The Downside to Canadian Health Care

Can it really be called a downside?

According to Joseph M. Connors, MD, Clinical Professor and Director of the BC Cancer Agency’s Centre for Lymphoid Cancer, Vancouver, British Columbia, in an article in the ASCO Post, the downside to Canadian health care is

We [the Canadian health care system] don’t get to give patients treatments unless they have proven benefit, so we have an entire system devoted to examining what evidence justifies which treatments…….

……….I [Dr. Conners] cannot give a drug without evidence-based proof that the drug has efficacy and works better than the less-costly alternatives in the particular disease I’m treating. So the drawback to a centralized system is that it constrains innovative behavior, is resistant to change, and is slow to introduce new approaches. The system waits for adequate evidence before moving ahead…….

Well, I’m not so sure I’d categorize that as a downside, and neither do I believe it constrains innovation.

Just because something is new, and may have shown efficacy in a petri dish, or even in a stage 1 trial, doesn’t necessarily mean it will be effective when given to humans. And let’s not forget about potential side effects of rushing treatments to market. You only have to look at drugs such as Thalidomide, and more recently Avastin, to recognize the flaw in that thinking.

And besides, isn’t that what clinical trials are for? Something else Canadians and Europeans have far greater access to than those in the US, that is unless you

have adequate coverage or can pay out of pocket

(But then again, why would you invest in a costly clinical trial, with an uncertain outcome, if off label use is making you money?)

I don’t know about everyone else, but if that’s the only downside to Canadian health care, I’m willing to take my chances!


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