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What if Canada and the US were ranked 30th and 37th in Hockey?

Hockey has always been taken very seriously in Canada. With the growth of the game in the US (particularly after the 1980 Miracle on Ice) it is clear hockey is taken very seriously there too. 

So imagine if the International Olympic Committee (IOC) or International Ice Hockey Federation (IIHF) declared that “Canada and the US were ranked 30th and 37th respectively in Ice Hockey”

I think it fair to say: 30th place in hockey would never be allowed to happen in Canada!  And given (perhaps particularly) the fervor of the Women’s competition alone it seems unlikely that 37th would be allowed to happen “South of the Border” either.

Life and Death: In some circles sports can feel like life and death.  This was likely never more so than the 1980 Miracle on Ice which, given the state of the world, perhaps transcended “sport” more than any other moment in sporting history.  Even so, at the end of any day (and even on February 22, 1980) – any sport is ultimately a game.  

Health Care actually IS life and death!   So it may seem paradoxical that the 2000 World Health Report by the World Health Organization (WHO) ranked the health systems of Canada 30th and the US 37th out of 191 Countries – and drew little concern. (Source: World Health Report 2000, WHO)

Keeping score: One of the easy things about hockey rankings is there is a giant scoreboard that tracks the results of individual games - thereby enabling accurate won-loss records. 

Health Care rankings leave much more room for debate (it appears).  On that point, the WHO report measured:

  • Population Health and Life Expectancy and how evenly each was distributed;
  • Responsiveness and how evenly that was distributed, and
  • (fair) Financial Contribution.

The WHO’s purpose was to stimulate a vigorous debate about better ways to measure health system performance and thus find a successful new direction for health systems to follow.  (Source: World Health Report 2000, WHO, Summary). 

The WHO succeeded in stimulating the vigorous debate alright – most of it fired back in its own direction over methodology, parameters and (even) having overstepped its boundaries by conducting the ranking in the first place.  In fact there was such criticism and controversy, the WHO has never published a subsequent ranking.  (Source: Wikipedia, December 24, 2015)

Winning or Losing?  But before concluding the WHO findings were done by a bunch of folks living in a different part of the world who simply don’t get how good we really are at this: a 2014 Bloomberg Report on the World’s Most Efficient Health Care Systems ranked Canada 21st and the US 44th out of 51 countries.  (Source: Bloomberg, August 25, 2014)

Interestingly, many of the Countries which ranked highly on the WHO list (like France, Italy, Singapore, Spain, and Japan) likewise ranked well in the Bloomberg report.  Whether it means anything or not Norway was 11th on both.  If it looks like Canada improved significantly, ten (10) Countries that were ranked higher than Canada on the WHO Report were not included on the Bloomberg Report.   And it’s not a case of economic or population advantage: Mexico was 12th on the Bloomberg list; China was 26th.  

An ugly truth: Whatever the debate over health system rankings or ideologies there are certain similarities that suggest the Canada and US systems are FAR more alike than some may wish to acknowledge:  

  • The US and Canada lead the world in per capita spending on prescription drugs: US is 1st at US$1010 per person; Canada ranks 2nd at US$771.             (Source: Canada Institute for Health Information, Drug Spending in 2014)
  • Medical error is the third leading cause of death in both Countries: 400,000 in the US; 30,000 in Canada.                                                                             (Sources: US: Health Care IT News, July 18, 2014; Canada: The Huffington Post: October 24, 2015) and
  • “Adverse reactions to prescription drugs taken as prescribed” (like the one I had in connection with Guillain Barre) is the 4th leading cause of deaths in each Country: 106,000 in the US; 10,000 in Canada.                                       (Source: Facts on prescription drug deaths and the drug industry, Terence Young, MP Oakville, Ontario, Founder/Chair of Drug Safety Canada, Health January 2012)

Is this the best we can do?  With the challenges of aging populations, shrinking tax bases, higher costs and longer life expectancy, health care clearly requires a focus on both effective and efficient methods.

On that point there is nothing effective or efficient in basing the standard of care on substances whose very advertisements state: XYZ pharmaceutical may reduce some symptom while causing (seemingly) up to 20+ new problems and (be sure to ask your doctor if it’s “right” for you) because some of those problems have proven fatal.  REALLY?   

If this was an advertisement for a motor oil or household cleaner the product(s) would be removed from the marketplace.  How did this ever become the standard of care for us?

To go back to sports:  at 30th place if Canada was an NHL NFL, NBA or MLB Team it would be in line for the first draft pick annually; at 37th the US would finish outside of each league.   

Kindest regards

James, 647-289-3791

Replenishing Technologies Inc (RTI) does not diagnose, treat, nor cure any illness or medical condition.  Our services promote wellness and improved athletic performance; results vary.  Readers and users alike are advised to use the information, technologies, and methods presented under the supervision of their family doctor and/or other health professionals they rely upon.  


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Replenishing Care does not diagnose, treat, nor cure any illness or medical condition. Our services promote fitness, wellness and improved athletic performance; results vary. Readers and users alike are advised to use the information, technologies, and methods presented under the supervision of their family doctor and/or other health professionals they rely upon. RCC is a division of Replenishing Care and Technologies (RC&T)

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