During an appointment with my family doctor I told her that I was willing and able to leave the province to access a diagnostic tool called a Magnetic Resonance Imaging (MRI) scan. I found a private clinic in Vancouver, British Columbia, where I could pay directly for the scan. My doctor wrote a referral and the clinic scheduled my appointment within a couple of days. I received an electronic copy of the scan before I left the clinic and the results of the scan were emailed to my doctor and me two days after my appointment.

Here’s why I didn’t choose the public health care route:

Only a specialist can order an MRI scan in Saskatchewan. Your family doctor has to refer you to a specialist. You could spend a few months waiting on a list for a specialist appointment. The specialist then sends the order for the MRI scan to a central booking office. The MRI radiologist reviews your medical history and assigns you an urgency classification level based on government guidelines for prioritization. Consideration is also given to the availability of hospital resources as well as other surgical and emergency cases.

Cheaper imaging tools must be used before allowing the more expensive MRI scan, as the guidelines for patient prioritization state “In general, other appropriate, more accessible and less expensive imaging examinations will be required prior to considering the MRI request. The MRI radiologist should review these studies prior to assigning a priority.”

Wait times for MRI scans in Saskatchewan are posted on the Ministry of Health website. As of December 31, 2011, there were 4,317 patients waiting on the list. Wait times are now reported as certain percentages indicating the number of scans completed within a certain number of days. These numbers are only updated quarterly. Also, keep in mind that health authorities can use various data collection and reporting methods. This wait time information is essentially useless for patients trying to figure out when they will have access to MRI.

There are no guarantees for wait times but not to worry, the government is balancing the needs of the population within the limits of a public health care system. As the guidelines state “The wait times suggested for MRI studies in the prioritization guidelines are the recommended maximum wait times for patients with the conditions listed, based on what we feel is an appropriate balance between limited access and patient need. The actual wait times for patients may be different depending on demand and availability of scanning time.”

Who really knows how long you’ll wait for an MRI scan in the public health care system? What impact will wait times have on your health and quality of life? When they do call your number, can you choose a day and time that’s convenient for you? Can you choose which hospital to go to? Can you choose the state-of-the-art MRI scanner or will you be assigned to an old scanner? Do you get to make any decisions about your health care while travelling the public health care path?

My health belongs to me. I’m willing to do my own research, weigh the risks and benefits, make health care decisions and spend my own money on my own health care. I’ve found the path to patient-centred care and I’m going to keep following it.

Last year’s Supreme Court of Canada ruling on Insite and a recent Ontario Court of Appeal ruling on prostitution laws and the Canadian Charter of Rights and Freedoms should serve as wake-up calls to patients across the country. It’s time to start paying attention to health care legislation and its impact on your individual rights.

Every individual in Canada is guaranteed “…the right to life, liberty and security of the person…” under Section 7 of the Canadian Charter of Rights and Freedoms.

Dr. Jacques Chaoulli and George Zeliotis made headlines across the country when their case concerning Charter rights and health care legislation in Quebec reached the Supreme Court of Canada in 2005. They won their case but the landmark ruling only applied in the province of Quebec.

Lindsay McCreith and Shona Holmes of Ontario and Dr. Brian Day of British Columbia are currently involved with court cases in their respective provinces. Both cases claim that their provincial health care legislation violates the individual rights of patients by prohibiting them from purchasing medical services and private insurance for medical services. For this patient, these court cases and the individuals supporting them are beacons of hope.

Someday we’ll find it, the Charter connection. The drug addicts, the prostitutes, and me.

What about those unlucky Saskatchewan patients whose numbers don’t get called? It’s more than luck preventing them from accessing the Liberation Treatment in their home province. It’s a health care system that gives politicians and health care bureaucrats the final say on which medical treatments patients can access.

Today it’s about medical treatment for multiple sclerosis patients. Tomorrow it could be about you and your medical treatment. What if the political spotlight doesn’t shine on your disease or condition? What if our politicians and health care bureaucrats don’t call your number?

BINGO!

Patients who don’t have time to play games with their health would be wise to push for a tax refund so that they can spend their own money on their own health care within their own province.

Why is our current health care system unsustainable? Why do politicians and health care bureaucrats decide what type and quality of medical care patients receive? Why are patients forced to wait on lists for medical care? Why can’t patients spend their own money on medically necessary services? Why don’t we have a health care system that promotes and protects the individual freedoms of patients and doctors? Visit us often for information that will help you find answers to these questions and more.

Your Top Five
Click on the links to view the top posts accessed by our readers in 2011:

Ranking of the World’s Health Systems
Our homepage
Canadian Health Care 101: Stakeholders
Survey: Long Wait Times in Canadian Health Care
Know the Issues

Online Survey
Our survey Long Wait Times in Canadian Health Care gives patients and caregivers an opportunity to provide feedback on their waiting list experience. Responses show a majority of these patients are waiting from 4-6 months for access to a specialist appointment and from 7-9 months for access to surgery within their home province/territory. Almost half of them have a medical condition that does not fall into any of the five wait time priority areas identified by government. They see system inefficiencies as the number one barrier to accessing health care. The majority of these patients are females, between the ages of 16-64, living in an urban area in the province of Ontario. Please share your waiting list experience with us by taking a few moments to answer the survey.

Videos
In recognition of Canadian Patient Safety Week, we posted a number of videos featuring straight talk on Canadian health care from patient safety advocates in Manitoba. Click on the links below to view these great video posts.

Canadian Patient Safety Week: Straight Talk From Patient Safety Advocates Among Us
Patient Safety Advocates Talk About Access to Health Information
A Patient Safety Advocate Talks About Transparency and Accountability in Canadian Health Care
Patient Safety Advocates Talk About the Bureaucracy in Canadian Health Care
A Patient Safety Advocate Talks About the Bureaucracy in His Health Region

Please contact us if you have any suggestions for our website. Thank you for visiting and contributing to the site in 2011. We look forward to hearing from you in 2012.

My body starts convulsing; my blood pressure continues to drop. I’m exhausted and weak. This is it I think to myself. I’m not going to make it. There’s a call for help and a doctor rushes into the room. Her voice booms orders as she takes control of the situation, “OK guys, ABCs,” she says as she proceeds to direct the medical resident and the nurse to start an oxygen mask and IV. A hot air mattress appears and quickly covers me. Another person enters the room and takes a poke of blood from my foot. I hear them talking about crossmatching and a blood transfusion. I turn my head to the side and look across the room at my husband holding our new baby and think – there is the family that I’ve always dreamed of having and now I’m not going to live to enjoy them. The doctor starts asking me questions, “What are you going to name your baby? Are you cold?” A wave of tiredness consumes my body and my mind. It’s a strange type of tiredness, one that I’ve never felt before and that causes me to fully expect death to follow. Yet, each time this doctor speaks her voice is like a lifeline. It’s unlike the other voices, the one that denied my requests for my doctor, the ones that left my care in the hands of a medical resident and a nurse seemingly borrowed from another floor. This doctor’s voice exudes a confidence that comes from critical thinking and skill. It owns a competence that can only be acquired from years of education and training, years of experience and dedication. The voice belongs to an anesthesiologist.

A stillborn death at Victoria General Hospital last August brought public attention to the issues surrounding hospital anesthesia services for expectant mothers in British Columbia. Following months of failed contract negotiations over fees and workloads, a few anesthesiologists spoke openly about their concerns over the death. In December 2011 the president of the BC Anesthesiologists’ Society announced their intention to withdraw services starting April 1, 2012. Both the BC health minister and the British Columbia Medical Association (BCMA) scolded them for trying to bargain outside of the box and for shaking up the confidence in our public health care system. The government and the BCMA worked quickly to reach a deal that would help prevent the strike.

When contract negotiations with government are not going well the focus often shifts to patient safety concerns which then continue to grow in silence after the contracts are signed. In November 2010 failing contract negotiations in Newfoundland and Labrador spurred its medical association to hold lengthy press conferences about the resignation of more than a dozen specialist doctors and its impact on patient safety. When they finally settled the dispute all but one of the resignations were rescinded as part of the deal.

Is it about money or patient safety? It’s about money, patient safety, doctors and patients. It’s about the realities of a government monopoly on health care that stifles performance, competition and innovation. It’s about a government-run health care system that breeds the type of incompetence that ultimately jeopardizes the safety of every patient. One of the most telling paragraphs from the Vancouver Island Health Authority’s review of the stillborn death in August 2011 at Victoria General Hospital is this one:

“Finally, neither the patient-focused review nor this system-focused review were conducted with the purpose of evaluating the performance of any of the healthcare providers or administrators; to do so would be inappropriate and not in accordance with the philosophy of systems analysis.  Any decisions about conducting performance reviews are left with VIHA.  Furthermore this review will make no comment on whether or not any type of performance review is necessary.” p.3

This is just another report following another review following more committee meetings resulting only in more recommendations and guidelines. It’s a pattern replicated throughout the Canadian health care system. In the meantime, are expectant mothers waiting for anesthesia services in hospitals in British Columbia any safer today than they were yesterday? Will they be any safer tomorrow than they are today?

Despite what supporters of the status quo tell us, a publicly-funded universal health care system based on need is a fallacy. Reality shows us that our system is neither universal nor based on need. Reality shows us that it’s time to put Medicare to sleep and usher in a new health care system that promotes and protects the medical freedoms of patients and doctors.

A special boy from British Columbia named Walid is now recovering from surgery in a hospital south of the border. It’s a surgery he could not access in the Canadian health care system because of waiting lists that are two or more years. Walid’s mother Debbie, who is also a nurse, worked tirelessly to bring attention to his case before making the decision to leave the country to seek medical care. You can help break the waiting list silence by watching Walid’s story and passing on its message “No more waiting”.

Romanow’s staunch defence of a universal, government-run health care system includes the die-hard notions that Medicare is a social good, a necessity for national unity and a part of our Canadian identity.

Perhaps he should ask the patients receiving hallway medicine in his home province of Saskatchewan if they agree that it’s just part of their Canadian identity.

Do you think hallway medicine is part of our Canadian identity?

As part of its harm reduction program the Vancouver Coastal Health Authority is now handing out crack pipe kits to drug addicts in Vancouver. This is in addition to funding and operating a supervised injection facility for drug addicts. Insite costs around $3 million a year and provides drug addicts with clean needles and other supplies for injecting their drugs all under the guise of a harm reduction program aimed at – you guessed it – improving population health and minimizing public health care costs.

Supporters of Insite claim it reduces the number of deaths by drug overdose and the transmission of certain diseases. That may sound good for population health statistics, but what about the individual health of these drug addicts? Prolonged drug use impacts the brain and body and can lead to various chronic conditions, heart disease, strokes and organ failure. I wonder what family members and former employers of these individuals have to say about the impacts of prolonged drug use on quality of life?

How did such a place come to be? In 2003 the facility received an exemption from Canada’s federal drug law, the Controlled Drugs and Substances Act, for the purpose of scientific research. Drug addicts serving as research subjects explains the avid support Insite receives from the academic and research community.

Supporters of Insite say that we must take care of the needs of the most vulnerable in our society. A line often used to try and guilt us into embracing ideas like this one that serves to transfer all personal responsibility for using drugs from the drug addicts themselves on to the rest of us. If the family members or friends of a drug addict were providing them with needles for injecting drugs or pipes for smoking crack wouldn’t they be called enablers?

Since drug addicts face no legal consequences for their drug use at Insite and no financial consequences for the services provided to them at this facility they really have no incentive to stop using drugs. How can a drug addict get clean without quitting drugs? How many drug addicts have been cured of their drug addiction through Insite?

Last September a decision by the Supreme Court of Canada mandated Insite’s continued exemption from the federal drug law. However, the original exemption only allows for injecting drugs not inhaling them so Insite’s new inhalation room for crack addicts will have to stay empty for now.

What’s next? Will the government start providing the drugs to drug addicts as part of its harm reduction model? It’s already happening under the banner of scientific research. Enrollment for the latest study started on December 19, 2011.

A few weeks ago the public health director in Montreal and the provincial minister of health put out the call for new safe injection sites in Quebec as a harm reduction measure aimed at improving population health and minimizing public health care costs.

Another danger of socialized medicine is that it makes all of us more vulnerable. I’d like to recommend a harm reduction measure for the law-abiding, taxpaying citizens footing the bills for safe injection sites and crack pipe kits – just say NO!

A much bigger barrier to health care is patient waiting lists for access to diagnostic tests, specialists and surgery. Is waiting on government imposed lists for medical care fair to patients?

If hospitals don’t charge for parking then where will the money for maintaining the parking lots come from? As a patient, I’m willing to pay for access to a hospital parking lot because patient-centred care doesn’t require free parking. There is no such thing as free parking just as there is no such thing as free health care.

The information raises a number of important questions including: How many health care bureaucrats does it take to run a health region? How does the Winnipeg Regional Health Authority compare to other health regions of similar size? How well do regional health authorities perform when it comes to efficiency and effectiveness?

More information is needed for us to better understand how much our health care bureaucracy is truly costing us as taxpayers. With health care spending now consuming close to half of our provincial budgets it’s time for us to start asking the right questions.

In today’s video clips Charles Cruden talks about the bureaucracy in the Winnipeg Regional Health Authority in Manitoba.