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Friday, October 03, 2008

Health care in US and Canada compared

I doubt this will surprise regular readers of this blog, but Canada's single payer health system isn't all that Michael Moore makes it out to be. From a new report of the Fraser Institute:

On a comparable basis, Canadians have fewer doctors and less high-tech equipment than Americans. Canadians also have older hospitals and have access to fewer advanced medicines than Americans. Health care appears to cost less in Canada than in the United States partly because Canadian government health insurance does not cover many advanced medical treatments and technologies that are commonly available to Americans. If Canadians had access to the same quality and quantity of health care resources that American patients enjoy, the government health insurance monopoly in Canada would cost a lot more than it currently does.

Not only do Canadians have fewer health care resources than Americans, experience also shows that the Canadian health system is not financially sustainable in the long run. Ever since the single-payer system was established in Canada in the early 1970s, government spending on health care has grown faster than the ability of governments to pay for it. In Ontario, Canada’s largest and most populated province, health spending will soon consume close to half of all government revenues.

Another false economy of the Canadian health system is the money saved by delaying access to necessary medical care. Canadian patients wait much longer than Americans for access to medical care. In fact, Canadian patients wait much longer than what their own doctors say is clinically reasonable (Esmail and Walker, 2007b). Many Canadian patients wait so long for treatment that, in practical terms, they are no better off than uninsured Americans. In Canada, the government promises everyone that they have health insurance coverage for all medically necessary goods and services; but, in reality, access to treatment is often severely limited or restricted altogether.


James Papastamos said...

It is true: America is more medically advanced than Canada. I know. I had two 12 hour operations to remove a brain tumor at Pittsburgh's Centre for Cranial Based Surgery, in Pittsburgh Pennsylvania. I also know that one month at the hospital cost OHIP roughly $106,000 U.S. Now, I have gastro-intestinal cancer. The treatment drug, Sutent, costs about $7,000 a month (a bottle containing 30 capsules), and I do not pay for it, give or take the odd deductible. The Trillium Health Plan covers it. So, you tell me which country has a "fairer" healthcare system?

Yes, the waiting lines for MRI are longer, and our hospitals ARE older and less equipment. However, our system emphasises equal healthcare for all Canadians - not just for those who can afford it. I can still picture it, in my mind, the sight of a black woman, in a NYC hospital's emergency ward, lying on the floor, screaming in pain, dying slowly. Is this fair? When I was diagnosed, I had a CT scan the very next day. When I was sent to Emergency, I was called up right away.

Yes, Canada's health system does have its flaws. But Canada is fair to all Canadians. America, while seemingly offering better and more advanced treatment, does so only to those who are able to afford it. America neglects its underclass, choosing, instead, to direct its energies to foreign wars. I shall always be grateful to America for saving my life, but it was Ontario's Ministry of Health that footed the bill.

Nathan Benefield said...


Where will Canadians go for health care, if the US adopts a Canadian style health care system? For that matter, where will the Italians, French, and British go if we adopt their models?

As to the notion that the US doesn't care about its poor - you will note that US taxpayers spend more on Medicare and Medicaid for the elderly and poor than they do on their own insurance (note that like Social Security, Medicare taxes are taken from the "trust fund" to pay other expenses). Indeed the $3,200 spent per US resident on government health care, is nearly what the Canadian government spends - though government health care in the US covers only a fraction of our residents.

We have noted previously that Medicaid and Medicare - like Canadian health care - are inferior in quality (despite the exorbitant cost). In that regard, I agree with you that there are flaws in the US health care system.

But our solutions to the problem, along with reforms to Medicaid, are better than imitating the Canadian failure.

bobguzzardi said...

There are two ways to allocated scare resources: the free market price system or government rationing. The Government will be America's HMO? oh well....the economies of scale. Eliminating inequality is a utopian goal and many of the drugs and procedures that Mr. Papastamos resulted from unequal distributions of wealth ( and talent ). Societies were income is more equally distributed are not as productive.