Canadian report comparing health systems

[Guest guest]

Hi Sharry

Glad to hear you are doing so well. Wish I had a hot tub at home

like you have, as I have to admit I haven't been swimming once.

found the Canadian report by the Fraser Institute and

posted it a couple of days ago. The URL is:

http://www.davidgratzer.com/report1/toc.html

and you can read it all on-line. You need to look at the appendixes

first to make sense of how they rated the various countries. No

country got a particularly high rating out of a possible 100, and

there were some areas that were stronger in one country than in

others, which is why it may make sense to look around the world for

help, depending on one's problem.

Although we have our own approval systems in Canada, I think a lot of

our journals and conferences are " North American " , which means we

mainly get the U.S. information (or lack thereof). Luckily, some

Canadian OS's are sent on a learning and teaching exchange to other

countries every year, and a couple of years ago they went to England

and South Africa, and learned about the BHR, which is probably why

it's now available, especially in BC and Alberta. After that trip,

McMinn and Treacy were invited to Vancouver to teach a few OS's here

how to do it. In Alberta it's totally covered by their provincial

health insurance, I understand, but in BC we still have to pay about

$3000.00 for the cost of the " appliance " , which is considered

experimental, while the surgery and the hospital stay are totally covered.

The problem here is the long waiting lists. In most other

countries, if you are willing to pay, you can get your surgery done

sooner. Here, the government doesn't believe that rich people should

be able to jump the queue, so supposedly the surgeries are done first

on those who need them the most. And by the time most of us have

waited a couple of years, we will be in a really bad state and

therefore top of the list. The irony is that most government members,

doctors, sports and movie stars, etc. who can afford it will jump the

queue anyway by going to the U.S. or abroad and paying for their

surgery. So it would make more sense to allow them to do it at home,

and keep more of our hospital beds open, employ more Canadian hospital

staff, etc. If they kept to a strictly public system but had a " user

fee " or " deductible " for those who could afford it, in the same way

that Medical Services Plan fees are on a sliding scale depending on

income, I think it would drastically decrease the waiting lists.

In the meantime, I think that all of us, not just doctors, can

learn a lot from being " globally oriented " and interesting ourselves

in developments that are standard in other parts of the world. Just

because we live in a highly developed society doesn't mean we have all

the answers, and in fact we have some problems like childhood obesity,

large numbers of drug addicts, etc. that don't exist in some poorer or

less democratic countries. Also, every few years they find scientific

evidence for the properties in some folk or alternative medicines that

were previously scoffed at. But they find that some other herbal

remedies can be toxic. So I say, keep learning, keep an open mind, and

don't disregard anecdotal evidence when it gets to a critical mass

with a reasonably long history (more than 25,000 hip resurfacings have

been performed so far around the world, according to MMT). To me, it

was just common sense that an operation that destroys less of the

femur (which in many of us is still reasonably healthy) would probably

do less harm. The tricky part was getting the right materials and

procedures, which of course was somewhat a process of trial and error

at the beginning. After 12 years of following up on patients, we know

that most BHR's allow the femur to improve it's density, so a

resurfacing for most of us is not only less destructive than a THR, it

actually leads to stronger bones.

n

rBHR Oct.17/03 McMinn