Ontario's doctors support the action taken by theprovincial government today to remove trans-fats and junk food from schools.In 2005, The Ontario Medical Association (OMA) called for a restriction onnutrient-poor foods for students while under the care of school boards inorder to help curb the rate of childhood obesity. Doctors have also beencalling on the provincial government to mandate one hour per day of structuredaerobic physical activity and exercise for elementary and secondary schoolstudents in order to help reverse this dangerous trend.
"The evidence is clear, obesity rates in children can be siginificantlydecreased with appropriate physical activity and healthy food options," said Dr. Janice Willett, President of the OMA. "It is essential that school be ahealthy environment for children, where they can experience healthy behavioursthat will continue into adulthood."
The OMA report, An Ounce of Prevention or a Ton of Trouble: Is there anepidemic of obesity in children? showed that from 1981 to 1996, the proportionof overweight boys increased from 15 to 28.8 per cent and overweight girlsfrom 15 to 23.6 per cent. The report also highlighted the severe andpotentially life-threatening consequences of obesity. Obese children face anincreased risk of heart disease, high blood pressure, Type 2 diabetes,breathing problems (such as obstructive sleep apnea) and orthopediccomplications.
"The provincial government has shown that health prevention is a priorityand tackling junk food in schools shows they are committed to improving thehealth of our children," said Dr. Willett. "This action, in combination withmore physical activity and public education, will help address this growingpublic health issue."
Thursday, December 6, 2007
Wednesday, November 28, 2007
Disparities in Healthcare Access and Use: Yackety-yack, Yackety-yack
| Healthcare Policy / Politiques de Santé, 3(2) 2007: 10-18 |
| Despite change, uncertainty and disarray in Canada's healthcare system(s), some observations about Canadian medicare still seem beyond challenge: |
The last point deserves elaboration. A growing body of research evidence indicates that use of hospital services in Canada is generally consistent with relative need across income groups (e.g., Manga et al. 1987; van Doorslaer and Masseria 2004; Allin 2006). Some studies (van Doorslaer and Masseria 2004; Allin 2006) show greater use of hospital services by those with lower income after controlling for healthcare need - perhaps calling into question the adequacy of existing measures of need. On the other hand, studies of specialist services have demonstrated a direct relationship between use and income, education or both (McIsaac et al. 1993, 1997; Roos and Mustard 1997; Dunlop et al. 2000; Finkelstein 2001; van Doorslaer et al. 2006; Allin 2006) - wealthier and better-educated Canadians use more specialist services independent of need. The picture with respect to primary care physicians' services is less clear. Some studies show an equitable (i.e., needs-based) distribution across education and income groups (McIsaac et al. 1993, 1997; Roos and Mustard 1997; Dunlop et al. 2000), while others do not. For example, Birch et al. (1993) found the use of family physician services to be positively associated with level of education (and extent of contact with friends and relatives). Based on data from the 2001 Canadian Community Health Survey (CCHS), van Doorslaer et al. (2006) found that, after standardizing for healthcare need, higher income was associated with a greater likelihood of seeing a primary care physician but a lower number of visits. Using 2003 CCHS data and a similar methodology, Allin (2006) observed a pro-rich inequity in the probability of visiting a family physician, a finding that was inconsistent among the provinces and territories. In the 2002/03 Joint Canada/US Survey of Health, Canadians with low income were less likely to have a regular doctor and more likely to report unmet healthcare needs than those with high income (Lasser et al. 2006). In an earlier international population survey, Canadian respondents with below-average income were more likely than those with above-average income to report having difficulty getting needed care (Shoen et al. 2000). Data from the 1994/95 National Population Health Survey showed that the likelihood of women in the appropriate age groups having either a Pap smear or a mammogram was associated with higher education level and being born in Canada (Gentleman and Lee 1997; Lee et al. 1998). Income level was also independently associated with having a Pap test (Lee et al. 1998). In the 2005 CCHS, respondents in the highest two (of four) income categories were more likely than those in the lowest income category to report having a flu shot in the previous 12 months (Kwong et al. 2007). Ontario-based studies have shown a positive association between income and access to coronary angiography and revascularization (Alter et al. 1999) and to in-hospital occupational therapy, physiotherapy and speech pathology following a stroke (Kapral et al. 2002). Patients from the lowest-income neighbourhoods waited much longer for coronary angiography (Alter et al. 1999) and carotid artery surgery (Kapral et al. 2002) than those from the highest-income neighbourhoods. Recently published studies in Healthcare Policy/Politiques de Santé point to inequities in access to radiation therapy for breast cancer based on income level (Fortin et al. 2006) and to mental health services for anxiety or depression provided by both family physicians and psychiatrists based on education level (Steele et al. 2007). This summary, reflecting a brief and unsystematic scan of the literature, describes only the tip of a much larger evidence iceberg. Clearly, Canadian medicare has failed to achieve healthcare access (and use) based on need, even for those services within the purview of the Canada Health Act: hospital and physicians' services. Being poor, poorly educated or both impairs access to specialist and (probably) family physician services, to preventive care (e.g., Pap tests, mammograms and flu shots) and to services for specific health problems (e.g., cardiovascular and mental health). But income and education are not only associated with access to services; they are themselves determinants of health, and often cluster together with other determinants such as Aboriginal status, early life experiences, employment and working conditions, food security, housing, social exclusion, social safety net, unemployment and employment security (Raphael 2004). The very people who need care the most are the least likely to get the care they need. Evidence of the continuing relationship between socio-economic characteristics and access to health services under medicare is abundant, long-standing and persistent. This evidence is without doubt well known (at least in part) to health system decision-makers. Why, then, is there so little sign of concerted heath policy or health system design and management initiatives at the federal or provincial/territorial levels to address this violation of the fundamental rationale for Canadian medicare? It may be more than coincidence that those on the receiving end of inequitable access are among the least politically and economically powerful members of Canadian society. Although many Canadians are passionately committed to the principle that access to essential health services should be based only on need, they may, given a lack of media and political attention to the issue, assume that the elimination through medicare of (most) financial barriers to obtaining hospital and physicians' services has solved the access problem. Under these circumstances, politicians and governments at the federal and provincial/territorial levels are under little or no pressure to mount a response. As a result, current policy complacency seems likely to continue unless equity of access emerges as a public issue that resonates with Canadians who support the core principles of medicare and mobilizes civil society. Now, there's a challenge for knowledge translation. Meanwhile, there will undoubtedly be lots of talk (research on access inequities and acknowledgment - out of public view - of their existence), but little policy action. |
Wednesday, November 21, 2007
Transforming Healthcare Organizations
Imagine you are a member of a hospital's executive team, having just left a meeting in which you and other members discussed the possible introduction of an ambitious Computerized Physician Order Entry (CPOE) system. Around the conference table you and others questioned whether CPOE would be the most effective way to realize your hospital's commitment to patient safety. Other issues that were raised included whether clinicians would support or resist the change, whether staff would have sufficient skills, where to begin, affordability and whether to proceed incrementally or with a "big bang." While there was much disagreement with respect to each of the issues, there was near unanimity around two important decisions - CPOE would be implemented and you would be the executive responsible for the system's design and implementation. This article, based on the experiences of a multi-site hospital, and drawing on past research on organizational change, provides a Four-Stage model to help change leaders in healthcare. Although relying on Toronto's University Health Network to illustrate the change model, the model is intended to speak to change leaders implementing various types of complex changes in all healthcare organizations. [from Healthcare Quarterly, 10(Sp) 2006: 10-19. Author:Brian Golden]. For the full article go here.
Transforming Healthcare Organizations
Imagine you are a member of a hospital's executive team, having just left a meeting in which you and other members discussed the possible introduction of an ambitious Computerized Physician Order Entry (CPOE) system. Around the conference table you and others questioned whether CPOE would be the most effective way to realize your hospital's commitment to patient safety. Other issues that were raised included whether clinicians would support or resist the change, whether staff would have sufficient skills, where to begin, affordability and whether to proceed incrementally or with a "big bang." While there was much disagreement with respect to each of the issues, there was near unanimity around two important decisions - CPOE would be implemented and you would be the executive responsible for the system's design and implementation. This article, based on the experiences of a multi-site hospital, and drawing on past research on organizational change, provides a Four-Stage model to help change leaders in healthcare. Although relying on Toronto's University Health Network to illustrate the change model, the model is intended to speak to change leaders implementing various types of complex changes in all healthcare organizations. [from Healthcare Quarterly, 10(Sp) 2006: 10-19. Author:Brian Golden]
Monday, November 12, 2007
It's time to balance fight for life with ballooning health costs. Robert Cushman
By Andrew Thomson, Ottawa Citizen
Published: Wednesday, October 31, 2007
With acute-care beds being filled at area hospitals with chronically ill seniors, the time for a serious public discussion on the collision of rising medical costs and the "death with dignity" debate is now, says the man charged with co-ordinating health care in Eastern Ontario.
It's the ethical responsibility of doctors to encourage discussion regardless of the painful moral, ethical, and political questions that arise, said Dr. Robert Cushman, CEO of the Champlain Local Health Integration Network, who added that the demand for such health care is likely to rise.
"Do I have personal opinions on this? Yes I do," he told the Citizen editorial board this week during a wide-ranging, candid meeting.
"But my professional and my public opinion is that we need to have this healthy debate."
Legislatures and courts across North America and Europe have long grappled with the right to die.
For Dr. Cushman, it's a matter of money and higher levels of respect and care for seniors. The strain on acute care resources has to be addressed as Canada's population ages and pressure mounts on health services, said the former medical officer of health for the City of Ottawa.
Dr. Cushman described a number of 80- or 90-year-olds on ventilators being sent to intensive care units, some of whom have Do Not Resuscitate orders lost in the system. His own 87-year-old mother "would not be happy" with such a scenario, he said.
"It's bad enough with our parents' (generation) but when we get these it's going to really burst the bubble," he said of himself and fellow baby boomers.
Health care administrators now face a zero-sum ethical game where dollars are used for chronic patients in "high-end" acute-care facilities instead of community programs and home care, Dr. Cushman argued, reminding his interviewers that bottom lines aren't his only motivation for seeking public dialogue.
"What kind of heroics can you do in the last six months or two or three years of a life?" he asked. "For someone who's over the age of 80, a hospital is a pretty scary place, and a pretty dangerous place.
"We're talking about the frail elderly. And we have too much of an emphasis on the cure when the returns for the cure can be very low. I think we need to respect seniors' independence and their dignity."
Dr. Cushman, who oversees health care funding and delivery for more than a million residents between Cornwall and Algonquin Park, hopes the growing popularity of living wills is one solution.
He also wants to stop seniors from bouncing around the health care system like a "ping-pong ball." That includes improving "ordinary" procedures such as basic nursing care, home support, and meal delivery.
For more on this story go here
Published: Wednesday, October 31, 2007
With acute-care beds being filled at area hospitals with chronically ill seniors, the time for a serious public discussion on the collision of rising medical costs and the "death with dignity" debate is now, says the man charged with co-ordinating health care in Eastern Ontario.
It's the ethical responsibility of doctors to encourage discussion regardless of the painful moral, ethical, and political questions that arise, said Dr. Robert Cushman, CEO of the Champlain Local Health Integration Network, who added that the demand for such health care is likely to rise.
"Do I have personal opinions on this? Yes I do," he told the Citizen editorial board this week during a wide-ranging, candid meeting.
"But my professional and my public opinion is that we need to have this healthy debate."
Legislatures and courts across North America and Europe have long grappled with the right to die.
For Dr. Cushman, it's a matter of money and higher levels of respect and care for seniors. The strain on acute care resources has to be addressed as Canada's population ages and pressure mounts on health services, said the former medical officer of health for the City of Ottawa.
Dr. Cushman described a number of 80- or 90-year-olds on ventilators being sent to intensive care units, some of whom have Do Not Resuscitate orders lost in the system. His own 87-year-old mother "would not be happy" with such a scenario, he said.
"It's bad enough with our parents' (generation) but when we get these it's going to really burst the bubble," he said of himself and fellow baby boomers.
Health care administrators now face a zero-sum ethical game where dollars are used for chronic patients in "high-end" acute-care facilities instead of community programs and home care, Dr. Cushman argued, reminding his interviewers that bottom lines aren't his only motivation for seeking public dialogue.
"What kind of heroics can you do in the last six months or two or three years of a life?" he asked. "For someone who's over the age of 80, a hospital is a pretty scary place, and a pretty dangerous place.
"We're talking about the frail elderly. And we have too much of an emphasis on the cure when the returns for the cure can be very low. I think we need to respect seniors' independence and their dignity."
Dr. Cushman, who oversees health care funding and delivery for more than a million residents between Cornwall and Algonquin Park, hopes the growing popularity of living wills is one solution.
He also wants to stop seniors from bouncing around the health care system like a "ping-pong ball." That includes improving "ordinary" procedures such as basic nursing care, home support, and meal delivery.
For more on this story go here
Friday, November 9, 2007
Hospital Standardized Mortality Ratio (HSMR) in Canada
| |
| The hospital standardized mortality ratio (HSMR) is an important new measure of patient safety that compares a hospital's mortality rate with the average Canadian rate. It examines observed versus expected deaths and is adjusted for various factors such as the age, sex, diagnoses and admission status of patients. The ratio provides a starting point to assess mortality rates and identify areas for improvement, which may help to reduce preventable deaths. |
| Developed in the United Kingdom in the mid 1990s, the HSMR has also been used in hospitals in Holland and the United States. When tracked over time, the ratio can be a motivator for change, by indicating how successful hospitals or health regions have been in reducing inpatient deaths - leading to improved patient care. CIHI has led the effort in calculating HSMRs for Canada and later in 2007, will be releasing its first public report on results for facilities in all provinces outside Quebec. To learn more about the HSMR, see the documents below:
To learn more about the public release:
Source: http://secure.cihi.ca/cihiweb/dispPage.jsp?cw_page=hsmr_e |
Thursday, October 25, 2007
Canada in a Flat World: A Health & Science Superpower
The following article written by Dr. Alan Bernstein, President of the Canadian Institutes of Health Research (CIHR), ran in the May 23, 2007 edition of the Globe and Mail. It is an abbreviated version of an address Dr. Bernstein gave to the Canadian Club of Toronto on March 26, 2007
The rise of India and China as economic powerhouses, the development of new global communication technologies, global warming, the emergence of new infectious pathogens like SARS, powerful new insights into the workings of the human body, are all creating tremendous challenges and opportunities for countries like Canada. In a flat world, no country is immune from these global tectonic shifts.
We are in a race without a finish line
The 20th century has been characterized by remarkable improvements in human health, virtually everywhere, except sub-Saharan Africa. Longevity in the West has increased by almost two years per decade for the past sixteen decades. New drugs and diagnostic technologies, fuelled by profound advances in the biological sciences, are increasingly based on a detailed molecular understanding of human biology and disease. We are reaching the stage where we can prevent or slow down the onset of some diseases before clinical symptoms are even apparent.
Information and communication technologies (ICTs) will also play a key role. As our population ages, and as we move increasingly from the acute diseases to the chronic conditions of aging (dementias, diabetes, arthritis, frailty), ICTs will link together our homes, our bodies, our clinics and our hospitals. Regenerative medicine, including nanotechnology, bioengineering and perhaps stem cells, will transform how we repair or replace defective or worn out body parts.
But, most profoundly, it will be the synergy that will come from combining this new science and new technology and a heightened sensitivity of our personal responsibility for our own bodies, that will transform human health and our health system.
This profound transformation of health care into a knowledge-based activity has huge economic implications. In our country, health care is a $140 billion industry. In the U.S., that number is $2 trillion. China currently spends $60 per person per year on health care. For Canada, that number is $4,600. So, as China's spending on health care goes from $60 to $600 million over the next decade, the health care industry in China will become a $800 billion industry.
Despite all our concerns about our own health system, Canada has arguably one of the best and well run health systems in the world. That know-how, that knowledge is as exportable and profitable as lumber or oil. Health care is Canada's largest knowledge industry, an industry that will experience phenomenal growth and export opportunities over the next twenty-five years. It is an example of the importance of knowledge and knowledge industries to Canada's future. And, it is a model for how we should structure our thinking about Science and Technology (S&T).
To start, we need to rethink our view of productivity and competitiveness. Productivity today is not about lowering the unit costs of manufacturing picture-tube TVs. Productivity today is about inventing flat screen technologies. Productivity today is not about lowering the unit production costs of bovine insulin. Productivity today is about invention of recombinant DNA technology to produce human insulin in bacteria.
Productivity today is not about improving the efficiency of our health system through training fewer doctors and nurses. Productivity today is about the invention and system-wide application of new ideas and new technologies that will speed up and improve health delivery.
The process of discovery is itself transforming the nature of competition. In a resource-based economy, scarcity drives up price. But in a knowledge economy, it is just the opposite. Software's value goes up the more it is shared. The first fax machine or phone was useless.
And there seems to be no end to new knowledge. Knowledge is not like oil or a piece of capital equipment. Knowledge is not used up, worn out or consumed. Quite the opposite - knowledge and new ideas are different: the more you use them, the more valuable they become.
The centrality of S&T to Canada's future raises other issues such as the need for partnerships and collaborations. In a knowledge economy, knowledge is the most precious commodity. Often, the ideas or intellectual property generated in one company or one university acquires value only when combined with the ideas from another company or university.
Companies, universities and countries must therefore strike strategic and dynamic collaborations in an attempt to create the synergies and complementarities that can only come by merging ideas, creating partnerships and building relationships.
Canada is well positioned to take leadership in this area. Science diplomacy, particularly health science diplomacy, will be a powerful way for Canada to reach out to the world. We place importance on good health and a public health system. I believe that those values, coupled with Canada's exceptionally strong health research enterprise and the universal nature of science that transcends language and culture, will make health science diplomacy as important a diplomatic tool in this century as Pearsonian diplomacy was for Canada in the last century.
For our cities to become a knowledge-based hub, proximity to market is no longer the issue. But, proximity to the world's best universities and to the best research talent is.
We are witnessing the 'death of distance'
The last point is obvious. A successful knowledge economy is built on a highly educated workforce and a society that understands what research is all about and engaged in the issues raised by science. Science is, quite simply, the best way humanity has come up with to solve important problems. Indeed, some of the greatest opportunities for economic progress will come from helping the world solve its biggest problems - in human health, in energy, the environment, in building sustainable cites. This is how, I believe, we will generate the new jobs, wealth for our country, and well-being for our citizens.
This is what science and innovation is all about - discovering and applying new scientific ideas, new knowledge to change the world.
Real, cutting-edge research is tough to do
But transforming science into new products and new policies is even tougher - it is a complex process that involves iterative interactions between the producers and users of new knowledge.
Canada is in a race without a finish line. It's a race to build a nation that provides rewarding careers for our children, that has a sustainable health system, a strong education system, and that is a paradigm for the planet. We're in a race to generate new ideas and to transform those ideas into economic advantage.
I believe Canada can win that race. But how on earth do you win a race without a finish line? First, you have to enter the race. And second, you have to enter it to win.
The rise of India and China as economic powerhouses, the development of new global communication technologies, global warming, the emergence of new infectious pathogens like SARS, powerful new insights into the workings of the human body, are all creating tremendous challenges and opportunities for countries like Canada. In a flat world, no country is immune from these global tectonic shifts.
We are in a race without a finish line
The 20th century has been characterized by remarkable improvements in human health, virtually everywhere, except sub-Saharan Africa. Longevity in the West has increased by almost two years per decade for the past sixteen decades. New drugs and diagnostic technologies, fuelled by profound advances in the biological sciences, are increasingly based on a detailed molecular understanding of human biology and disease. We are reaching the stage where we can prevent or slow down the onset of some diseases before clinical symptoms are even apparent.
Information and communication technologies (ICTs) will also play a key role. As our population ages, and as we move increasingly from the acute diseases to the chronic conditions of aging (dementias, diabetes, arthritis, frailty), ICTs will link together our homes, our bodies, our clinics and our hospitals. Regenerative medicine, including nanotechnology, bioengineering and perhaps stem cells, will transform how we repair or replace defective or worn out body parts.
But, most profoundly, it will be the synergy that will come from combining this new science and new technology and a heightened sensitivity of our personal responsibility for our own bodies, that will transform human health and our health system.
This profound transformation of health care into a knowledge-based activity has huge economic implications. In our country, health care is a $140 billion industry. In the U.S., that number is $2 trillion. China currently spends $60 per person per year on health care. For Canada, that number is $4,600. So, as China's spending on health care goes from $60 to $600 million over the next decade, the health care industry in China will become a $800 billion industry.
Despite all our concerns about our own health system, Canada has arguably one of the best and well run health systems in the world. That know-how, that knowledge is as exportable and profitable as lumber or oil. Health care is Canada's largest knowledge industry, an industry that will experience phenomenal growth and export opportunities over the next twenty-five years. It is an example of the importance of knowledge and knowledge industries to Canada's future. And, it is a model for how we should structure our thinking about Science and Technology (S&T).
To start, we need to rethink our view of productivity and competitiveness. Productivity today is not about lowering the unit costs of manufacturing picture-tube TVs. Productivity today is about inventing flat screen technologies. Productivity today is not about lowering the unit production costs of bovine insulin. Productivity today is about invention of recombinant DNA technology to produce human insulin in bacteria.
Productivity today is not about improving the efficiency of our health system through training fewer doctors and nurses. Productivity today is about the invention and system-wide application of new ideas and new technologies that will speed up and improve health delivery.
The process of discovery is itself transforming the nature of competition. In a resource-based economy, scarcity drives up price. But in a knowledge economy, it is just the opposite. Software's value goes up the more it is shared. The first fax machine or phone was useless.
And there seems to be no end to new knowledge. Knowledge is not like oil or a piece of capital equipment. Knowledge is not used up, worn out or consumed. Quite the opposite - knowledge and new ideas are different: the more you use them, the more valuable they become.
The centrality of S&T to Canada's future raises other issues such as the need for partnerships and collaborations. In a knowledge economy, knowledge is the most precious commodity. Often, the ideas or intellectual property generated in one company or one university acquires value only when combined with the ideas from another company or university.
Companies, universities and countries must therefore strike strategic and dynamic collaborations in an attempt to create the synergies and complementarities that can only come by merging ideas, creating partnerships and building relationships.
Canada is well positioned to take leadership in this area. Science diplomacy, particularly health science diplomacy, will be a powerful way for Canada to reach out to the world. We place importance on good health and a public health system. I believe that those values, coupled with Canada's exceptionally strong health research enterprise and the universal nature of science that transcends language and culture, will make health science diplomacy as important a diplomatic tool in this century as Pearsonian diplomacy was for Canada in the last century.
For our cities to become a knowledge-based hub, proximity to market is no longer the issue. But, proximity to the world's best universities and to the best research talent is.
We are witnessing the 'death of distance'
The last point is obvious. A successful knowledge economy is built on a highly educated workforce and a society that understands what research is all about and engaged in the issues raised by science. Science is, quite simply, the best way humanity has come up with to solve important problems. Indeed, some of the greatest opportunities for economic progress will come from helping the world solve its biggest problems - in human health, in energy, the environment, in building sustainable cites. This is how, I believe, we will generate the new jobs, wealth for our country, and well-being for our citizens.
This is what science and innovation is all about - discovering and applying new scientific ideas, new knowledge to change the world.
Real, cutting-edge research is tough to do
But transforming science into new products and new policies is even tougher - it is a complex process that involves iterative interactions between the producers and users of new knowledge.
Canada is in a race without a finish line. It's a race to build a nation that provides rewarding careers for our children, that has a sustainable health system, a strong education system, and that is a paradigm for the planet. We're in a race to generate new ideas and to transform those ideas into economic advantage.
I believe Canada can win that race. But how on earth do you win a race without a finish line? First, you have to enter the race. And second, you have to enter it to win.
Monday, September 17, 2007
Saturday, September 15, 2007
Breakfast with the Chiefs :: Longwoods Publishing
We have added a new location to our Breakfast with the Chiefs :: Longwoods Publishing series. This year BWTC is going to Montreal.
Tuesday, August 28, 2007
Uh-oh, Canada
Uh-oh, Canada
By Bill Steigerwald
TRIBUNE-REVIEW
Sunday, August 26, 2007
If Canada's national health-care system is so dang wonderful, why are so many Canadians coming to America to pay for their own medical care?
Why is the hip replacement center of Canada in Ohio -- at the Cleveland Clinic, where 10 percent of its international patients are Canadians?
Why is the Brain and Spine Clinic in Buffalo serving about 10 border-crossing Canadians a week? Why did a Calgary woman recently have to drive several hundred miles to Great Falls, Mont., to give birth to her quadruplets?
It's simple. As the market-oriented Fraser Institute in Vancouver, B.C., can tell you, Canada's vaunted "free" government health-care system cannot or deliberately will not provide its 33 million citizens with the nonemergency health care they want and need when they need or want it.
Courtesy of the institute, here are some unflattering facts about Canada's sickly system: story continues here:
By Bill Steigerwald
TRIBUNE-REVIEW
Sunday, August 26, 2007
If Canada's national health-care system is so dang wonderful, why are so many Canadians coming to America to pay for their own medical care?
Why is the hip replacement center of Canada in Ohio -- at the Cleveland Clinic, where 10 percent of its international patients are Canadians?
Why is the Brain and Spine Clinic in Buffalo serving about 10 border-crossing Canadians a week? Why did a Calgary woman recently have to drive several hundred miles to Great Falls, Mont., to give birth to her quadruplets?
It's simple. As the market-oriented Fraser Institute in Vancouver, B.C., can tell you, Canada's vaunted "free" government health-care system cannot or deliberately will not provide its 33 million citizens with the nonemergency health care they want and need when they need or want it.
Courtesy of the institute, here are some unflattering facts about Canada's sickly system: story continues here:
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