The Credit Valley Hospital in Mississauga, Ontario has just added a new MRI unit; Alberta has committed itself to increasing the number of MRI units in the province by seven; and the Federal Government has allocated $1 billion of spending to increasing health technology. What is all this sudden fuss about MRI units?
The MRI machine is a relatively new device that became popular in the late 1980s. It creates images of the human body so doctors can analyze fluid movements, search areas like the brain or spinal cord for abnormalities, and diagnose muscle or soft tissue injuries. Although the machines are not cheap, they are of great value to surgeons, as none of these areas can be diagnosed with traditional x-ray based machines.
So now that Canada is investing heavily in these new, high-tech machines, will Canada be a health technology leader in the near future? Unfortunately, no.
Not for Lack of Spending
The country’s failure as a technology leader is not due to a lack of spending. Canada spends a lot of money on health care. In fact, when we consider the percentage of GDP spent on health care, Canada is the sixth highest spender in the Organization for Economic and Cooperative Development (OECD), and the fifth highest in actual dollars spent per person. (See table.)
Despite our record for high spending, relatively few health technologies are available to Canadians. Canada currently ranks a depressing nineteenth in a comparison of 25 OECD countries for MRI availability. A number of countries that spend less than Canada rank higher in the availability of MRI scanners.
At present, Canada would have to add 161 MRI machines to place sixth on the chart, which would equal its rank in total spending as a percent of GDP. That number leaps to an astonishing 327 MRIs if we wished to place second (leaving out Japan, which has a disproportionately high number of MRI machines).
These simple facts go a long way towards explaining the alarming median waiting time of 12 weeks for an MRI scan. We simply don’t have the technology available to us in quantities comparable to the rest of the OECD.
Less-Expensive Technology?
Of course, some will argue that Canada may have chosen to substitute less-expensive equipment for the very costly high-tech MRI machines. A computed tomography (CT) scanner, for example, can sometimes be used as a lower-cost, albeit lower-quality, alternative to an MRI scanner.
CT scanners generate an x-ray of a cross-section of the body (as opposed to the usual lengthwise image), which allows doctors to diagnose far more than they can with a basic x-ray, but still less than they can with an MRI. Specifically, the CT scanner is less able to diagnose problems in soft tissue or muscles.
If Canada in fact has been using CT scans in place of MRI scans to reduce costs, then Canada would rank relatively high on the CT scanner comparison in order to compensate for a relatively low ranking on the MRI comparison. Unfortunately for Canadians, this is not the case. In a comparison of 23 OECD countries, Canada’s rank for the availability of CT scanners was similar to its rank for MRI scanners: a depressing eighteenth.
There can be no disputing the facts: Health technology is not available to Canadians in a quantity that compares favourably with other wealthy OECD countries.
Nadeem Esmail is health policy analyst at The Fraser Institute. He completed his B.A. in economics at the University of Calgary, and his Masters in economics at the University of British Columbia. He can be reached by email at [email protected].
