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most of the world has centralized care

Other Stats on Canadian Healthcare

The number of physicians per capita is nearly 50 percent higher in the U.S. than in Britain and Canada, resulting in smaller case loads and more individualized attention in the U.S. (Anderson et al. 2002).

Whereas only a little more than 11 percent of U.S. physicians are general practitioners, in Canada and Britain nearly half are. This means patients in the U.S. have greater access to specialists than patients in other countries (Goodman, Musgrave, and Herrick 2004).

Only a handful of PET scanners, the best tool for diagnosing cancer, are available for use in Canada, compared to more than 1,000 in the U.S.

The U.S. has nearly 80 percent more CT scanners per capita than Canada and nearly twice as many as Britain.

The U.S. has nearly three times as many MRI scanners per capita as Canada, and more than twice as many as Britain (Goodman, Musgrave, and Herrick 2004; Anderson and Hussey 2000).

One of the key doctors in Canada has this to say about the lack of competition:

CANADIAN HEALTH CARE EARNS DISMAL FINISH IN INTERNATIONAL RANKING   from NCPA, May 27, 2009

For the second time in less than two weeks, the Canadian public health care system has flunked an international comparison test, says the Health Consumer Powerhouse (HCP), a research organization. Canada's health care system ranks 23rd among 32 nations surveyed for quality, access and innovation.

The second annual Euro-Canada Health Consumer Index measures patients' rights and information, waiting times for treatment, outcomes, the range and reach of services provided and access to pharmaceuticals.  Out of the 1,000 points available, the Index ranked countries in the following manner:

The Netherlands was in the top spot with 824 points. Austria was second with 813 points. Luxembourg and Denmark took third and fourth place with 795 and 794 points, respectively. Germany came in fifth with 769 points. Canada placed 23rd with a score of just 549 points.

According to researchers, wait times to see a doctor and receive treatment dragged the Canadian ranking toward the bottom:

Patients were waiting between 3-15 months for treatment, when they could have received the same quality of care in Germany, France or the Netherlands in two weeks.  While Canada is one of the highest per capita spenders on health care, patients don't get much for their money. On the so-called "bang for the buck scale," that measured health care results for the number of dollars spent, Canada ranks dead (last).

Moreover, the Canadian system is in some respects held hostage by vested interests, such as public sector unions, say researchers.  Some of these groups like to attach themselves to one method of service delivery, and they become religious about it.  They become kind of fundamentalists about public health care delivery, as opposed to saying how can we do it like Europe, and have a variety of service providers.

Source: Mike McCourt, "Canadian health care earns dismal finish in international ranking," Metro News, May 26, 2009; based upon: Arne Björnberg and Daniel Eriksson, " Euro-Canada Health Consumer Index 2009," Health Consumer Powerhouse and The Frontier Centre for Public Policy, 2009.