Canadians face longest waits for health care on record

From the Fraser Institute

Just when you thought Canadian health care had hit rock bottom, wait times in 2024 have hit an all-time high.

According to the latest version of our annual report published by the Fraser Institute, the median wait from referral by a family doctor to treatment (averaged across 10 provinces and 12 medical specialties including surgeries) is now 30 weeks—the longest wait in the report’s history and more than three times longer than the 9.3-week median wait in 1993.

Of course, wait times vary by province, and some provinces are worse than others. In New Brunswick and Prince Edward Island, the median wait is more than one year. And even in Ontario, which reported the shortest wait times in Canada this year, patients faced a 23.6-week wait, the longest in the province’s history.

In fact, compared to last year, wait times grew in every province (except Nova Scotia where patients still faced a median wait just shy of 40 weeks this year).

There’s also considerable variation in wait times depending on the type of care. For example, patients faced the longest waits for orthopedic surgeries (57.5 weeks) and neurosurgery (46.2 weeks) and shorter waits for chemotherapy (4.7 weeks), and radiological cancer treatments (4.5 weeks). In total, the study estimated that Canadian patients were waiting for more than 1.5 million procedures in 2024.

These waits for care are not benign inconveniences. Patients may experience physical pain, psychological distress and worsening physical condition while awaiting care. This year, the 15-week median wait for treatment after seeing a specialist was more than a month and a half longer than what physicians consider a reasonable wait (8.6 weeks). And this doesn’t even include the median 15-week wait to see a specialist in the first place.

Moreover, according to the Commonwealth Fund, a U.S.-based health-care research organization, among nine universal health-care systems worldwide, last year patients in Canada were the second-most likely to report waiting longer than one month for a specialist consultation, and the most likely to report waiting more than two months for surgery. In other words, although long wait times remain a staple of Canadian health care, they are not a necessary trade-off for having universal coverage.

And to be clear, wait times are only one manifestation of the strain on Canada’s health-care system. It’s now also normal to see emergency room closures, health-care worker burnout, and data suggesting millions of Canadians are without access to a regular health-care provider.

What’s the solution to Canada’s crippling health-care wait times?

There are many options for reform. But put simply, if policymakers in Canada want to reduce wait times for patients across the country, they should learn from better-performing universal health-care countries where patients receive more timely care. With wait times this year reaching an all-time high, relief can’t come soon enough.

Bacchus Barua

Director, Health Policy Studies, Fraser Institute

Mackenzie Moir

Senior Policy Analyst, Fraser Institute

Related Topics:#BacchusBarua #FraserInstitute #MackenzieMoir CanadaHealthCareWaitTimes

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US plastic surgeons’ group challenges ‘consensus’ on ‘gender transitions’ for minors

Published on December 16, 2024

Todayville

From LifeSiteNews

By Alliance Defending Freedom

The American Society of Plastic Surgeons argued that ‘genital surgical interventions’ have not been proven an effective solution to adolescent gender dysphoria, adding that current ‘research’ backing medical intervention is of ‘low quality/low certainty.’

One of the most effective weapons that proponents of radical gender ideology have wielded in support of their cause has been “consensus.”

When pressed to explain how blocking a young boy’s puberty or removing a teenage girl’s healthy breasts provide any medical or mental benefit, they often cite “experts” or refer to a “consensus” of medical organizations and government agencies.

But there’s a problem with that strategy.

Recent research has shown the glaring flaws in the argument that transition drugs and procedures are appropriate or helpful for minors. European countries that had once embraced “gender affirming care” for minors, including the U.K., have begun to reverse these policies.

While American medical organizations and governments have been slow to respond, recent developments indicate that may be changing.

Earlier this year, City Journal reported that the American Society of Plastic Surgeons (ASPS) had not signed on to “any organization’s practice recommendations for the treatment of adolescents with gender dysphoria.”

ASPS added that there is “considerable uncertainty as to the long-term efficacy for the use of chest and genital surgical interventions” and that “the existing evidence base is viewed as low quality/low certainty.”

More recently, the president of that organization, Dr. Steven Williams, told a local media outlet, “I don’t perform gender-affirming care in adolescents, and the reason why is because I don’t think the data supports it.”

Prominent plastic surgeon Dr. Sheila Nazarian echoed that sentiment. “I think some physicians and some medical associations have been overtaken by a vocal minority and they are politicized,” she said. “This is 100 percent an American political issue. If we look at Europe, very progressive governments have backed off of these procedures in minors because they’re just analyzing the data – as we should with every procedure. Why is it that for this procedure, in this patient population, we just have to shut up?”

In addition, whistleblowers have come forward to reveal the damage being done to children. Evidence now shows that the World Professional Association for Transgender Health (WPATH) has exerted pressure on researchers. In fact, leaked files from WPATH show that some doctors understood many of the concerns about pushing such drugs and procedures on minors – but did so anyway.

A landmark review of the available research on the effect of these drugs and procedures by Dr. Hilary Cass “demonstrated the poor quality of the published studies, meaning there is not a reliable evidence base upon which to make clinical decisions, or for children and their families to make informed choices.”

The Cass review, commissioned by the U.K. National Health Service, noted that “[t]he strengths and weaknesses of the evidence base on the care of children and young people are often misrepresented and overstated, both in scientific publications and social debate.”

In short, the “consensus” that our media, doctors, activists, and politicians rely upon is no consensus at all. It’s based not on proven science but on a commitment to ideology.

These cracks in the façade that advocates of gender ideology use as a shield provide hope to those who have long been advocating for the truth – in the courtroom and in the culture:

The truth that no amount of cross-sex hormones or permanently damaging surgery can change a person’s sex.
The truth that doctors have a duty to “do no harm,” and that includes being honest with patients about the facts regarding procedures that are mischaracterized as “gender affirming.”

It’s heartening to see prominent doctors from at least one major medical association speak the truth about the harm being done to so many children.

In the wake of Donald Trump’s election, we are hopeful that the new administration will follow through on promises to protect boys and girls from gender ideology.

And the issue of gender transition efforts for children has reached the U.S. Supreme Court too. On December 4, the court heard arguments in United States of America v. Skrmetti, in which the state of Tennessee is defending its law protecting children from these harmful and unnecessary procedures.

But we know that regardless of what happens in Washington, D.C., we will continue to face challenges in statehouses, government agencies, and school districts across the country.

The fight for truth isn’t over yet – but this is a big step toward achieving a lasting victory.

Reprinted with permission from the Alliance Defending Freedom.

armed forces

You wouldn’t believe how complicated distributing public money can get

Published on December 15, 2024

Todayville

David Clinton

Veteran Affairs: the Big Picture

While researching posts for The Audit, I’ll often confront massive datasets representing the operations of agencies with which I’m not in the least familiar. Getting to the point where all the raw numbers turn into a useful picture can take considerable effort, but it’s a satisfying process.

But my first attempts to understand Veteran Affairs Canada (VAC) felt a bit different. I wasn’t just looking at funding and costs, but at the frustrations and suffering of people who, to a greater or lesser degree, were harmed through their service to the country. Here, I hope, is part of their story.

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Veterans Affairs Funding

There are currently more than 460,000 living veterans of the Canadian military. The estimated 2024-25 spending allocation for Veteran Affairs Canada – whose mandate is to serve that population – is around $4.8 billion. The department employs less than four thousand people, which is actually around eight percent fewer than in 2010. Having said that, employment at the distinct Veterans Review and Appeal Board has grown from zero to 161 since 2017.

Besides VAC, the Office of Infrastructure of Canada will spend around $16.5 million on their Veteran Homelessness Program, and Department of National Defence has another $1.6 million budgeted for Community Support for Sexual Misconduct Survivors Program – something for which veterans will also be eligible.

In addition, nearly $2.5 million in grants from various government agencies (including Canada Mortgage and Housing Corporation) was given in 2023 to the Homes for Heroes Foundation, which provides housing and support for at-risk veterans.

Non-government agencies also work to support veterans. In 2023, for instance, the War Amps reported spending $2.7 million on “Service Bureau and Advocacy” and around $700,000 on “Veterans Issues – Special”. The Royal Canadian Legion Dominion Command spent around $1.15 million on veterans services in 2022.

The True Patriot Love Foundation is also a big player in this area, channeling nearly $2.7 million in 2024 to other charities working for veterans. At the same time, more than 30 percent of their own budget came from government sources.

One example of such flow-through funding was the $360,000 given by True Patriot Love to Veterans Transition Network in 2024. In 2023, Veterans Transition Network themselves received another $2.2 million from government along with a total of $1.7 million from other charities.

These kinds of ultra-complex relationships are common in Canada’s charitable sector. The complexity may provide benefits that outsiders can’t easily see. At the same time, knowing whether moving funds through multiple organizations leads to unnecessary inefficiencies and waste is something that would probably require a serious forensic audit.

Veterans Affairs Spending

The largest line items in this year’s VAC spending include $1.6 billion for pain and suffering compensation, $1.34 billion for the Income Replacement Benefit, and $990 million for pensions for disability and death.

In 2023, VAC awarded $41.6 million in external contracts. The largest of those was worth $13.8 million and went to 674725 ONTARIO LTD for “Other Business services not Elsewhere Specified”. 674725 Ontario Ltd. appears to be closely associated with a company called Agilec which, in turn, is a part of Excellence Canada. Here’s how Excellence Canada describes itself:

“Founded in 1992 by Industry Canada as the National Quality Institute (NQI), then rebranded as Excellence Canada in 2011, we are an independent, not-for-profit corporation that is dedicated to advancing organizational performance across Canada.”

In that context, it’s interesting that in 2022, VAC awarded a $159 million contract to a joint venture between WCG International Consultants Ltd. and March of Dimes Canada for “Other Health Services not Specified Elsewhere”.

What makes that interesting? Well, WCG also shows up on an Innovation, Science and Economic Development Canada (ISED) page related to compliance with the Investment Canada Act (ICA). The ICA exists to provide transparency relating to foreign investments in the interest of maintaining a fair and competitive marketplace

This particular page identifies a “U.S.” company called Ancora BidCo Pty Ltd as the new owners of a number of businesses under contract with the federal government. Those businesses include 674725 Ontario Ltd. and WCG International Consultants Ltd.

In fact, Ancora isn’t really a U.S. company at all. They’re actually Australian (as the Pty designation suggests). But their parent company – the private equity firm Madison Dearborn Partners, LLC – indeed operates in Chicago.

There’s no direct evidence to suggest there’s anything dark and nefarious happening here. But it is strange that so many discrete contracts turn out to be awarded to what now amounts to a single foreign for-profit company.

External Contracting Patterns

Has VAC been increasing their reliance on external contracts in recent years? Well, as you can see from this graphic, it’s complicated:

I don’t know what policy changes drove those two huge spikes in 2014 ($933 million) and 2021 ($2.25 billion). But I can tell you which specific vendors are responsible for most of the increase.

In 2014, three contracts worth a total of $803 million went to Medavie Inc for “Other Business services not Elsewhere Specified”. That was 86 percent of the sum of all VAC contracts from that year.

An eye-popping 98 percent of 2021’s external spending went to just six contracts worth $2.2 billion. Medavie Inc received one of those contracts – worth $228 million. But the other five (worth a total of $1.99 billion) were all joint ventures involving WCG International Consultants Ltd.

Lifemark Health Corp. (currently owned by Loblaw) partnered with WCG for three of those contracts, and March of Dimes Canada had the other two dance slots.

What Is Medavie?

Medavie Inc. is the owner of:

Medavie Blue Cross
Medavie EMS Inc.
Medavie health Services New Brunswick Inc.
Emergency Medical Care Inc.

Between them, those companies provide health insurance, healthcare training, and emergency management services. They also provide public health program administration – which would probably account for the majority of those contract amounts.

What’s not clear to me is why there’s no record of Medavie receiving any federal contracts of any sort since 2021 – despite the fact that the VAC website tells us that they’re still actively engaged in service provision through Partners in Canadian Veterans Rehabilitation Services (PCVRS).

What Is WCG International Consultants Ltd?

As we’ve seen, WCG is now owned by an American private equity firm and is most certainly no longer not-for-profit. Their website tells us that they’re part of the APM Group, which is an Australian company providing “services in early childhood, youth, employment, insurance, justice, veterans, health, disability, and aged care”.

You’re correct to assume the APM Group is more or less synonymous with Ancora BidCo Pty Ltd. More specifically: all of APM’s publicly-traded shares were bought out in the past couple of months on behalf of Madison Dearborn Partners.

Just one more detail: according to WCG’s website, they’re:

“Partners in Canadian Veterans Rehabilitation Services (PCVRS) coordinates and administers the Rehabilitation Services and Vocational Assistance Program on behalf of Veterans Affairs Canada (VAC).”

Curious about PCVRS? Since late 2022, they’ve been tasked with administering all medical, psycho-social and vocational assistance services on behalf of VAC. However, reports suggest that not everyone has been happy with either accessibility or responsiveness under the new system.

None of this is necessarily inappropriate. And if you’re willing to work at it, you’ll be able to use public information sources to uncover a wealth of related relationships and details. But the vast amounts of money involved, along with the operational complexity make abuse possible. Which means external oversight is a good thing.

Besides all that logistical stuff, what really matters is whether veterans themselves are receiving the support and services they deserve. And that’s a question only they can answer.

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