Coordinated Care and Equal Access: An International Perspective in Response to the Harvard School of Public Health Poll Finding that U.S. Cancer Care Lacks Appropriate Coordination
On Sunday, Juvan's Health Law Update included a post entitled ""Harvard School of Public Health Poll Finds Cancer Care Lacks Appropriate Coordination." The post sparked an interesting conversation via e-mail with a breast cancer survivor from Canada I met a few months ago. Juvan's Health Law Update has decided to include portions of this e-mail communication below because of the unique insight offered of Canada's health care system from a patient's perspective. While the source requested to remain anonymous (we'll call her "Hope"), Juvan's Health Law Update has documentation substantiating the conversation.
On the U.S. and Canadian health care systems, Hope says,
[F]rom my point of view, US health care has the best and the worst of all worlds. It has some of the BEST health care in the world . . . and the worst.
This accounting and billing for every band aide and needle and tracking it all must be a stunning expense for your system - and clearly ridiculous for the patients. One Canada is definitely superior on.
I also read about the lack of coordination with all the doctors, and I was quite shocked to hear about this. In Canada, the "team" approach is very heavily emphasized with the doctors having set days in their calendars to get together and discuss not only all their cases in common, but also any difficult cases so that group's combined expertise and experience can come to bear on the patient's situation. The information, conclusions, exams and medical treatments are centrally filed and electronically accessible in everyone's office. And that means everything - all the data on my scans, MUGAs, blood work are available. It saves duplication since a test result might be useful to my regular GP to answer a different question than it was originally taken for by my oncologist. I can also access the information myself at no charge.
It does seem to me, though, for all it's flaws, that very superior medical treatment is available in the United States. But it appears that you have to be a good researcher, a strong advocate and have been smart enough to get the right kind of insurance to access the benefits. So the psychological stress on both patient and caregiver are much higher in the States........but that isn't as measurable as cash, is it?
One of the biggest problems with the Canadian health care system is access to care. The government rations access by creating waitlists that can be many months to years long. Years can be a long time to wait in a debilitated state for a joint replacement, for instance. People lose their jobs, quality of life and physical condition as they are stuck waiting in a chair or bed at home for their name to be called. The most urgent cases are always bumped to the front of the queue so that treatment is assured to the desperate, but who wants to BECOME the desperate?
Also the queue is regularly abused by connected queue jumpers. Politicians, celebrities, RCMP, certain ranks of civil servants - all jump to the front of the queue. Also, if you are injured on the job and are covered by worker's compensation - worker's compensation pays directly (not the government), so they jump to the front, while the great unwashed masses wait ever longer for their betters to be cured.
The worst abuse comes to those who are over the age of 70 who are deemed the least valuable. Rest assured that this ranking is not publicly acknowledged, but with a little bit of google, you can definitely verify my comments.
So our system offers increased coordination, but it isn't equally open to all.
Juvan's Health Law Update has not independently verified each of these statements. Juvan's Health Law Update simply provides this commentary to show a view of the Canadian health care system from a patient's perspective.
Special thanks to Hope for authorizing Juvan's Health Law Update to publish this correspondence.
