT scan. If you need a hip replacement, you'll wait 14 weeks. And for cataract surgery, up to 10 weeks.
Anne: If somebody wants to pay, they should be able to pay.
There's a perpetual debate in Canada: stick with a system where everyone has equal access to healthcare, or allow for some private services, which would relieve wait times. But that would mean people who could afford it would jump the queue.
The Leibls see merit in a system that provides some private services. But for now, they're happy to be at home in Winnipeg. Especially, during a time of economic hardships right across the continent.
Anne: Massive layoffs in the United States. Those people now have no medical coverage. At least that's my understanding anyways. They have no medical coverage. Layoffs are happening in Canada, but those people are still covered. And that's a big plus as far as I'm concerned.
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