Yes, I know, that headline is going to get a ton of “baloney” responses. Not to mention all the “then go back to Canada” replies from people not interested in really looking at the issue. I’ve heard it all before a million times.
I want to be clear about the purposes of this posting. I’m not going to try and argue for Americans to adopt a single-payer system of universal (not “socialized”) healthcare. Like gun control, the American system is too undermined by lobbyists, corporate interests and mythology to ever really grapple coherently with the issue. But as someone who has lived under both health care systems for considerable periods of time, it angers me to hear the misinformation and lies that these anti-single payer advocates love to spread about Canada every time the debate about improving American health care arises.
So let’s look at the opinion expressed in the above headline. It’s not just my personal opinion. It’s the opinion of a recent Harvard Medical School study that studied the health care of more than 3000 Canadians and 5000 Americans. It was based on the first-ever health survey carried out jointly by the two nations’ official statistics agencies.
Here are a few paragraphs about the study which was printed in the American Journal of Health in July 2006:
“Canadians had better access to most types of medical care (with the single exception of pap smears). Canadians were 7% more likely to have a regular doctor and 19% less likely to have an unmet health need. U.S. respondents were almost twice as likely to go without a needed medicine due to cost (9.9% of U.S. respondents couldn’t afford medicine vs. 5.1% in Canada). After taking into account income, age, sex, race and immigrant status, Canadians were 33% more likely to have a regular doctor and 27% less likely to have an unmet health need. For each of these measures, the average Canadian did about as well as insured U.S. residents. Race and income disparities, although present in both countries, were larger in the U.S. Nonwhites were more likely than whites to have an unmet health need in the U.S. (18.6% vs. 11.1%); while in Canada they were not (10.8% vs. 10.2%). Notably, both white and non-white Canadians had fewer unmet health needs than white U.S. residents. After taking into account income, age, sex, race and immigrant status, poor U.S. residents (making less than $20,000 per year) were 2.6 times less likely to have a regular doctor than the affluent ( those making $70,000 or more). In Canada, the poor were only 1.7 times less likely.”
But this next paragraph is even more important, because it deals with that great bugaboo that those opposed to single payer like to bring up about the Canadian system – waiting times:
“Lead author Dr. Karen Lasser, primary care doctor at Cambridge Health Alliance and Instructor of Medicine at Harvard commented, ‘Most of what we hear about the Canadian health care system is negative; in particular, the long waiting times for medical procedures. But we found that waiting times affect few patients, only 3.5% of Canadians vs. 0.7% of people in the U.S. No one ever talks about the fact that low-income and minority patients fare better in Canada. Based on our findings, if I had to choose between the two systems for my patients, I would choose the Canadian system hands down.’ ”
Here the study’s other author, another American doctor:
“These findings raise serious questions about what we’re getting for
the $2.1 trillion we’re spending on health care this year,” said Dr.
David Himmelstein, Associate Professor of Medicine at Harvard and
co-author of the study. “We pay almost twice what Canada does for care,
more than $6,000 for every American, yet Canadians are healthier, and
live two to three years longer.”
So let’s look at three important myth-busters this report contains: 1) Under the Canadian system, people were more likely to have a regular doctor than Americans, and to have fair fewer unmet health care needs 2) About 2. 8 percent of Canadians have to wait longer than Americans to receive certain kinds of health care. That means of every 1000 people, 28 more Canadians have to wait longer. Not exactly the huge lines portrayed by certain American lobbyists, is it? 3) The author of the study, an American doctor, when asked which system she would choose for her patients, took the Canadian system “hands down.”
There is also the fact that the Canadian system costs a lot less for all this great care.
And that’s just one study. I found several others that stated the same observations. They can be easily found via Google.
The reality of the health care debate is that it boils down to another Republican versus Democrat battle. In a poll done by Harris Interactive last year for the Harvard School of Public Health., 54% of Americans said U.S. private health care may not be better than national systems in Canada, France and the U.K. Which meant that 46% thought the US system was just hunky dory. But when you break those numbers down by political persuasion, you find that 68 percent of those who identified themselves as Republicans, 32 percent of Democrats
said the U.S. system was the best.
Which gives you a hint about why President Obama choose this moment to reform health care. He can read poll numbers too, and when Republicans are at a nadir both in terms of party numbers and public support, there may be no better time to reform health care.
But sadly, it won’t be single payer. It would be nice, but I’m not stupid. You can count on an avalanche of even more negative misinformation being put forward in the coming weeks. Facts don’t matter in Washington, nor with the mainstream media inside the beltway, who will be happy reporting this in the Politico-style winners and losers model. It’s all about spin. The best we can hope for is a health care system that will be universal in the sense that everyone will be covered.
Finally, one last personal note. The argument in this debate often boils down to who has better care. As I stated above, I’ve lived in both systems for a long time, and I can honestly say the quality of the care in both countries is excellent. I’ve had great doctors and care on both side of the border. Where the Canadian system fair surpasses the American system is in cost and availability. It’s not a perfect system for sure. But if I was a doctor and I had to choose one of the two for my patients, I would pick the Canadian one hands down too.
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I think your quotes you say are from the New England Journal are misleading. I was not able to find your quotes but did find this in the Journal which should give you pause:
“Costs of Health Care Administration in the United States and Canada
PDA Full Text
Related Article
by Aaron, H. J.
Related Article
by Woolhandler, S.
PubMed Citation
To the Editor: There is little doubt that per capita health care administrative costs are lower in Canada than in the United States, as Woolhandler et al. report (Aug. 21 issue),1 even though the precise magnitude of the gap is open to debate, a point that Aaron makes in his accompanying editorial.2 However, the Canadian single-payer system results in chronic shortages of medical services because of underfunding. The underfunding problem is usually considered to be a separate issue from the single-payer system itself,2 but the very structure of the single-payer system may cause the problem.
In the United States, persons who wish to spend more on health care than the norm have a simple way of doing so: they can purchase premium private medical insurance. Notwithstanding the Medicare prescription-drug plans currently being discussed, it is generally not an option in the United States to increase medical expenditures through the taxation system, given contemporary political and fiscal constraints. In Canada, however, increases in medical expenditures are possible largely only through the taxation system. And even if, as some surveys suggest, most Canadians are willing to spend more on health care,3 taxpayers cannot be sure that any given tax increase will actually go to health care expenditures. Therefore, Canadian taxpayers generally resist tax increases, and underfunding and chronic shortages result.
I think we have a fundamental difference in philosophies. I do not think healthcare should EVER be free. If it is free, that means we do not value it. Even if we were to have a universal health care system, there needs to be some cost, to prevent abuse.
Also, my ideas for reforming healthcare are based on setting liability limits, which bring down costs of insurance, finding a way to ensure that the consumer is aware of price (via a scaling copay), so that they must factor costs into their healthcare costs. Lower cost alternatives are preferable when they are an option, but currently their is no incentive for any insured patient to choose a lower cost option.
The most important element of healthcare reform, though, is increasing the supply of healthcare. We can make it free, but we do not have enough doctors or hospital beds to provide healthcare to everyone wants it is made “free.” If we could flip a switch and have universal healthcare, the demand will skyrocket, but the supply won’t.
It will take 8 to 12 years for the supply to increase the supply of healthcare, and that is only if we lower the costs of becoming a doctor or nurse, or increasing the pay as an incentive. Any healthcare plan that does not phase in over a minimum of 8 years will create chaos.
No worries! But, Dennis’s point goes toward my point in a weird way. A $10,000 a dose medicine–developed in America. There MUST be a country that innovates and leads in the development of new treatments. Otherwise, there will be no new experimental drugs.
My stance has always been, socialize medicine when you are happy with the number of diseases cured.
The differences between Canadian and American healthcare are more than just the pay system. When’s the last time a Canadian hospital had to pay $10s of millions to a single patient in a lawsuit? What is the last medical or pharmaceutical advance to come out in Canada?
And Dennis, who goes to Cuba for medical care? They have some of the worst healthcare in the world! Other than Michael Moore, who actually wants Cuba-style healthcare?
Hmm. Kyle, I want to apologize to you. That last response was too snarky. I don’t agree with your position on healthcare one bit and I really believe you are dead wrong about the Canadian system, but it doesn’t move the debate one bit to reply in such a peevish way. I”m annoyed at something else I’m dealing with and I think I took it out on you. Sorry about that.
Gee, Kyle doesn’t agree. That’s a shock to my system.
And look, he’s using the same old tired, retread data that all the anti-Canadian folks love to haul up all the time. Then again, why let the facts get in the way of a good argument. Must be that Harvard Medical School and the two countries official statistics agencies are just bodunk organizations in the can for socialism, eh?
But Kyle, you are totally wrong about “if it were not for the country’s proximity to the United States, there would be outrage among the population.” That is such a load of horse manure. And so typical of the kind of nonsense arguments the right always makes about this case. I’d wager to say that the percentage of Canadians who won’t trade their system for the US system is in the 90 percent range. The last poll take in 2002 showed that only 8 percent of Canadians thought the US system was better. Here’s the link. (http://www.queensu.ca/cora/_files/MendelsohnEnglish.pdf.)
In a Harris Poll taken last year (http://www.harrisinteractive.com/harris_poll/index.asp?PID=927) of the attitudes of people in ten countries about their health care, 33 percent of Americans believed that their system “has so much wrong with it that we need to completely rebuild it”, while only 12 percent of Canadians felt this way. (This may also explain why so many Americans are seeking care outside the US, particularly those who are well-off). The American system had the poorest rating of the 10 countries surveyed.
But again, why let facts spoil the fun.
There is always anecdotal statements. If you lived in Canada for 3 years Kyle and got free drugs then you were a student and got your drugs from the university clinic. Yes? So here are my anecdotal stories. Short.
Cousin was 53, diagnosed finally after a long time with a rare cancer. Apparently less tn 100 in US have it. Certainly no one in our town had ever had it. He was flown to Mayo, costs paid by Canada, and diagnosed. Cured- no. The drug available was approved but not for his form of cancer. Each IV does about $10,000. Needed 6 per year. Paid by Canada. He has had several other near death calls because of complications of the disease. He is now 65 and still alive, two kids putting through college.
Father- 90. Several operations for kidney stones, spot on the lung, gallbladder. Never had to wait. Sees his cardiologist when needed, gets free ambulance for emergency.
Mother 80- lives in Quebec, doctor is in Ontario. Could her care be better in Quebec- sure it could.
Aunt- 92, another aunt 89 and uncle 92. Recently had hip replacement, had to wait 6 months but he got it, free.
Bottom line- do you see any Canadian politicians running on a platform of creating private medicine. No . Do you see Canadians wanting the US system- No.
Now the big question- why do some Canadians come here for treatment? 1. bigger country so more specialized medical centers. Best doctors in the world, no question. Canada pays for much of their costs if they elect to use US 2. They are wealthy and can afford it.
Do Canadians go to Cuba for treatment- No. Do Americans- if they can yes. Do Americans go to Canada? In droves, using fake medical ID cards or some other scam. Why- they cant afford US care. NO Canadian comes to US because they can’t afford medical care.
How many bankruptcies in Canada due to medical costs- Zero.
So is the Canadian system perfect? No. It is universally better- Oh yeah. I live in confidence knowing if the American system screws me (and my insurance company might some day) I can go home. I paid into that system for 30 years.
I lived in Canada for three years and I cannot disagree enough. Of course, anything I say will be anecdotal, but I can remember spending a total of 14 hours across 2 days to get amoxycillin for a sinus infection. But it was free.
Also, Canada has a problem with flat out denying treatment because the the costs outweigh the benefits. One of my professors was in his 70’s, and developed a tumor, but was denied treatment because it would not “impact his length of life.” So he flew to America three times in the semester for treatment.
The problem is “waiting lists.” Sure they have access, but the waiting lists are so long, that by the time they get to the front of the line, treatment is no longer deemed viable, and they are denied. When that happens, they are statistically counted as being untreatable, but while they are on the list, they are statistically counted as having access.
Here is a great list of articles detailing the problems with the Canadian healthcare system (the page also details problems with Australia, Great Britain, Europe, and Cuba): http://www.liberty-page.com/issues/healthcare/socialized.html#canada
Even the Obama administration is avoiding references to Canada’s healthcare system, they instead like to mention Sweden. Canada’s healthcare system is broken, and if it were not for the country’s proximity to the United States, there would be outrage among the population.