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Thursday, October 13, 2005

Canadian health care doing the Colonel Bogey March 

So I read this story and a little song started running through my head:
Provinces say they can't meet year-end deadline for setting medical wait times: In the federal-provincial accord, first ministers promised evidence-based benchmarks in five areas - cardiac and cancer surgery, eye operations, joint replacements and diagnostic scans . . . Alan Hudson, who heads Ontario's wait-times program, says there is evidence to support benchmarks in only two of the five areas - cardiac surgery and cancer treatment.
Bullshit, was all the band could play
"In a broad context - hips and knees and all the rest of it - there's very little evidence," said Hudson.
Bullshit, they played it night and day
Solid evidence relating wait times and health outcomes would require double-blind studies where some patients received care quickly and others received it after a delay, he said.
Bullshit, they just played bullshit, da da da dum dum, da dum dum, da da ...
Ah ha -- now, we've got plenty of Canadians who have had to wait for-goddamn-EVER for their new hips and cataract removals and MRIs, so there's no problem finding half of the study subjects, but maybe the problem is that we just don't have enough Canadians who have actually received care quickly, to compare our data to? Of course, we are right next door to a country with ten times our population, where they have lots of people who got their cataract surgery and joint replacements and MRIs quickly, so we could use THEM for comparison, couldn't we?
Well, nobody mentioned this.
Could it be, perhaps, that the provinces just don't want to create benchmarks? Because then there would be a standard that they would have to live up to?
So here's the next shoe dropping -- in response to this first story comes this next story, titled Medical groups attack government backtracking on wait time benchmarks. And this story says establishing these benchmarks isn't really that difficult:
The Wait Times Alliance, which includes six medical specialist societies and the Canadian Medical Association, has already proposed benchmarks for the five high-priority areas.
For example, it says hip and knee replacement should be done within 24 hours in emergency cases, within 90 days in urgent cases, and within nine months in routine cases. It says heart bypass surgery should be done within 48 hours in emergency cases, and within 10 working days in routine cases. The benchmarks are based on the best available evidence and on the clinical judgment of specialists in each field, says [Alliance spokesperson Normand] Laberge. He said that 80 per cent of medical practice is not based on double-blind studies.
True, of course. And here's what the feds say, in a not-so-subtle "put up or pay us back" line.
A spokesman for Health Minister Ujjal Dosanjh said the minister "believes that benchmarks will be delivered because all First Ministers agreed to the December 31 deadline. "They made the pledge and accepted the $41 billion so we expect their governments to live up to their word. No government has an option not to deliver benchmarks by December 31."

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