A concern about the Canadian Health Care system

This post is by Joseph from West Coast Stat Views (on Observational Epidemiology and more)

This is Joseph.

A 2017 CMAJ article has been making the rounds on Twitter that has the headline result of:
Medical assistance in dying could reduce annual health care spending across Canada by between $34.7 million and $138.8 million, exceeding the $1.5–$14.8 million in direct costs associated with its implementation. In sensitivity analyses, we noted that even if the potential savings are overestimated and costs underestimated, the implementation of medical assistance in dying will likely remain at least cost neutral.

While costs are never irrelevant and this was a pre-implementation estimate, there is a concern about focusing on costs in a context of medical resource shortages.  We also have concerning cases like the case where the only condition listed was “deafness” on an application for medical assistance in dying in 2019. Or the high profile concerns that Jennifer Gunter, a US physician, had for the end of life care for her father in Manitoba. 

Now, I know that people will blame COVID for the problems, and that is certainly not unrelated, but there consensus that this is also a problem with health care policy:

But experts say decades of bad policy, including the closure of hospitals and past austerity budgets, coupled with Canada’s vast and complex geography, have exacerbated the pandemic pressure

And this is a real challenge to the goal of the system, to create equitable outcomes:

Canada’s system, however, ranks lower overall than the UK and others in international comparisons . . . Canada (Read more…)