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UNDERNEWS

Undernews is the online report of the Progressive Review, edited by Sam Smith, who covered Washington during all or part of one quarter of America's presidencies and edited alternative journals since 1964. The Review, which has been on the web since 1995, is now published from Freeport, Maine. See main page for full contents

June 16, 2009

CANADIAN HEALTH CARE MYTHS

Rhonda Hackett, Denver Post - As a Canadian living in the United States for the past 17 years, I am frequently asked by Americans and Canadians alike to declare one health care system as the better one.

Often I'll avoid answering, regardless of the questioner's nationality. To choose one or the other system usually translates into a heated discussion of each one's merits, pitfalls, and an intense recitation of commonly cited statistical comparisons of the two systems.

Because if the only way we compared the two systems was with statistics, there is a clear victor. It is becoming increasingly more difficult to dispute the fact that Canada spends less money on health care to get better outcomes. . .

As America comes to grips with the reality that changes are desperately needed within its health care infrastructure, it might prove useful to first debunk some myths about the Canadian system.

Myth: Taxes in Canada are extremely high, mostly because of national health care.

In actuality, taxes are nearly equal on both sides of the border. Overall, Canada's taxes are slightly higher than those in the U.S. However, Canadians are afforded many benefits for their tax dollars, even beyond health care (e.g., tax credits, family allowance, cheaper higher education), so the end result is a wash. At the end of the day, the average after-tax income of Canadian workers is equal to about 82 percent of their gross pay. In the U.S., that average is 81.9 percent.

Myth: Canada's health care system is a cumbersome bureaucracy.

The U.S. has the most bureaucratic health care system in the world. More than 31 percent of every dollar spent on health care in the U.S. goes to paperwork, overhead, CEO salaries, profits, etc. The provincial single-payer system in Canada operates with just a 1 percent overhead. Think about it. It is not necessary to spend a huge amount of money to decide who gets care and who doesn't when everybody is covered.

Myth: The Canadian system is significantly more expensive than that of the U.S.

Ten percent of Canada's GDP is spent on health care for 100 percent of the population. The U.S. spends 17 percent of its GDP but 15 percent of its population has no coverage whatsoever and millions of others have inadequate coverage. In essence, the U.S. system is considerably more expensive than Canada's. Part of the reason for this is uninsured and underinsured people in the U.S. still get sick and eventually seek care. People who cannot afford care wait until advanced stages of an illness to see a doctor and then do so through emergency rooms, which cost considerably more than primary care services. . .

Myth: Canada's government decides who gets health care and when they get it.

While HMOs and other private medical insurers in the U.S. do indeed make such decisions, the only people in Canada to do so are physicians. In Canada, the government has absolutely no say in who gets care or how they get it. Medical decisions are left entirely up to doctors, as they should be.

There are no requirements for pre-authorization whatsoever. If your family doctor says you need an MRI, you get one. In the U.S., if an insurance administrator says you are not getting an MRI, you don't get one no matter what your doctor thinks - unless, of course, you have the money to cover the cost.

Myth: There are long waits for care, which compromise access to care.

There are no waits for urgent or primary care in Canada. There are reasonable waits for most specialists' care, and much longer waits for elective surgery. Yes, there are those instances where a patient can wait up to a month for radiation therapy for breast cancer or prostate cancer, for example. However, the wait has nothing to do with money per se, but everything to do with the lack of radiation therapists. Despite such waits, however, it is noteworthy that Canada boasts lower incident and mortality rates than the U.S. for all cancers combined, according to the U.S. Cancer Statistics Working Group and the Canadian Cancer Society. . .

Myth: Canadians are paying out of pocket to come to the U.S. for medical care.

Most patients who come from Canada to the U.S. for health care are those whose costs are covered by the Canadian governments. If a Canadian goes outside of the country to get services that are deemed medically necessary, not experimental, and are not available at home for whatever reason (e.g., shortage or absence of high tech medical equipment; a longer wait for service than is medically prudent; or lack of physician expertise), the provincial government where you live fully funds your care. Those patients who do come to the U.S. for care and pay out of pocket are those who perceive their care to be more urgent than it likely is.

Myth: Canada is a socialized health care system in which the government runs hospitals and where doctors work for the government.

Princeton University health economist Uwe Reinhardt says single-payer systems are not "socialized medicine" but "social insurance" systems because doctors work in the private sector while their pay comes from a public source. Most physicians in Canada are self-employed. They are not employees of the government nor are they accountable to the government. Doctors are accountable to their patients only. More than 90 percent of physicians in Canada are paid on a fee-for-service basis. Claims are submitted to a single provincial health care plan for reimbursement, whereas in the U.S., claims are submitted to a multitude of insurance providers. Moreover, Canadian hospitals are controlled by private boards and/or regional health authorities rather than being part of or run by the government.

Myth: There aren't enough doctors in Canada.

From a purely statistical standpoint, there are enough physicians in Canada to meet the health care needs of its people. But most doctors practice in large urban areas, leaving rural areas with bona fide shortages. This situation is no different than that being experienced in the U.S. Simply training and employing more doctors is not likely to have any significant impact on this specific problem. Whatever issues there are with having an adequate number of doctors in any one geographical area, they have nothing to do with the single-payer system.

Rhonda Hackett of Castle Rock, Colorado is a clinical psychologist.

8 Comments:

Anonymous robbie said...

with respect, these are most all Republican talking points. The author's eloquent and detailed debunking of these myths will fall on deaf ears. Hannity, Limbaugh, etc., have told them it is "socialized medicine" and that's all the minions will believe.

June 17, 2009 6:48 AM  
Anonymous Anonymous said...

Robbie, you sound like every other left wing loon. Unless you actually live it you will never truly know. People like you have to quit believing everything you read on the internet no matter what the source. Your one of those people that if it fits what you believe then you will take it as fact.

June 25, 2009 12:40 PM  
Anonymous Anonymous said...

Yeah. I mean, "Anonymous" knows for a fact that if you don't treat Rush Limbaugh as the voice from the Burning Bush, then you're a left-wing loon.

August 20, 2009 1:40 PM  
Anonymous CJ said...

I found this very informative, but would really appreciate links to sources for the facts and figures included. Otherwise, I am unable to point friends and acquaintances here, because they would simply dismiss any arguments without reliable sources. (Some of them would dismiss even if there were reliable sources cited, but that's beside the point.)
Thanks!

September 1, 2009 5:49 PM  
Anonymous Anonymous said...

The insurance company I work for doesn't spend anywhere near 31 cents on the dollar for admin. But I know that we spend a LOT of money combating fraud. Does Canada have the same issues with people trying to defraud the system?

September 2, 2009 9:06 AM  
Blogger AVANCE said...

How would you defraud an egalitarian health care system and what would be the point of doing so?

September 6, 2009 11:51 AM  
Blogger john said...

I know that in Nova Scotia you'll get a letter from the NS government with a yes-no card to send back, to verify that you actally saw a certain physician on whatever the date was. You usually get something like that perhaps once or twice a year.

September 12, 2009 7:30 PM  
Anonymous Anonymous said...

Average wait time in the ER is significantly longer than in the US.
http://www.cbc.ca/health/story/2008/05/21/ot-er-waits-080521.html?ref=rss

"Those patients who do come to the U.S. for care and pay out of pocket are those who perceive their care to be more urgent than it likely is."
And this is based on....

November 8, 2009 2:57 AM  

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