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May 2 / Jonathan

Comparing Canadian health care

(Cleaning out my closet of health-care pieces.)

Ezra Klein points us to a new study comparing Canadian to US health care outcomes.

Canada vs. America
It’s not that the data shows unbelievable advantages for Canada, to be sure. As the authors conclude, “although Canadian outcomes were more often superior to US outcomes than the reverse, neither the United States nor Canada can claim hegemony in terms of quality of medical care and the resultant patient-important outcomes.” The question raised is slightly different: How can we possibly countenance a system that costs twice as much as the Canadian system but delivers slightly worse care? Even assuming diminishing returns, our expenditures should result in care outcomes at least 20% or 30% better than Canada’s. Instead, they’re about 5% worse, but cost around 187%. Does it sound like we’re getting a good deal?

5 Comments

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  1. Mark Swanson / May 12 2007

    Hey Jonathan,

    The study you link was a lot more humble in its conclusions:
    “Available studies suggest that health outcomes may be superior in patients cared for in Canada versus the United States, but differences are not consistent”

  2. Jonathan / May 12 2007

    As Klein pointed out, “of the 38 studies examined, 14 showed clear advantaged for Canadian patients, five suggested US care was superior, and the remainder were mixed.”

    And the study itself: “Canadian health care has many well-publicized limitations. Nevertheless, it produces health benefits similar, or perhaps superior, to those of the US health system, but at a much lower cost. Canada’s single-payer system for physician and hospital care yields large administrative efficiencies in comparison with the American multi-payer model. Not-for-profit hospital funding results in appreciably lower payments to third-party payers in comparison to for-profit hospitals while achieving lower mortality rates. Policy debates and decisions regarding the direction of health care in both Canada and the United States should consider the results of our systematic review: Canada’s single-payer system, which relies on not-for-profit delivery, achieves health outcomes that are at least equal to those in the United States at two-thirds the cost.”

    Let’s agree that quality of care isn’t significantly different. What’s the extra cost buying us?

  3. Alexis Finlay MD / Oct 18 2007

    This was sent from Canada to a friend in the States.

    A BLOG circulating in the New York KeratoRefractive Society

    I saw on the news up here in Canada where Hillary Clinton introduced her new health care plan. Something similar to what we have

    in Canada. I also heard that Michael Moore was raving about the health

    care up here in Canada in his latest movie. As your friend and someone who lives with the Canada health care plan I thought I would give you some facts about this great medical plan that we have in Canada.

    First of all:

    1) The health care plan in Canada is not free. We

    pay a premium every month of $96. for Shirley and I to be covered. Sounds great eh. What they don’t tell you is how much we pay in taxes to keep the health care system afloat. I am personally in the 55% tax bracket. Yes 55% of my earnings go to taxes.

    A large portion of that and I am not sure of the exact amount goes directly to health care our #1 expense.

    2) I would not classify what we have as health care

    plan, it is more like a health diagnosis system. You can get into to see a

    doctor quick enough so he can tell you “yes indeed you are sick or you need an operation” but now the challenge becomes getting treated or operated on. We have waiting lists out the ying yang some as much as 2 years down the road.

    3) Rather than fix what is wrong with you the usual tactic in Canada is to

    prescribe drugs. Have a pain here is a drug to take- not what is causing

    the pain and why. No time for checking you out because it is more important to move as many patients thru as possible each hour for Government re-imbursement

    4) Many Canadians do not have a family Doctor.

    5) Don’t require emergency treatment as you may wait

    for hours in the emergency room waiting for treatment.

    6) Shirley’s dad cut his hand on a power saw a few weeks back and it required that his hand be put in a splint – to our surprise we had to pay $125. for a splint because it is not covered under health care plus we have to pay $60. for each visit for him to check it out each week.

    7) Shirley’s cousin was diagnosed with a heart blockage. Put on a waiting

    list Died before he could get treatment.

    8) Government allots so many operations per year.

    When that is done no more operations, unless you go to your local newspaper and plead your case and embarrass the government then money suddenly appears.

    9)The Government takes great pride in telling us how much more they are

    increasing the funding for health care but waiting lists never get shorter. Government just keeps throwing money at the problem

    but it never goes away. But they are good at finding new ways to tax us, but they don’t call it a tax anymore it is now a user fee.

    10) A friend needs an operation for a blockage in her leg but because she is a smoker they will not do it. Despite paying into the health care system

    all these years. My friend is 65 years old. Now there is talk that maybe

    we should not treat fat and obese people either because they are a drain on the health care system. Let me see now, what we want in Canada is a health care system for healthy people only. That should reduce our health care costs.

    11) Forget getting a second opinion, what you see is

    what you get.

    12) I can spend what money I have left after taxes on booze, cigarettes, junk food and anything else that could kill me but I am not allowed by law to spend my money on getting an operation I need because that would be jumping the queue. I must wait my turn except if I am a hockey player or athlete then I can get looked at right away. Go figure. Where else in the world can you spend money to kill yourself but not allowed to spend money to get healthy.

    13) Oh did I mention that immigrants are covered automatically at tax payer expense having never contributed a dollar to the system and pay no premiums.

    14) Oh yeah we now give free needles to drug users to try and keep them

    healthy. Wouldn’t want a sickly druggie breaking into your house and stealing your things. But people with diabetes who pay into the health care system have to pay for their needles because it is not covered by the

    health care system.

    I send this out not looking for sympathy but as the election looms in the

    States you will be hearing more and more about universal health care down there and the advocates will be pointing to Canada. I just want to make sure that you hear the truth about health care up here and have some food for thought and informed questions to ask when broached with this subject.

    Step wisely and don’t make the same mistakes we have.

  4. Jonathan / Oct 23 2007

    Gee, Canada’s health care system sounds pretty terrible, doesn’t it? Perhaps they should adopt the US model: spend twice as much, have worse outcomes, and leave a substantial portion of the populace without coverage.

    Yeah, that’s the ticket.

  5. Jonathan / Jan 27 2008

    Comment #3 seems to be getting around quite a bit. Here’s the relevant Snopes link: http://www.snopes.com/politics/medical/canada.asp

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