It鈥檚 one of the oddities of our health system that although Canadians, by a wide margin, are generally satisfied with it, experts keep telling us we shouldn鈥檛 be. The latest expression of disapproval comes from the Health Council of sa国际传媒.
In a scathing new report, the council says prolonged efforts to improve quality of care have been wasted. In 2004, the federal government gave provincial health ministries $40 billion to produce better outcomes.
According to the council, which was set up to track progress, gains are minimal, we lag behind other developed nations and the provinces have their heads in the sand.
Perhaps the authors can be forgiven some bitterness. The federal government announced this year that the council is being shut down.
But have the country鈥檚 health officials really squandered $40 billion and a decade of labour? There are certainly areas of medical treatment where sa国际传媒 has done poorly.
Among 11 of the world鈥檚 richest countries, for example, we have the longest wait times for elective surgery. Twenty-five per cent of Canadians face a delay of four months or more for a hip or knee replacement; no one in Germany waits that long.
Moreover, one of the commitments made by the provinces, in exchange for Ottawa鈥檚 $40 billion, was that these procedures would become more accessible. So the council has a point.
But so do provincial health ministers. Since 2004, they鈥檝e increased the annual number of hip and knee operations by 35,000. The reason wait times haven鈥檛 improved is that Canadians keep getting heavier, and obesity strains the leg joints.
Our wait times for specialists are likewise poor. Forty per cent of Canadians wait two months or longer to see a specialist. Only five per cent of Swiss patients and nine per cent of Americans wait that long.
Yet unflattering comparisons like these ignore other factors. Sparse population is a huge challenge for health planners in sa国际传媒, far less so in Switzerland
And the U.S. spends almost twice as much per capita on health care as we do. Would Canadians accept the kind of tax increase needed to double the health-care budget?
These duelling statistics show there are numerous ways to rate a system as complex as health care.
However, there is perhaps one consideration that should count for more than the others. What do patients think of the care they receive?
Presumably, if the system is in trouble, those on the receiving end would be the first to know. But as the council admits, Canadians are pleased with the treatment they get. Better than 80 per cent of us rate our primary medical care good, very good or excellent.
That seems like a critical point. Most of us don鈥檛 know about morbidity rates or queuing theory. We have no idea how much hospitals spend per discharge.
But we can say if the doctor or nurse who treated us was caring, friendly and competent. And we know better than anyone whether our quality of life improved or got worse.
Not enough weight is given to this metric. Most provinces, sa国际传媒 among them, have no systematic way of measuring patient satisfaction. They don鈥檛 routinely follow up after the treatment is completed, and ask the most basic of questions: Is the pain gone, is your mobility restored, are you back at work?
It seems our health planners know all about the price of the system, but little about its value in the eyes of patients. That is the real issue in need of attention.
Those 80 per cent approval ratings mean something is right. Now, if decision-makers would only give patients a voice, they might learn what鈥檚 really going on.
