Medical Technology in Canada - Washington Examiner Part 2

By: Sally C. Pipes, Examiner Contrbutor- 6/5/09 6:43 AM
KEY DATA: The average patient waiting period between referral and actual treatment for 12 most-frequently needed specialties was nearly four-and-one-half months in 2008, double the average from 15 years ago.

KEY DATA: A third of Canada's gamma cameras, used in nuclear medicine imaging, and a quarter of its angiography and cardiac catheterization labs, for heart-related ailments, are more than 10 years old.

Last month, the recipient of the first successful face transplant in the United States appeared publicly for the first time since her operation in late 2008. Ohio resident Connie Culp could barely swallow or breathe after being shot in the head by her husband.

Doctors used skin grafts from a recently deceased woman to replace 80 percent of her face. Now Ms. Culp can taste, smell, eat solid food, and even smile.

In the same week, doctors in Pittsburgh completed the first double hand transplant in the U.S. on a 57-year old Georgia man.

Both groundbreaking procedures are indicative of the advanced medical care that's readily available throughout the United States. Such medically-sophisticated procedures are often not an option in my birthplace, Canada. In fact, Canadian patients have limited access to many of the advanced medical technologies taken for granted here in the States.

Would-be health reformers in this country who call for a health care system with “universal coverage” as exists in Canada fail to recognize the system’s inherent inability to provide patients with the latest and most advanced therapies. The consequences can be deadly.

Advanced medical technologies are essential to improving patient health. They help doctors identify and treat diseases more effectively and safely. They can also deliver treatment to patients with less discomfort and pain.

Canadians have significantly lower levels of access to several key medical technologies than citizens in other developed countries. Among member nations of the Organization for Economic Co-operation and Development, Canada ranks a dismal 19th out of 26 for the number of CT scanners per million residents. It ranks 14th out of 25 for MRI scanners, and 19th out of 21 for lithotripters, which are used to treat kidney and gall stones.

Limited access to high-tech equipment has resulted in lengthy wait times for care. After visiting a primary care physician, the average Canadian has to wait more than a month to get a CT scan and more than two months to get an MRI.

According to Canada’s Fraser Institute, roughly 800,000 of Canada’s 33 million citizens are currently on a waiting list for some medical treatment. For 12 specialties across the country's 10 provinces, the average waiting period between referral from a general practitioner and actual treatment was nearly four and a half months in 2008. That’s double what the average wait time was 15 years ago.

Canadians face some of the longest lines for access to the advanced technologies essential to most major surgeries. The lag between a general practitioner’s referral and treatment by a specialist is eight months for neurosurgery and nine months for both orthopedic surgery and plastic surgery.

Once a Canadian patient finally makes it into the examination or operating room, there’s a good chance that his doctor is using antiquated equipment. The country’s healthcare system employs far too many old and potentially unreliable medical technologies. Many machines should have been junked years ago. Others will need to be replaced in the near future.

According to the Fraser Institute, the European Coordination Committee of the Radiological and Electromedical Industries (ECCREI) recommends that no more than 10 percent of a country’s health technology inventory be older than 10 years old. Beyond that age, the equipment is not considered state-of-the-art and thus could pose a health hazard or lead to substandard treatment of patients.

The Canadian health system doesn't even come close to adhering to this standard. As of 2007, the share of its medical inventory that's over a decade old includes 21 percent of its bone densitometers, which are used to measure the bone density of osteoporosis patients, and 28 percent of its SPECT units, which are used to create three-dimensional images of the body.

A third of Canada's gamma cameras, which are used in nuclear medicine imaging, and a quarter of its angiography and cardiac catheterization labs, for heart-related ailments, are more than 10 years old. Not only does Canada have comparatively few lithotripters to fight kidney and gall stones -- a third of the machines it has are more than a decade old.

The ECCREI also recommends that 60 percent of a country’s medical machines be less than five years old, according to a Fraser Institute study. Canada’s hospital inventories fail in this regard for a seemingly endless list of different machines: bone densitometers, MRI machines, SPECT units, gamma cameras, lithotriptors, and angiography suites, to name a few.

The widespread use of antiquated medical equipment puts Canada’s patient population in a dangerous position. These machines are liable to break down during treatment. Older imaging technologies may yield low-quality images, which can cause doctors to misdiagnose conditions and prescribe ineffective or even harmful treatment regimens.

Canada's dearth of advanced medical technologies is the natural product of a penny-pinching government-run health system. If America moves closer to a fully government-run health system itself, the days of medical -- and technological -- miracles like Connie Culp’s face transplant may be numbered.

Sally C. Pipes is President & CEO of the Pacific Research Institute. Her latest book is The Top Ten Myths of American Health Care.