Friday, July 31, 2009

American health care

Reading the US papers and listening to Fox News I am struck by the debate over health care. It seems odd that something so obviously necessary as universal health care can be seriously debated.



Canada's system isn't perfect, and to a degree our weaknesses are covered by the ability to go to the US for treatment if necessary. But overall our system is pretty good. I have (sadly) seen friends and family go through the worst illnesses and the treatment, although often unsuccessful, was caring and competent. And it was not based on ability to pay. Other advanced countries all have some system of universal health care.



The US spends about twice as much per person on medical care than Canada but has lower life expectancy and higher infant mortality. The leading cause of bankruptcy in the US is medical bills. And working people who lose their jobs lose their health insurance.



The lack of American universal health care is a shame. The USA is an amazing place -- as a neighbour Canada is very fortunate -- American instincts are good, the people disposed to err on the side of freedom and charity and justice are taken seriously. But the lack of health care for all is unique among advanced nations. It doesn't have to be the Canadian model -- it could follow the mixed European models -- but it's time for America to join the mid-Twentieth Century and have a health care system.

8 comments:

Anonymous said...

Morton, what don't you understand?

1. Americans don't want to be Canadian's. Canada are the reject's America didn't want.

2. American's don't want Big Brother telling you what surgeon you HAVE TO USE. American's want to know who is operating on them,and when and if he/she has ever been sued or has committed malpractice. Canadian's don't have this resource. American's would not put up with Canada's state controlled marxist

3. American's don't want rationed care for 90% of the country(which have insurance) just so 10% can have free care.

4. American's see that Canadian's have to go to the USA daily for normal everyday care, like having a baby. American's don't want to have to go to Mexico or Brazil to have a baby. American's would not accept having to go to another country just to have a baby, let alone to save your life,all because the Marxist government in Canada forces you to use "their" care.

5. Americans don't want to have to pay more taxes for free care for 10% of the population. American's are not Canadians and are not Marxist in thinking. America would not be America today if it thought like Canada.

6. American's understand that Canada does not have any of the top pharmaceutical companies in the world. American's have 12 out of the top 17. American's want the best. Canada has none, let alone any of the best. American's would never accept being left behind.

7. American's understand that Canadian's pay more for alcohol, food, gas, cars, electronics,insurance,houses,and just about everything else to pay for a system that can only be grouped with Vietnam and Cuba. American's don't want to be a part of anything that is only exclusive to Vietnam and Cuba. Period. American's want the best and rationed care is not the best.

8. American's understand that Canadian doctor's go to the USA to make 42% more money, while Canadian's have to deal with foreign doctor's who barely speak English. American's want the best and when they see Canadian doctor's flocking to the USA, they understand. American's are not stupid.

Need any more? Got lots.

American's are freedom loving mostly government haters.

Canadian's are Marxist loving mostly government lovers.

American's ,as you see in the great health care debate, are more than that.

America is America for a reason.

Canada is Canada for a reason.

Don't try to push Cuba, Vietnam's or Canada's rationed health care on American's.

Maybe France's or another private/public system but surely not Canada's.

Dav e said...

No matter what America has to say (and I am a dual American/Canadian citizen), in Canada the working poor have health coverage: it's one less worry off their minds. In the U.S., the working poor and the destitute must often rely on state and federal government funded Medicaid insurance , and most American doctors, pharmacists, and dentists refuse to accept Medicaid patients: every aspect of the U.S. health care system(s) is multi-tiered.

Anonymous said...

I'm a dual citizen as well.

And i can tell you that the only thing better in Canada is the access for the poor.

Everything else is worse.

Grant said...

To Anonymous guy at the top of the page... speaking of not understanding things:

1. I'm going to ignore your first point as beneath response.

2. You do realize you just described the US, and NOT Canada, right? There is exactly one person in Canada who tells you whether to see a specialist. Your doctor. Nobody else is in that decision loop. If your doctor says there is some medical need for you to see a specialist, you go see one, the end.

What happens if you're an American citizen and you want to see a specialist for something? Is anyone involved in that decision besides your doctor? Perhaps... the insurance company whose accountant needs to tell you that they'll pay for it? When their JOB is to find a way to REFUSE to do so if they possibly can to protect company profits? Unless of course you're stinking rich and can just write a check for the thousands of dollars specialist care would require... then lucky you!

3. Too bad, you HAVE rationed care. EVERYONE has rationed care. How could you possibly not grasp this?

The Canadians ration based on medical need and leave it to the doctors. If your doctor says you need urgent care you get that care, immediately. If your doctor says you don't need urgent care and there is someone else who does, they go ahead of you and you wait your turn.

In the US they ration largely based on the size of the bank balance of the patient. If you can't afford insurance, you get severely restricted access to care. If you can afford insurance but not GOOD insurance you're often going to find you've been paying all that money to the insurance company so they could turn around when you get seriously expensively ill and say "Oh... we're not paying for that, sorry. Didn't you read the fine print in your policy on page 673, paragraph 4? If you're really rich you can of course get any care you want by writing a big check. If you think that’s a situation where 90% of the country DOESN'T have rationed care right now you're deluded.

4. Actually, Americans IMAGINE that Canadians have to go to the US for care all the time. They don't. That's a fairy tale invented by the US insurance industry back in the 90s the last time serious health care reform was on the table. But guess what? When they started telling that to people, someone decided to study it:

http://content.healthaffairs.org/cgi/content/full/21/3/19

It was a lie then, and nothing has changed since. Oh sure, there are a small handful of Canadians occasionally trickling across the border and receiving medical care. Of course there were also something like an estimated million Americans who went overseas for medical treatment last year too...

To be continued due to char count restriction...

Grant said...

...continuing...

5. I LOVE this one. It’s the greatest laugh out load hilarious argument from Americans on this issue. You do realize that Americans currently pay more for their health care than any other nation on earth? But let me give you the exact numbers as of 2005 (latest available OECD data) then you tell me all about how scary it is to think of paying those massive amounts the Canadians have to pay, those poor souls...

Public (that's tax dollar) spending on health care in 2005:

Canada: 6.9% of GDP. Or $2,263US per person.
US: 6.85% of GDP. Or $2,695US per person. (higher US per capita GDP)

Oops. Where exactly are those giant tax increases you're afraid of?

But wait, there's more!

You see, for those tax dollars Canadians get most of their health care needs met. I know it's a novel idea, but they actually GET SOMETHING for their tax money. And what that means is that they have very little remaining out of pocket expenses that need to be paid towards health care. THOSE numbers are:

Canada: 2.91% of GDP, or about $955US out of pocket per person after taxes.

US: 8.4% of GDP, or about $3,320US out of pocket after taxes.

Now, in case you had trouble following that, let me sum it up. you have just argued that you would rather pay $100 in taxes and $150 out of pocket to get a service, than pay $101 in taxes and $50 out of pocket to get the same (actually, slightly better) service, because $100 in taxes is less than $101 in taxes and lower taxes are always good! Yay! Go USA!

And just nevermind that you argued your way into paying $250 for something you could have had for $151.. you paid $1 less taxes! And lower taxes means you win! Because taxes are evil! Woo!

That’s genius. You sure showed those clueless Canadians with their silly higher taxes.

6. Oh right, of course... how could I have overlooked that all the hundreds of billions of extra dollars paid every year to health insurance company executives, their lawyers whose job it is to screw you out of coverage, and the accountants and billing departments, and the advertising agencies... is the reason The US has many large pharmaceutical researchers! It has nothing to do with you having a really large economy for them to operate in... or the MASSIVE GOVERNMENT SUBSIDIES they receive to perform that research. Nope, it's all about your huge insurance premiums and all those companies will just vanish if you start paying more reasonable rates. Uh-huh.

7. Are you posting from a parallel universe? Last time I checked Canada was grouped above Finland and Australia for it's health care system... while THE US was sandwiched between Costa Rica and Slovenia.

8. Canadians understand that many doctors are now starting to move back to avoid dealing with the massive increased administrative overhead and malpractice threats in the US that eat away all that extra salary while denying them the ability to focus on actually providing medical care to their patients.

Well, that should about wrap things up. Been fun.

Anonymous said...

Good diatribe nutbar.

However, you have failed miserably.

American's have the best everything, including health care.

If they didn't Belinda Stronach would have never went to California.

Case closed.

Access is a problem in the USA. The level of care however, is beyond the rest of the world.

Again, case closed.

Anonymous said...

"To examine the extent to which Canadian residents seek medical care across the border, we collected data about Canadians’ use of services from ambulatory care facilities and hospitals located in Michigan, New York State, and Washington State during 1994–1998."

Are you serious?

You use a study from 1998 to justify your loony position in 2009?

Grow up.

The Canadian government could easily up the information about how much money and for what services they have sent Canadians to the USA for.

The fact Canadians and the media in Canada hide those facts prove my point.

You can have the same health care system as Cuba and Vietnam.

Canada is more or less the same as those two country's anyway.

America is America.

Completely different than Canada.

I find it funny that Canadian's don't even realize that American's pay for their health care.

85% of Canadian exports go to the USA, so without those exports, there is no health care in Canada.

Canada is no role model for anything in the world.

Health care being one.

Grant said...

Wow... you sure showed me! I should have known better than to try to argue with someone who had mastered the supreme tactic of:

[Make bald faced ridiculous assertion like "Americans have the best everything"... add "case closed!"].

There's simply no defeating you! Your debate-fu is too strong! The fact that a lady came to the US to get some medical procedure done TOTALLY establishes the relative quality of the two health care systems covering a combined ~350 million people! Why didn't I think of that? Duh, I feel so stupid.

I mean, If I was going to argue about comparative levels of care in two entire nations health care systems I might have done something boneheaded like refer to a scientific systematic review of multiple studies of comparative health outcomes across a wide variety of conditions and medical procedures or something... like, oh, this one:

http://www.openmedicine.ca/article/view/8/1

...which compiled dozens of scientific studies on the results of treatment of everything from cancer to coronary artery disease to various chronic illnesses to surgical procedures in the two countries... and then pointed out that while the two systems produce roughly comparable results Canada is the one with the edge in positive outcomes... but boy would I have made a fool of myself eh? No way can that possibly complete with "look what this lady did". I am simply outclassed it seems. Because, after all... "case closed" right?

And oh my god! Do I feel like a dunce for using the most recent comprehensive study of cross border patient behavior between the US and Canada as a data point in an argument when it was an entire 10 years old. I mean, in the last 10 years the health care systems of those two countries have obviously COMPLETELY CHANGED and that would totally invalidate the results since the behaviors of all 33 million people in Canada would have also changed right along with it.. as, once again, illustrated by the obvious fact that you fond some lady who crossed the border for care which therefore means that's what the average Canadian does like.. every week! How could I not have realized this before? How could I have missed when the US, for example, totally tore down and rebuilt it's entire health care system in 2002? I mean, sure everyone else on the planet missed it too... but that's no excuse! Thank you so much for enlightening me!

And good grief! I totally overlooked the massive Canadian government conspiracy to hide from the world the fact that this is happening, but it's so obvious now that you point it out! I just keep feeling dumber and dumber...


Plus... Americans PAY FOR THEIR HEALTHCARE!?!?!?!??! OH. MY. GOD. You're RIGHT! I NEVER realized that before!

And holy crap! The majority of Canadian exports go to the only country they share a land based border with? That just completely blows my mind!


Toggling the sarcasm switch for a moment... had enough of doing this yet or would you like to continue making an idiot of yourself?