XPost: alt.tv.pol-incorrect, alt.politics.usa, alt.fan.rush-limbaugh   
   XPost: can.med, can.politics   
   From: HeilTrumpenFuehrer@gop.net   
      
   Ubiquitous wrote   
      
   > A survey by the Fraser Institute found a median wait of 20   
   > weeks for "medically necessary" treatments and procedures in   
   > 2016 - the longest-recorded wait time since the think tank   
   > began tracking wait times.   
      
   Once again gullible rightists have been sucked in.    At least   
   Trump is saving you from Canadian health care.   
      
      
   Analysis   
   Fraser Institute's wait-time survey: Does it still count if   
   most doctors ignored it?   
   Only around 20% of doctors responded to questionnaire   
      
      
      
   Fill out this survey and have a chance to win $2,000 — that's   
   the annual enticement from the Fraser Institute, an offer made   
   to thousands of doctors whose names appeared on a mailing list.   
      
   But it wasn't tempting enough to get doctors to participate.   
      
   No medical oncologists in Saskatchewan, Manitoba or New   
   Brunswick took the bait.   
      
   Zero responses came back from radiation oncologists in New   
   Brunswick or from cardiovascular surgeons in Manitoba.   
      
   Not a single plastic surgeon in Prince Edward Island or   
   Newfoundland answered the questionnaire.   
      
   Across Canada, just seven per cent of psychiatrists on the list   
   bothered to answer the short survey asking them to estimate how   
   long their patients are waiting for care.   
      
   The Fraser Institute is a think-tank that has long advocated   
   for more private-sector options in the Canadian health-care   
   system.   
      
   Every year for more than two decades it has published a gloomy   
   report about wait times for health care. This year's came out   
   on Wednesday.   
   1 in 5 doctors respond   
      
   And every year only around one in five doctors participate,   
   despite that offer of a $2,000 cash draw. In Ontario, less than   
   15 per cent of all specialists on the mailing list weighed in   
   on the issue of wait times.   
      
   The survey — just six questions — doesn't ask the busy   
   specialists to check their patient records or submit any hard   
   patient data. Doctors are asked only to estimate how long their   
   patients wait to see them, and then wait for diagnostic tests   
   and surgeries.   
      
       'We would love it if we had more responses.'   
       - Bacchus Barua, Fraser Institute   
      
   "We're absolutely clear about the fact that this is a survey,"   
   said Bacchus Barua, one of the authors of the report. "This is   
   not something we can control. We would love it if we had more   
   responses."   
      
   As a way to measure wait times, it's "preposterous," said   
   Steven Lewis, a health policy consultant based in Saskatoon.   
   "Why not use a thermometer rather than asking people for their   
   opinion about the weather?"   
   'Participation bias' skews results   
      
   "Physicians are inundated with surveys, so they pick and   
   choose," Lewis said. "It's also plausible that the most   
   frustrated physicians respond, representing the worst of wait-   
   time experiences."   
      
   It's called "participation bias"— a well-established fact in   
   statistical science that people who take the time to answer a   
   survey are different than the ones who ignore it.   
      
   "Individuals sometimes complete surveys when they are having   
   particular difficulties with the issue being studied," said   
   Monique Gignac, a professor at the Dalla Lana School of Public   
   Health at the University of Toronto. In other words, doctors   
   who don't think wait times are unreasonable might not be   
   motivated to fill out the survey.   
      
   "Doctors were also asked to mentally average wait times for   
   what might have been very different conditions and experiences   
   among their patients," she said. "As a result, the questions   
   may have introduced a number of biases into the study."   
      
   'To inform patients'   
      
   For the Fraser Institute, wait times have held a historic   
   fascination. Its founder, Michael Walker, is cited in this   
   year's report as the person "responsible for helping navigate   
   the beginnings of wait-time measurement in Canada."   
      
   Back in the late 1980s, Walker was a vocal critic of the   
   Canadian health-care system.   
   Bacchus Barua   
      
   Bacchus Barua says the Fraser Institute is 'absolutely clear   
   about the fact that this is a survey.' (Fraser Institute)   
      
   "High-income Canadians effectively are prevented from using   
   their incomes to buy a higher standard of health-care equipment   
   and service," he wrote in a 1989 report for the Heritage   
   Foundation, a U.S. conservative think-tank.   
      
   Three years later, Walker started releasing the annual Canadian   
   wait-time surveys. In the 1992 report, he stated that the   
   Fraser Institute's objective was "the redirection of public   
   attention to the role of competitive markets in providing for   
   the well-being of Canadians."   
      
   In more recent versions of the report, there is no longer any   
   discussion of policy alternatives, just the facts — as reported   
   by a fraction of the country's specialists.   
      
   Barua said he only has one agenda: "to inform patients about   
   wait times in Canada."   
      
   However, the 2013 survey has been entered as evidence in a   
   constitutional challenge against medicare. The plaintiff,   
   investor-owned Cambie Surgeries Corporation in Vancouver and   
   its CEO, Dr. Brian Day, aim to change the law to allow private   
   payment for medically necessary hospital and physician care.   
   The attorneys general of B.C. and Canada are intervening on   
   behalf of the Canada Health Act and the B.C. Medicare   
   Protection Act.   
      
       Landmark private health care lawsuit heads to court   
       Should Canada have a hybrid public-private health care   
   system?   
      
   Health policy analyst Karen Palmer was sitting in on the trial   
   when one of the Fraser Institute's wait-time study researchers   
   was called as an expert witness for the private clinic.   
      
   Palmer, an adjunct professor at Simon Fraser University, said   
   the flaws in the reports methodology were exposed under cross-   
   examination from the lawyers representing the B.C. attorney   
   general.   
   Provincial data available   
      
   "The Fraser Institute methodology is — and I use the word   
   carefully — an abomination," Lewis said, adding that there's a   
   better way: use real data.   
      
   "If you tag a referral to the billing code for an office visit,   
   you can easily calculate the time between seeing the GP and   
   getting referred, and the visit to the specialist," he said.   
      
       'The Fraser Institute methodology is — and I use the word   
   carefully — an abomination.'   
       - Steven Lewis, health policy analyst   
      
   Barua said the Fraser Institute doesn't have the resources to   
   do a more detailed survey, and sticking to this format allows   
   them to compare results with the older surveys.   
      
   There is another source of data about wait times in Canada.   
   Since 2006, the Canadian Institute for Health Information has   
      
   [continued in next message]   
      
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