Health Care By Number

As Canadians know, Canada has the best healthcare system in the world. And the main reason why is because it is comprised of Canadians. Canadians are polite. Canadians have a sense of fairness bordering on the pathological. And Canadians are mostly socialists whether they remain in the closet or have come out. These are all qualities as we shall see that contribute to our excellent healthcare system.

In Canada, the process of medical diagnosis and treatment begins with the self-detection of lumps and bumps. Ladies have a focus on lumps associated with a primarily female characteristic of the anatomy. Men are more prone to bumps associated with a structural weakness in the lower male abdominal musculature, otherwise known as a hernia. Following the odyssey of a friend who recently detected a “bump”, we will show the delightfully simple and efficient operation of the public healthcare system in Canada.

Before we start, however, we need to describe one other social activity and structure that Canadians excel at – waiting in lines or forming queues. We wait in lines at gas pumps, at theatrical and sports events, at supermarkets – indeed wherever commerce occurs. The line is the ultimate expression of fairness, something we Canadians carefully enforce as anyone who attempts to jump a queue quickly finds out. We remain patient and placid when in line – except for in lines of traffic. In traffic, we at a minimum swear and maximally try to punch someone out.

So having discovered his bump, our friend entered the first queue. He phoned his general practitioner (GP) and was assigned an appointment time several days out. When the day arrived he went to his GP’s waiting room and became part of another queue, the queue of patients who were now waiting to see the doctor. These secondary queues are essential to the operation of the system because on any given day, the doctor never knows what he will be facing or how long each patient will take. Indeed in one group practice office if there aren’t 20 people already queued up one suspects that something is wrong.

Our friend finally was moved in turn into an examination room where he eventually saw his doctor and had his suspicion confirmed. He had a hernia. Now GPs don’t do things like open heart surgery or even hernia repair. Specialists do and you can’t get to see a specialist in Canada unless you are referred by a GP or have connections. So his GP referred him to a general surgeon who was very good at fixing bumps. This moved him into the next queue, that of waiting to hear from the surgeon’s office staff. After a couple of weeks he got the call and was given a date a couple of months out to see the surgeon. You see the surgeon is a very busy man with many bumps to fix and wanted to see what kind of a bump our friend had before he decided what to do. He was in the first ‘bump’ queue now.

On appointment day, the surgeon explained what procedure he would perform on our friend, creating a hand-drawn diagram in the process. Our friend later showed the diagram to his wife who snorted and inquired if his life insurance was up to date. Our friend was then directed to the surgeon’s assistant for a surgery date. Thereupon he entered the next queue. To his surprise, this was not the queue for people waiting to be operated on but a queue for people waiting to be scheduled into the queue for operations. It turns out that the surgeon is an expert on breast cancer surgery. He fixes lumps as well as bumps and lumps take priority over bumps, a principle that we applaud.

Our wonderful socialist system of healthcare measures the success of our healthcare system by wait times. A metric might be ‘how long people have to wait for hernia surgery’ – not quite so simple as it turns out. First of all, our friend’s surgery is considered “elective”. This seems to mean he could live the rest of his life without his bump fixed with the only caveat being that if it progressed to the point of creating a strangulated bowel, he would still have a few days before he died of peritonitis. We’re not sure as a result of this designation if the system even counts him. But even if the bureaucrats do count him, he is at this point technically not countable because he is not waiting for surgery. He can’t even get into that queue. He’s waiting to be assigned a position in the queue of those waiting for surgery. If there is an outbreak of lumps, he could be waiting a long time.

In the meantime our friend awaits surgery – just not in any measurable time-frame.

Follow-up

A friend subsequently emailed his experience with the US healthcare system that we Canadians understand is much worse than ours. Here it is:

To provide a contrasting story, two weeks ago I went to the gym here in Florida and as one might expect from a pending geriatric, the next day my back hurt. Three days later, instead of it getting better, I woke up in excruciating pain and literally thought that I might pass out. After a call to our insurance company in Canada, we drove about 5 minutes down the road to a satellite emergency room operated by a nearby hospital. This facility was conveniently located in a shopping mall and is one of three operated by the hospital.
 
From the time I approached the window until the time that I got into a treatment room was under a minute and would have been less had I been able to walk quickly. The time to be seen by two nurses was under two minutes. The time to see the doctor on duty was less than 10 minutes. The doctor decided that I should have a CATSCAN on my back and the time from entry into the facility until completion of the CATSCAN was less than 30 minutes (they have one on site). It took about an hour for the radiologist to file her report and by that time the nurse was calling the hospital to see where it was. As she pointed out to me, they have standards and an hour wait was not acceptable. By comparison when I needed a CATSCAN in Ottawa, it took over 6 weeks.
 
In spite of all the stories, nobody pressured me about money and when I asked, the nurse said that the administrator was out for lunch and they would just bill the insurance company
 
It turned out that I had a sprained back , something that I have never heard of
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