At lunch the last day, I sat with some nice nurse practitioners from Canada and asked them about how things work at their hospital in the electrophysiology department - after all they worked for a big regional hospital outside a major metropolitan city like mine. I asked how many electrophysiologists they had there: three - two of whom do afib procedures and one who does more device rather than ablation work. I asked how many defibrillators performed a year and asked who paid for them, and she said the
government. "But we got authorization to do five more devices next year," she said.
"Only five?" I asked in disbelief."
Yep, and we were lucky. Other centers got fewer. They're expensive, you know. We have to be very careful about who we select to get one of those. It's not like America - people here are used to waiting."
"But what about SCD-HeFT and MADIT-II and the other trials?"
She smiled and looked down at her plate. "We have no choice, people up here don't have to pay for their care, so we have to choose who we think the best candidates are and do the best we can."
Those of you advocating for patient centered health care and single payer health care have some serious ‘splainin’ to do!
(For that matter, can you even practice EBM under single payer)?