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    Sunday, September 24, 2006

    Canadian Truth: A Canadian explains Canada's healthcare system. The health policy wonks here in the U.S. often tout Canada's system as the gold standard, and claim that having the government assume all of our healthcare cost will save money because none would be going to the extravagant salaries of insurance company CEO's. Think again:

    Just three years into government–run hospital care in British Columbia, in 1952, the government noted that "the demands for additional beds and better standards of service are being put forward on all sides, presumably with the assumption that someone other than the proposer will pay for them. It seems the government is expected to satisfy these demands at no additional cost to the people."

    In the past 30 years, total per capita health–care spending in Canada more than doubled in real dollar terms; health spending was 10.4 percent of GDP in 2005. The private sector's share of the "single–payer" system has increased 27.7 percent since 1975. If it hadn't, our infamous waiting lists and other rationing would be worse. People paying out–of–pocket and private insurers have picked up the slack and will continue to do so—to the benefit of our health.

    The idea that a state government can pay for virtually every health–care service and save money doing it can be called many things–just don't call it Canadian.
     

    posted by Sydney on 9/24/2006 08:31:00 AM 4 comments

    4 Comments:

    You said "In the past 30 years, total per capita health–care spending in Canada more than doubled in real dollar terms; health spending was 10.4 percent of GDP in 2005. "

    And still in the US how much has the total health-care percapita spending increased, and isn't health spending about 15% or more of GDP in the US?

    If you compare the health of Britons to citizens of the US - such as in this JAMA article from May 2006.


    "Conclusion: Based on self-reported illnesses and biological markers of disease, US
    residents are much less healthy than their English counterparts and these differences
    exist at all points of the SES distribution."

    So for a F**ked up system the NHS does a better job than the US privatised model.

    Cheers
    Benedict

    By Blogger Benedict 16th, at 6:51 AM  

    Benedict,
    A bit testy aren't we? Anyone with a morsel of knowledge about medicine would not attempt to correlate health itself with health care. Especially given Americans' proclivity for overeating and a sedentary lifestyle, fast cars, isolated rural highways and guns- all of which are easier to come by here than across the pond. That JAMA article does nothing to disprove this concept. In fact, others have editorialized that since it is a self-reported survey (and thus rife with potential bias), it may do nothing but reflect the fact that Americans like to complain, vs. the famous British stiff-upper-lip.

    However, if you wish to compare the actual CARE provided, the UK leaves a great deal to be desired. Like postoperative mortality rates four times higher than the US and rampant MRSA in most of the big hospitals. There is simply no comparing The London Clinic with Chelsea-Westminister, sorry.

    As to the Canadian system, I learned in health care econ 101 that the mere existence of a free (or nearly free) service will create demand. Anyone could have predicted THAT would happen. The main difference accounting for the cost of care between the US and Canada is paperwork- 10% vs. around 25% spent on administrative costs. But that's what multiple payers and over-regulation will get us, I suppose.

    By Anonymous Dani, at 6:44 PM  

    Benedict,
    A bit testy aren't we? Anyone with a morsel of knowledge about medicine would not attempt to correlate health itself with health care. Especially given Americans' proclivity for overeating and a sedentary lifestyle, fast cars, isolated rural highways and guns- all of which are easier to come by here than across the pond. That JAMA article does nothing to disprove this concept. In fact, others have editorialized that since it is a self-reported survey (and thus rife with potential bias), it may do nothing but reflect the fact that Americans like to complain, vs. the famous British stiff-upper-lip.

    However, if you wish to compare the actual CARE provided, the UK leaves a great deal to be desired. Like postoperative mortality rates four times higher than the US and rampant MRSA in most of the big hospitals. There is simply no comparing The London Clinic with Chelsea-Westminister, sorry.

    As to the Canadian system, I learned in health care econ 101 that the mere existence of a free (or nearly free) service will create demand. Anyone could have predicted THAT would happen. The main difference accounting for the cost of care between the US and Canada is paperwork- 10% vs. around 25% spent on administrative costs. But that's what multiple payers and over-regulation will get us, I suppose.

    By Anonymous Dani, at 6:48 PM  

    Canadians are starting to face the truth about universal coverage. Last month, Canadian doctors elected Brian Day as their future president. Day is clearly an advocate of what we call here a "two-tiered" or "two-speed" system.

    From the latest CMA Newsletter:

    Public-private issues dominate annual meeting
    Debate on the relationship between public and private medicine dominated
    many aspects of the CMA’s 139th annual meeting in August, including the selection
    of the new president-elect.
    The media painted the election contest between Drs. Brian Day and Jack Burak
    as a black-and-white battle between the forces of privatization (Day) and public
    medicine (Burak), but Day quickly put the issue to rest after he won the Aug. 22
    vote. “Listen to what I say, not to what people say I say,” he told reporters.
    Earlier, in addressing General Council delegates, Day commented: “My support
    for universal health care is unequivocal.”
    Day will assume the presidency at next year’s annual meeting in Vancouver.
    Burak was gracious in defeat, telling the Globe and Mail that “Dr. Day is a breath
    of fresh air.”
    Delegates voted on more than 20 motions concerning the relationship
    between the public and private sectors. They approved a motion asking governments
    to remove bans that prevent physicians from practising in both sectors, but
    also asked the CMA to develop a code of conduct for doctors who do this that
    balances professional autonomy with social responsibility. They also voted against
    establishing health insurance services that would lead to a parallel private system.
    President Ruth Collins-Nakai said delegates delivered a “mixed” message.
    “What delegates did say is that they do not want to close the door on any potential
    solution to improving access for our patients.”
    She said the meeting also left no doubt that Canada’s MDs “continue to support
    the principle that access to care must be based on need, not ability to pay.”

    http://www.cma.ca/multimedia/CMA/Content_Images/Inside_cma/CMA_Bulletin/English/2006/bulletinSept12.pdf

    By Anonymous Emmanuel M, at 12:29 PM  

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