Low Tech Care in a High Tech World
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Most discussions about the problems with Canadas health care system often focus on the lack of access to physicians and long wait times for medically necessary care. But equally significant, governments are failing Canadians when it comes to providing access to high-tech health care and its time we started paying more attention to the shortage of advanced medical technologies in this country.
Our health care systems over-reliance on a small inventory of often outdated and unsophisticated technologies has important consequences for all Canadians.
It should come as no surprise that medical technologies are becoming increasingly important in the diagnosis and treatment of disease in the developed world.
Consider some of the benefits that arise from new medical technologies. New technologies can increase patient comfort and reduce pain; they can reduce recovery times from treatment; and they can increase patient safety. Some new technologies offer patients options for treatment where none previously existed.
But if patients dont have access to these new technologies, that can seriously affect how comfortable a patients treatment will be, how successful it might be, and for how long and how well they can expect to live afterwards.
Consider what the Organization of Economic Cooperation and Development (OECD) found when looking at access to MRI machines and CT scanners, both of which might be considered basic tools of health care today. According to a recent OECD publication, Canada has about 60 per cent as many MRI machines and CT scanners per population as the average OECD nation and lags well behind some of the leaders in this regard. Little wonder that Canadians often endure long wait times for access to the services these machines offer.
Medicare is equally poor at delivering access to more advanced and cutting-edge technologies. According to various studies published independently and in medical journals by researchers across the developed world, Canada lags the average of developed countries in the inventory of PET scanners (Positron Emission Tomography); ranks last among developed countries in providing interventional radiology services (which offer a less-invasive option for patients as compared to surgery); is both a late adopter of and outpaced by a number of nations in the expansion in access to/inventories of select medical technologies over time, and falls well behind the United States in access to a number of advanced technologies including technologies such as gamma knives (which provide a minimally-invasive alternative to open-skull surgery) and implantable defibrillators (which allow patients at risk of sudden cardiac arrest to live independently and not be under constant surveillance).
This lack of access to medical technologies is not the only technology-related failure of Canadas health care system. Our health care system also performs poorly when it comes to keeping our current stock of technologies up-to-date. Specifically, the limited inventory of technology that is in place in Canada is all too often old, outdated, and unsophisticated.
At the start of 2007, 30 per cent of Canadas hospital-based MRI scanners, 46 per cent of Canadas angiography suites, 42 per cent of Canadas cardiac catheterization labs, and 42 per cent of Canadas lithotriptors were past their recommended lifecycles according to guidelines published by the Canadian Association of Radiologists.
At the same time, a number of Canadas CT scanners are more basic and unsophisticated models incapable of providing the higher quality images, broader range of services, and less-invasive screening options that their newer and more sophisticated counterparts provide. And a significant proportion of Canadas medical technologies, between 20 and 60 per cent depending on the type of machine according to the latest data release from the Canadian Institute for Health Information, were operating without the ability to digitally store images. This means Canadians are routinely struggling to access to the latest advances in care even from those technologies which are available to them.
The rarity of advanced medical technology in Canada is not the result of a lack of spending. To the contrary, Canada maintains one of the developed worlds most expensive universal access health care programs. In addition, between 2000 and 2004, the federal government gave provinces $3 billion to improve access to medical technologies.
Canadas health care model is clearly failing Canadians. It asks patients to endure long waits for access to medical services. It requires them to undergo more invasive, more painful, and less comfortable treatments than are available to citizens of other developed nations. It sometimes requires them to forego life saving and life improving/lengthening care. And at the same time, it asks Canadians to foot the bill for a world-class program.
Its time we stopped accepting proclamations from the political class that Canadas health care system is great, and started asking our governments where exactly our tax dollars are being spent in health care.
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