Health Care Watch: A Canadian Diagnosis

By GottaLaff

The L.A. Times has a great piece out today, written by Michael M. Rachlis. He is a physician, health policy analyst, and author in Toronto. Check this out:

[U]ntil 50 years ago, we [Canada, U.S.] had similar health systems, healthcare costs and vital statistics. [...]

On coverage, all Canadians have insurance for hospital and physician services. There are no deductibles or co-pays. Most provinces also provide coverage for programs for home care, long-term care, pharmaceuticals and durable medical equipment, although there are co-pays.

On the U.S. side, 46 million people have no insurance, millions are underinsured and healthcare bills bankrupt more than 1 million Americans every year.

Lesson No. 1: A single-payer system would eliminate most U.S. coverage problems.

On costs, Canada spends 10% of its economy on healthcare; the U.S. spends 16%. The extra 6% of GDP amounts to more than $800 billion per year. The spending gap between the two nations is almost entirely because of higher overhead. [...]

Even the U.S. Medicare program has 80% to 90% lower administrative costs than private Medicare Advantage policies. And providers and suppliers can't charge as much when they have to deal with a single payer.

Lessons No. 2 and 3: Single-payer systems reduce duplicative administrative costs and can negotiate lower prices. [...]

Lesson No. 4: Single-payer plans can deliver the goods because their funding goes to services, not overhead. [...]

Notwithstanding a few well-publicized and misleading cases, Canadians needing urgent care get immediate treatment. But we do wait too long for much elective care, including appointments with family doctors and specialists and selected surgical procedures. We also do a poor job managing chronic disease. [...]

[B]oth the American and the Canadian systems fare badly in these areas. [...]

On closer examination, most of these problems have little to do with public insurance or even overall resources. [...]

Lesson No. 5: Canadian healthcare delivery problems have nothing to do with our single-payer system and can be fixed by re-engineering for quality. [...]

American democracy runs on money. Pharmaceutical and insurance companies have the fuel. [...]

Compounding the confusion is traditional American ignorance of what happens north of the border, which makes it easy to mislead people. [...] The U.S. media, legislators and even presidents have claimed that our "socialized" system doesn't let us choose our own doctors. In fact, Canadians have free choice of physicians. It's Americans these days who are restricted to "in-plan" doctors.

Unfortunately, many Americans won't get to hear the straight goods because vested interests are promoting a caricature of the Canadian experience.

Please read the rest here.