OTTAWA, Sept 14 (Reuters) - Canada often boasts its universal health care program shows it is more caring than the United States, but the system is creaking alarmingly, with long wait lists for treatment, and shortages of cash and doctors.
And far from criticizing the United States, some people are choosing to go south of the border to pay for operations in private hospitals -- institutions that are forbidden in Canada by the law that set up the publicly funded system.
Politicians, experts and professionals generally agree that the medicare system needs major reforms, but the program's cherished status as an icon of Canadian identity means big changes are politically risky.
"Few would dispute the prevailing reality of our time: people in this country are increasingly anxious about their ability to get in to see the right health professional at the right time," Prime Minister Paul Martin said on Monday.
"Meanwhile, financial pressures are increasing as our population ages, as medical knowledge...expands, and as beneficial but expensive new treatments become available," he told a top-level meeting designed to rescue medicare.
Martin, joined at the table by the premiers of Canada's 10 provinces, faces a hornet's nest of problems as he tries to fix the health system. Medicare is jointly funded by the federal and provincial governments but run solely by the latter, an arrangement that causes plenty of rancor.
Medicare eats up C$85 billion ($66 billion) a year in public funds alone and the provinces continually demand more money, with no strings attached. Ottawa says it is prepared to contribute more but insists the provinces agree to benchmarks to ensure the funds are being spent properly.
As the politicians bicker, Canadians spend more time waiting in line. A study by the right-wing Fraser Institute this month said that average waiting time for treatment in 2003 rose to 17.7 weeks from 16.5 weeks in 2002.
"This grim portrait is the legacy of a medical system offering low expectations cloaked in lofty rhetoric," the study said, criticizing the fact that governments and not doctors are responsible for allocating resources.
Some delays are much longer. Patients in Ontario who require major knee surgery can wait six months to see a specialist and then another 18 months for surgery.
"When I started work 30 years ago it took three weeks to get a patient into a specialist's office. Now it can take six months. There is a lot of inhumanity built into the system," one unhappy family doctor told Reuters.
Statistics Canada said in June that some 3.6 million Canadians, or 15 percent of the population, did not have a regular doctor last year. This means hospital emergency rooms are flooded by people with routine problems.
Experts say the shortage of doctors will only get worse as an increasingly elderly physician population starts to retire over the next decade. And as medical expertise becomes ever more sophisticated, so will the demand and the expense.
"There will be new treatments which don't exist today that will exist 10 years from now and we'll have to address those wait times," New Brunswick Premier Bernard Lord told the meeting on Tuesday.
Some provincial premiers -- notably Ralph Klein of Alberta -- say one obvious solution is to increase the use of private clinics and hospitals, where people would pay for treatment.
Ottawa has in the past withheld health care funds to provinces experimenting with for-profit clinics and new federal Health Minister Ujjal Dosanjh took up his job in July with a vow to "stem the tide" of privatization.
And far from criticizing the United States, some people are choosing to go south of the border to pay for operations in private hospitals -- institutions that are forbidden in Canada by the law that set up the publicly funded system.
Politicians, experts and professionals generally agree that the medicare system needs major reforms, but the program's cherished status as an icon of Canadian identity means big changes are politically risky.
"Few would dispute the prevailing reality of our time: people in this country are increasingly anxious about their ability to get in to see the right health professional at the right time," Prime Minister Paul Martin said on Monday.
"Meanwhile, financial pressures are increasing as our population ages, as medical knowledge...expands, and as beneficial but expensive new treatments become available," he told a top-level meeting designed to rescue medicare.
Martin, joined at the table by the premiers of Canada's 10 provinces, faces a hornet's nest of problems as he tries to fix the health system. Medicare is jointly funded by the federal and provincial governments but run solely by the latter, an arrangement that causes plenty of rancor.
Medicare eats up C$85 billion ($66 billion) a year in public funds alone and the provinces continually demand more money, with no strings attached. Ottawa says it is prepared to contribute more but insists the provinces agree to benchmarks to ensure the funds are being spent properly.
As the politicians bicker, Canadians spend more time waiting in line. A study by the right-wing Fraser Institute this month said that average waiting time for treatment in 2003 rose to 17.7 weeks from 16.5 weeks in 2002.
"This grim portrait is the legacy of a medical system offering low expectations cloaked in lofty rhetoric," the study said, criticizing the fact that governments and not doctors are responsible for allocating resources.
Some delays are much longer. Patients in Ontario who require major knee surgery can wait six months to see a specialist and then another 18 months for surgery.
"When I started work 30 years ago it took three weeks to get a patient into a specialist's office. Now it can take six months. There is a lot of inhumanity built into the system," one unhappy family doctor told Reuters.
Statistics Canada said in June that some 3.6 million Canadians, or 15 percent of the population, did not have a regular doctor last year. This means hospital emergency rooms are flooded by people with routine problems.
Experts say the shortage of doctors will only get worse as an increasingly elderly physician population starts to retire over the next decade. And as medical expertise becomes ever more sophisticated, so will the demand and the expense.
"There will be new treatments which don't exist today that will exist 10 years from now and we'll have to address those wait times," New Brunswick Premier Bernard Lord told the meeting on Tuesday.
Some provincial premiers -- notably Ralph Klein of Alberta -- say one obvious solution is to increase the use of private clinics and hospitals, where people would pay for treatment.
Ottawa has in the past withheld health care funds to provinces experimenting with for-profit clinics and new federal Health Minister Ujjal Dosanjh took up his job in July with a vow to "stem the tide" of privatization.
