Monday, June 29, 2009


Health care: U.S. vs Canada

About a year and a half ago, former Canadian Prime Minister Kim Campbell was on the Brian Lehrer Show on WNYC, the local public radio station here in New York. Among other things, the topic of health-care coverage came up (listen at 30:10 into the audio), and Ms Campbell said, as part of her answer, “It’s interesting, because there are all sorts of myths here about Canadian health care, and I can’t answer all of them now, but the point is that the system is rational and it is accountable to the public.”

At the time, I wished I could contact Ms Campbell and get her list of myths. But now another Canadian — this time, Rhonda Hackett, a clinical psychologist now living outside of Denver — has written an article about Canadian health-care myths, published a few weeks ago in the Denver Post.

Read the article; it makes a number of things very clear. Allow me to summarize some points that one gets from Ms Hackett’s list:

United States: 31% of health-care money goes to overhead (paperwork, company salaries & profits, and so on).
Canada: 1% of health-care money goes to overhead.

United States: 17% of the gross domestic product (GDP) is spent on health care.
Canada: 10% of the GDP is spent on health care.

United States: Less than 85% of the population is covered, and many of those have inadequate coverage. The U.S. has many “hidden” costs when uncovered people go to emergency facilities in order to get health care.
Canada: 100% of the population is covered through the normal system.

United States: Insurance companies often overrule doctors’ health-care decisions.
Canada: Your doctors are the only ones who make your health-care decisions.

United States: 14.4% say they have unmet health-care needs.
Canada: 11.3% say they have unmet health-care needs.

United States: You have to find a doctor who’s in your health insurance plan.
Canada: You go to any doctor.

United States: Doctors are private businesses; they do not work for the government. Their fees are reimbursed by the health insurers.
Canada: Doctors are private businesses; they do not work for the government. Their fees are reimbursed by the government, which acts as the health insurer.

Ms Hackett finishes with a story of her aunt, who’s waited 14 months in Canada for elective knee-replacement surgery. The wait may sound bad, until you realize that she will get her new knee next month. In the U.S., she could not have afforded it, ever.

Further, according to Ms Hackett, Canadians do not pay significantly higher taxes, overall.


Ray said...

My brother lives in Canada, and his wife was diagnosed with cancer late last year. From that time until she died in April this year, they did not have to pay a single penny for the costs involved in her treatment: X-rays, MRIs, chemotherapy, radiation, medication, a special bed at home, multiple (per day) home visits by nurses and other carers, home visits by doctors, emergency supplies (needles & morphine for when the pain inevitably became worse), and finally hospice care.


No endless forms to fill in, no flood of bills, just peace of mind knowing that all that could be done was being done, and that they did not have the additional burden of wondering how they were going to pay for all of this.

On the other hand, I had a routine colonoscopy here in the US last October, and today, eight months later, I am *still* receiving bills from the multitude of people who were apparently involved in this minor, everyday procedure.

Similar stories to that of my sister-in-law exist in all the other countries where health care is provided to all. The US is not just a glaring exception, it is a flood light, or rather a supernova pointing out how *not* to care for its citizens. It simply astonishes me that there is still a sizable number of people who are against universal health care, and it is a most eloquent example of the power of brainwashing.

Sue VanHattum said...

>Further, according to Ms Hackett, Canadians do not pay significantly higher taxes, overall.

Well, it has to be paid for somehow, so I suppose what we pay for our boated military, they pay for good health care instead.

But if we made this change, it would make sense to see our taxes go up, and (for those of us with 'good' health insurance) our paychecks go up too, when our employers stop having to pay for our health insurance.

Hamster said...

I live in the United States
I am 62
I am self employed.
I am in good health but my wife has a pacemaker and takes statins.
All I can afford is catastrophic health insurance.
My Blue Shield family plan for my wife and myself costs us $900 a month
The deductible is $8000 per year so I rarely see a doctor unless it’s an emergency.
I have tried every option..even starting my own group plan.
But the premiums would be more than my mortgage payment.
I don’t think I can continue this way, especially with my business being down because of the economy.
I am thinking about canceling my health insurance and taking a chance that I won’t need a heart bypass, get cancer or need a liver transplant.
If I do, I am told I can file for bankruptsy.
Any ideas?

P.S. I envy those who live in Canada. Right now I’d settle for a socialized medicine. I might have to wait for treatment but it’s a lot better than the private health insurance plan I have now. Now I avoid seeing the doctor unless it's an emergency
Anyone out there in my shoes whose got a better way to get affordable medical care???

Anonymous said...

Hi, Barry.

This is the most informative and un-biased comparison I've read. I was just saying to my Dear Mom the other day: I would like to hear/read an informed and objective comparison of the Canadian and US health care systems - comparisons that aren't filled with Right-wingnut scare tactics, and generalized lack of information from Liberals.

Thank you. :)

D. said...

United States: 14.4% say they have unmet health-care needs.
Canada: 11.3% say they have unmet health-care needs.

I can imagine some using this to make the argument that we don't need to revamp our entire health care system in order to better satisfy some 3% of the population.

In the meantime, I am recently unemployed, and am having to weigh whether I can afford to enroll in Cobra, or have enough for food and gas.

I find myself wondering what a Libertarian or those against a national health care plan would have to say to me about this.

Barry Leiba said...

D: Right, just a raw number doesn't say anything about what needs are unmet. One Canadian person saying "I had to wait 2 months for an appointment," is not the same as one American saying, "I can't afford any health care at all, so the only thing I get is the occasional 'free' trip to the emergency room."

So I'm not sure what that particular stat means. I included it because the writer included it.

Lorne said...

It's hard to hear such stories; yes we have problems with wait times, but it's usually not so critical and most of the treatments you get on time
there are only 2 problems in Canada I would stress:
lower wages cause lack of therapists
it's very hard to break the administrative borders and get special treatment or services you want, even if you are willing to pay for it cash.
btw dont blame just the market! Your health care public spendings per capita are similar to Canadian. Something is completely wrong there, bu it's not just question of market...