THR in Canada

by Wayne

In Canada, we have a universal health care system, which at one time was touted as one of the better systems in the world. I’m from the Province of Ontario and can comment only about Ontario.

Today, when people in Ontario require major surgeries like a total hip replacement (THR), they will be referred by their family doctor to a specialist—for THR, an orthopedic surgeon. A patient from a smaller city in Ontario is usually referred to a larger city, to help offset the waiting time, because smaller hospitals are generally booked a long time in advance. (For instance, I was referred to Toronto.) The family doctor usually has the name of only a couple of these surgeons; therefore, the choices are likely to be very limited as to what surgeon does your surgery.

Due to cutbacks in Ontario Health Care spending, the wait to see the surgeon could take some time, and the wait for the actual surgery could be very much longer. When you arrive to see the surgeon, x-rays will be ordered, and the surgeon will view them and discuss your case with you.

If surgery is needed, you may not be given a surgery date at that time. Most likely, the surgeon’s secretary will contact you as soon as she has an opening. In the meantime, you should ask to be put on a cancellation list, since this could shorten your waiting time for surgery.

When you do get called, the secretary will schedule both your surgery date and the date for your pre-surgery medical examination. It’s important to be a bit early for this appointment, because there is a lot of paperwork to be done beforehand. The medical exam is very detailed, and you can expect to spend anywhere from three to five hours at the hospital.

During the exam, you will also learn whether you are recommended to return directly home after hospital discharge, or go first to a rehabilitation center until you can get around better by yourself.

Some history on Canada’s health care crisis:

Canada has ten provinces and two territories. Each province is allowed to elect its own provincial government. The three major parties are the Conservatives, Liberals, and New Democratic Party. Canada as a whole is now (2003) governed by the Liberal party out of Ottawa. Each province is allotted a certain number of dollars from Ottawa to assist them in health care costs. The province of Ontario is governed by the Conservative party, which is big-business oriented.

This Government decided to give tax breaks to Ontario residents, over time. To the average working person in Ontario, it amounted to peanuts. To the big business people making one to two hundred thousand dollars a year, it was quite a windfall.

To pay for these tax cuts, the government cutbacks started. The first people they went after were people on welfare, and they cut thousands from the assistance rolls. Then they attacked the health care system, laying off thousands of nurses, resulting in closure of many, many hospital beds.

Then they attacked the doctors, who are paid by the government. They put price caps on the amount of money a doctor could bill the government for services. If doctors went over that amount and couldn’t adequately justify why, the government would claw the money back from the doctors.

Many doctors who got fed up with working long hours for low wages decided the cost of doing business in Ontario was more than they cared for. Many doctors just packed up and left Canada and headed to the U.S.A. This had such an effect on the people in Ontario, in my area alone, that there’s said to be 10,000 people without family doctors. Hospitals were closed—or, in one case, where I had my first THR done in 2000, torn down.

In 2002, I was told I would have to wait at least a year for my next THR. Everything was backed up in the hospitals that were not closed or torn down. My surgeon told me there would be a wait of one year for surgery. He stressed to me twice that it was through no fault of his own.

I wrote to the leader of the Ontario government and asked if he understood anything about the pain of hip joint degeneration—and if he did, would he consider waiting for a year in pain to undergo surgery. I also sent the same letter to five major newspapers in Ontario.

I soon got a call from my surgeon’s office stating I had a confirmed surgery date in exactly two weeks’ time. I generated a lot of calls from people in the same boat as me, who were waiting for surgeries. When I went public, I was given a surgery date in two weeks—a far cry from one year. If I hadn’t taken that action, I would be still waiting in disabling pain, as of this writing (March 2003).

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