http://www.aarp.org/politics-society/government-elections/info-03-2012/myths-canada-health-care.html
Excellent article. Use the link, as the graphs did not come in the mail I
am forwarding.
I find it competently understandable why our Government Representatives
are attacking Medicare...... because it is a single payer plan.... it cuts
out the 40+% additional cost for health care, that enrichen the HMO's and
Insurance Giants..... as if they did anything to make you or I well.....
more like you will be needing a doctor after the anxiety they cause.
Scott
5 Myths About Canadas Health Care System
The truth may surprise you about international health care
by: Aaron E. Carroll, M.D., M.S. | from: AARP | April 16, 2012
Health care systems differ, and there can be many myths about their pros
and cons. Photo by RK Studio/Kevin Lanthier/Getty Images
How does the U.S. health care system stack up against Canadas?
Youve probably heard allegedly true horror stories about the Canadian
system like 340-day waits for knee replacement surgery, for example.
To separate fact from fiction, Aaron E. Carroll, M.D., the director
of the Center for Health Policy and Professionalism Research in
Indianapolis, identified the top myths about the two health care
systems.
.
Myth #1: Canadians are flocking to the United States to get medical
care.
How many times have you heard that Canadians, frustrated by long wait
times and rationing where they live, come to the United States for
medical care?
I dont deny that some well-off people might come to the United
States for medical care. If I needed a heart or lung transplant, theres
no place Id rather have it done. But for the vast, vast majority of
people, thats not happening.
The most comprehensive study Ive seen on this topic it employed
three different methodologies, all with solid rationales behind them
was published in the peer-reviewed journal Health Affairs.
How Many Canadians Use the U.S. Health System?Do not come to the US for
care: 99.39%Come to US for care electively: 0.5%Use the US for emergency
care: 0.11%
Source: Phantoms in the Snow: Canadians Use of Health Care Services in
the United States, Health Affairs, May 2002.
The authors of the study started by surveying 136 ambulatory care
facilities near the U.S.-Canada border in Michigan, New York and
Washington. It makes sense that Canadians crossing the border for care
would favor places close by, right? It turns out, however, that about 80
percent of such facilities saw, on average, fewer than one Canadian per
month; about 40 percent had seen none in the preceding year.
Then, the researchers looked at how many Canadians were discharged
over a five-year period from acute-care hospitals in the same three
states. They found that more than 80 percent of these hospital visits
were for emergency or urgent care (that is, tourists who had to go to
the emergency room). Only about 20 percent of the visits were for
elective procedures or care.
Next, the authors of the study surveyed Americas 20 best hospitals
as identified by U.S. News & World Report on the assumption
that if Canadians were going to travel for health care, they would be
more likely to go to the best-known and highest-quality facilities. Only
one of the 11 hospitals that responded saw more than 60 Canadians in a
year. And, again, that included both emergencies and elective care.
Finally, the studys authors examined data from the 18,000 Canadians
who participated in the National Population Health Survey. In the
previous year, 90 of those 18,000 Canadians had received care in the
United States; only 20 of them, however, reported going to the United
States expressively for the purpose of obtaining care.
Myth #2: Doctors in Canada are flocking to the United States to practice.
Every time I talk about health care policy with physicians, one
inevitably tells me of the doctor he or she knows who ran away from
Canada to practice in the United States. Evidently, theres a general
perception that practicing medicine in the United States is much more
satisfying than in Canada.
Problem is, its just not so. Consider this chart:
Physician Satisfaction with Practicing
Medicine8989888179777576644839SatisfiedVery
SatisfiedNZNORNETHUKSWEITACANFRAUSAUSGER0255075100Percent
Source: 2009 International Health Policy
Survey of Primary Care Physicians in Eleven Countries, The Commonwealth
Fund, November 2009.
The Canadian Institute for Health Information has been tracking
doctors destinations since 1992. Since then, 60 percent to 70 percent
of the physicians who emigrate have headed south of the border. In the
mid-1990s, the number of Canadian doctors leaving for the United States
spiked at about 400 to 500 a year. But in recent years this number has
declined, with only 169 physicians leaving for the States in 2003, 138
in 2004 and 122 both in 2005 and 2006. These numbers represent less than
0.5 percent of all doctors working in Canada.
So when emigration spiked, 400 to 500 doctors were leaving Canada
for the United States. There are more than 800,000 physicians in the
United States right now, so Im skeptical that every doctor knows one of
those émigrés. But look closely at the tan line in the following chart,
which represents the net loss of doctors to Canada.
Migration of Canadian Physicians, 1970-2010Doctors Leaving CanadaDoctors
Leaving for USDoctors Returning to CanadaNet
Loss19701980199020002010-750-500-2500250500750Number
Source: Canadian Institute for Health Information
In 2004, net emigration became net immigration. Let me say that
again. More doctors were moving into Canada than were moving out.
Myth #3: Canada rations health care; thats why hip replacements and
cataract surgeries happen faster in the United States.
When people want to demonize Canadas health care system and other
single-payer systems, for that matter they always end up going after
rationing, and often hip replacements in particular.
Take Republican Rep. Todd Akin of Missouri, for example. A couple of
years ago he took to the House floor to tell his colleagues:
I just hit 62, and I was just reading that in Canada [if] I got a
bad hip I wouldnt be able to get that hip replacement that [Rep. Dan
Lungren] got, because Im too old! Im an old geezer now and its not
worth a government bureaucrat to pay me to get my hip fixed.
Sigh.
This has been debunked so often, its tiring. The St. Louis
Post-Dispatch, for example, concluded: At least 63 percent of hip
replacements performed in Canada last year [2008] ... were on patients
age 65 or older. And more than 1,500 of those, it turned out, were on
patients over 85.
The bottom line: Canada doesnt deny hip replacements to older people.
But theres more.
Know who gets most of the hip replacements in the United States? Older
people.
Know who pays for care for older people in the United States? Medicare.
Know what Medicare is? A single-payer system.
Myth #4: Canada has long wait times because it has a single-payer system.
The wait times that Canada might experience are not caused by its being a
single-payer system.
Wait times arent like cancer. We know what causes wait times; we know how
to fix them. Spend more money.
Our single-payer system, which is called Medicare (see above),
manages not to have the wait times issue that Canadas does. There
must, therefore, be some other reason for the wait times. There is, of
course. Its this:
Comparison of Per Capita Health Care
SpendingUSCanada19601980200002,5005,0007,50010,000US Dollars
Source: Organisation for Economic Co-operation and Development (OECD)
In 1966, Canada implemented a single-payer health care system, which
is also known as Medicare. Since then, as a country, Canadians have
made a conscious decision to hold down costs. One of the ways they do
that is by limiting supply, mostly for elective things, which can create
wait times. Their outcomes are otherwise comparable to ours.
Please understand, the wait times could be overcome. Canadians could
spend more. They dont want to. We can choose to dislike wait times in
principle, but they are a byproduct of Canadas choice to be fiscally
conservative.
Yes, they chose this. In a rational world, those who are concerned
about health care costs and what they mean to the economy might respect
that course of action. But instead, they attack the system.
Myth #5: Canada rations health care; the United States doesnt.
This ones a little bit tricky. The truth is, Canada may ration by
making people wait for some things, but here in the United States we
also ration by cost.
An 11-country survey carried out in 2010 by the Commonwealth Fund, a
Washington-based health policy foundation, found that adults in the
United States are by far the most likely to go without care because of
cost. In fact, 42 percent of the Americans surveyed did not express
confidence that they would be able to afford health care if seriously
ill.
Adults Avoiding Needed Care Because of
CostUKNETHSWESWINORFRANZCANAUSGERUS010203040Percent
Source: How Health Insurance Design Affects Access to Care and Costs,
by
Income, in Eleven Countries, Health Affairs, November 2010.
Further, about a third of the Americans surveyed reported that, in
the preceding year, they didnt go to the doctor when sick, didnt get
recommended care when needed, didnt fill a prescription or skipped
doses of medications because of cost.
Finally, about one in five of the Americans surveyed had struggled to
pay or were unable to pay their medical bills in the preceding year.
That was more than twice the percentage found in any of the other 10
countries.
And remember: Were spending way more on health care than any other
country, and for all that money were getting at best middling results.
So feel free to have a discussion about the relative merits of the
U.S. and Canadian health care systems. Just stick to the facts.
Aaron E. Carroll frequently blogs about this topic for The Incidental
Economist and is the coauthor of Dont Swallow Your Gum: Myths,
Half-Truths, and Outright Lies About Your Body and Health.
"Whatsoever you do to the least of my people,
that you do unto me."Matthew 25-40
"We had fed the heart on fantasies,
the heart's grown brutal from the fare"William Butler Yeats
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