“Costs of Health Care Administration in the United States and Canada
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by Aaron, H. J.

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by Woolhandler, S.

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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.

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.

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?

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.

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.