Health
Canadian patients face long waits for diagnostic imaging
From the Fraser Institute
Polling data from earlier this year is crystal clear—the majority Canadians believe their health-care system has worsened over the past decade and more money won’t fix the problem.
Who could blame them?
This year we’ve seen reports of the regular closing of emergency room services, studies finding that one in five Canadians are without access to a regular a family doctor, and that the country now boasts some of the longest waits for medically necessary surgery in 30 years.
It’s no secret that the rationing of care through long wait times has become the defining characteristic of Canadian health care. In fact, in 2023 Canadians could expect to wait a median of 27.7 weeks for treatment—nearly seven weeks longer than in 2019 and almost three times longer than the 9.3-week wait in 1993.
While bottlenecks can be found nearly everywhere throughout the system, less talked about are the increasingly lengthy waits Canadians face when trying to access timely diagnostic services.
In 2023, reported waits for an MRI were found to be a median of 12.9 weeks—two weeks longer than last year, and the longest on record in at least a decade. We see a similar thing for CT scans where the 6.6-week wait this year is a week longer than last year (and also the longest in at least a decade).
So why the lengthening delays?
One reason is that, when compared to other countries with universal coverage, Canada has some of the lowest availability of key diagnostic imaging technology in the industrialized world despite being one of the highest spenders among the same cohort.
Take CT scanners, for example. In 2019 (the latest year of available data), Canada ranked 26th (of 30 countries) for the number of scanners available. At 14.9 units per million population, this doesn’t even come close to the availability of this technology among top performers such as Japan, which reported having five-and-a-half times as many scanners. We see a similar story with MRI units, where Canada ranks 25th out of 29 countries and reports an availability of stock four times smaller than Japan’s. Canada also had middling to poor results for the volume of diagnostic examinations performed, ranking 13th of 26 for CT scans and 18th out of 26 for MRI exams per thousand population.
Ultimately, poor access to diagnostic imaging not only frustrates the timely triaging of patients, it can also potentially add onto already lengthy waits for scheduled treatment (which again are the longest in at least three decades).
Canadian patients face many challenges in seeking to access timely elective surgical care including lengthy waits for diagnostic services. Improving access to medical imaging is a first step towards improving this access.
Brownstone Institute
The Cure for Vaccine Skepticism
From the Brownstone Institute
By
The only way to restore public trust in vaccination – which has taken a big hit since the lies attending the rollout of the Covid-19 vaccine – is to put a well-known vaccine skeptic in charge of the vaccine research agenda. The ideal person for this is Robert F. Kennedy, Jr., who has been nominated to lead the Department of Health and Human Services.
At the same time, we must put rigorous scientists with a proven track record of evidence-based medicine in charge of determining the type of study designs to use. Two ideal scientists for this are Dr. Jay Bhattacharya and Dr. Marty Makary, who have been nominated to lead the NIH and FDA, respectively.
Vaccines are – along with antibiotics, anesthesia, and sanitation – one of the most significant health inventions in history. First conceived in 1774 by Benjamin Jesty, a farmer in Dorsetshire, England, the smallpox vaccine alone has saved millions of lives. Operation Warp Speed, which rapidly developed the Covid vaccines, saved many older Americans. Despite this, we have seen a sharp increase in general vaccine hesitancy. Vaccine scientists and public health officials who did not conduct properly randomized trials made false claims about vaccine efficacy and safety and established vaccine mandates for people who did not need the vaccines, sowing suspicion and damaging public trust in vaccination.
What went wrong? The purpose of the Covid vaccines was to reduce mortality and hospitalization, but the randomized trials were only designed to demonstrate short-term reduction in Covid symptoms, which is not of great public health importance. Since the placebo groups were promptly vaccinated after the emergency approval, they also failed to provide reliable information about adverse reactions. Despite these flaws, it was falsely claimed that vaccine-induced immunity is superior to natural infection-acquired immunity and that the vaccines would prevent infection and transmission.
Governments and universities then mandated the vaccines for people with superior natural immunity and for young people with very low mortality risk. These mandates were not only unscientific but with a limited vaccine supply, it was unethical to vaccinate low-mortality-risk people when the vaccines were needed by older high-risk people around the world.
Since government and pharmaceutical companies lied about the Covid vaccine, are they also lying about other vaccines? Skepticism has now spread to tried-and-true vaccines that are proven to work.
And there are real, unanswered vaccine safety questions. Seminal work from Denmark has shown that vaccines can have both positive and negative non-specific effects on non-targeted diseases, and that is something that must be explored in greater depth. Vaccine Safety Datalink (VSD) scientists studying asthma and aluminum-containing vaccines concluded that while their “findings do not constitute strong evidence for questioning the safety of aluminum in vaccines…additional examination of this hypothesis appears warranted.”
While VSD and other scientists should continue to do observational studies, we should also conduct randomized placebo-controlled vaccine trials, as RFK has advocated. Since we have herd immunity for many diseases, such as measles, trials can be ethically conducted by randomizing the age of vaccination to, for example, one versus three years old, while spreading the trial over a large geographical area so that the unvaccinated are not all living close to each other.
I am confident that most vaccines will continue to be found safe and effective. While some problems may be found, that is more likely to increase rather than decrease vaccine confidence. For instance, it was found that the measles-mumps-rubella-varicella (MMRV) vaccine causes excess febrile seizures in 12- to 23-month-old children. MMRV is now only given as a second dose to older children, while the younger kids get separate MMR and varicella vaccines, resulting in fewer vaccine-induced seizures that scare parents. Although safety studies were inconclusive, it was also wise to remove mercury from vaccines. Even if we end up with fewer vaccines in the recommended vaccine schedule, that’s not necessarily a terrible thing. Scandinavia has a very healthy population with fewer vaccines in their schedules.
We won’t restore vaccine confidence by preaching to the choir. After the Covid debacle, Kennedy’s stated goal is to return to evidence-based medicine free from conflicts of interest. Letting him do that is the only way that skeptics will trust vaccines again, and those of us who trust vaccines have no reason to be afraid of that.
Attempts by the public health and pharma establishments to derail the nominations of RFK, Bhattacharya, and Makary are the surest way to further increase vaccine hesitancy in America. The choice is stark. We cannot let lopsided “pro-vaccine scientists” who clamp their hands over their ears at the mildest questions do any more harm to vaccine confidence. As a pro-vaccine scientist, and in fact, the only person ever being fired by the CDC for being too pro-vaccine, the choice is clear in my mind. To restore vaccine confidence to previous levels, we must support the nominations of Kennedy, Bhattacharya, and Makary.
Republished from RealClearPolitics
Addictions
Annual cannabis survey reveals many positive trends — and some concerning ones
On Christmas Eve, during his final year of high school, Justin Schneider’s friend handed him his first bowl of weed.
Schneider says he remembers it being an especially stressful evening and thinking, ‘Oh my God, they were lying to us about this.’
“Here I was this ‘good kid,’ staying away from alcohol and drugs, but this stuff is the best thing I’ve ever had,” he said. “But that reaction was brought on because it was the first time I’d ever taken any type of medication for anxiety.”
At first, Schneider used cannabis to cope with generalized anxiety, depression and insomnia. By his late twenties, he had become a heavy user.
In 2018, after more than 20 years of daily cannabis use, he was finally able to overcome his cannabis dependency with the help of a psychiatrist and addictions counselor.
Canadians’ relationship with cannabis has shifted dramatically since it was first legalized for non-medical use in 2018, a new survey shows.
The 2024 Canadian Cannabis Survey, released by Health Canada Dec. 6, reveals cannabis use has become increasingly normalized, driven by broader legal access and growing social acceptance. It also suggests legalization has achieved many of policymakers’ key goals.
But Schneider and others warn cannabis is not without its risks, and say better public education is required to address some of cannabis’ lesser known risks.
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‘Some sketchy guy’
Health Canada’s annual survey, which collected responses from more than 1,600 Canadians aged 16 and older, reveals a thriving legal cannabis market in Canada.
The number of users purchasing cannabis through legal channels has nearly doubled since legalization, rising from 37 per cent in 2019 to 72 per cent today.
“I imagine if I was just starting out [with cannabis] now, I wouldn’t ever have to interact with some sketchy guy, and that would have been easier growing up,” said Jesse Cohen, a 34-year-old daily cannabis user from Montreal.
Cohen uses cannabis to unwind after work or while performing menial tasks at home. Today, he picks up his supply from a sleek, well-lit government-regulated dispensary. He feels this interaction is safer than buying it on the black market.
Cohen says he has also seen the quality and variety of products on the market improve — accompanied by an increase in price.
In the survey, just over one-quarter of all respondents said they used cannabis for non-medical purposes in the past year, up from 22 per cent in 2018. Among youth, that number was 41 per cent.
The number of youth using cannabis has remained stable since 2018, a finding that challenges some critics’ claims that legalization would lead to higher rates of youth consumption.
“For youth, I do think that the whole legalization de-stigmatized and took the risk out of it — it wasn’t a taboo subject or a taboo activity anymore — so there wasn’t the same draw,” said Ian Culbert, executive director of the Canadian Public Health Association, a non-profit that promotes public health.
“Let’s face it, youth experiment, and if it’s something your grandmother is doing, you don’t necessarily want to be doing it too.”
Another positive trend, Culbert says, is that cannabis users now seem to be better informed about the risks of driving while high.
Only 18 per cent of people who had used cannabis in the past year reported getting behind the wheel after cannabis use, down from 27 per cent in 2018.
Culbert interviewed cannabis users when cannabis was legalized. At that time, many said they thought their driving abilities improved when under the influence of cannabis.
“Of course, that’s just not the truth … They felt that their video game experience was so much better when they were consuming, therefore why wouldn’t driving a car be better?” Culbert said.
“I think [because of] education efforts, and the fact that police across the country have put in programs to identify and prosecute people who are driving impaired, that message has gotten through, and people are now equating it to drinking alcohol and driving.”
Public health campaigns also seem to have raised awareness of cannabis’ risks to physical health. Successive Health Canada cannabis surveys have shown a growing understanding of cannabis’ effects on lung health and youth brain development.
Schneider believes public health campaigns now need to focus more on the mental health risks associated with heavy cannabis use.
“I think there’s a responsibility to say that, for a small proportion of people, it can be very psychologically addictive and very, very risky to mental health.”
According to Health Canada, regular cannabis users can experience psychological and mild physical dependence, with withdrawal symptoms that include irritability, anxiety, upset stomach and disturbed sleep.
“You don’t actually have anxiety,” said Schneider about his own withdrawal symptoms. “But your brain creates it anyway, driving you to use cannabis to relieve it.”
Research also shows frequent use of high-THC cannabis is linked to an increased risk of psychosis, a mental condition marked by a disconnection from reality. Individuals with mental disorders or a family history of schizophrenia are at particular risk.
In the survey, only 70 per cent of respondents said they had enough reliable information to make informed decisions about cannabis use. And the number of respondents saying they have not seen any education campaigns or public health messages about cannabis has increased, from 24 per cent in 2019 to 50 per cent today.
Culbert says the revenue that the government generates from cannabis creates a disincentive for it to issue strong health warnings.
“There’s no coherence in our regulatory and legal frameworks with respect to health harms and the level of regulation,” he said.
“Governments are addicted to their sin taxes,” he said.
This article was produced through the Breaking Needles Fellowship Program, which provided a grant to Canadian Affairs, a digital media outlet, to fund journalism exploring addiction and crime in Canada. Articles produced through the Fellowship are co-published by Break The Needle and Canadian Affairs.
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