Monday, November 09, 2009

Oh Canada! - excellent NY Times letter response on health reform

I read an extroidinarilary good comment on this article  in the "Prescriptions Blog" NY Times today that I thought was worth reprinting. It was a response to another comment from a Canadian chastising the United States and pointing out what an absurd and misleading benchmark it is to compare the systems and problems of Canada to the United States in many respects:
“Let me tell you about my life. We (Canadians) have health care that is equal to that which an insured American gets for about 1/3 the cost. ”

Let me tell you about Canada. It is 1/10 the size of the US. There is this thing called scaling. Take any program and scale it up 10x and see what happens.

First off it is about 1/2 the cost, not 1/3. US is 2.2x more expensive per capita.

Healthcare is not equal. The infamous study that ranked the US so low overall grugding concluded it was tops in choice and quality. Per capita spending is about double for Canada.
But guess what, the US is top in a number of things that add to that cost. Some examples:
#1 in teen pregnancy (20 times more than Canada)
#1 in obesity (more than twice that of Canada)
#2 in abortions (about 15 times more than Canada)

“We pay about 1/2 the cost for prescription drugs.”
Because the US is in effect subsidizing the Canadian government’s negotiated prices.

“We have about 1/10 the level of gun violence in our country”
Which means healthcare in the US has to be higher to cover those violence related injuries. Which are treated in emergency rooms so they are very expensive.

The US has about, at low estimate, 12M illegals. Canada, by high estimate, has 120K. That is 100x more in the US.

So, once you tried to scale the Canadian system into the US with its differing problems, but trying to keep the same high choice and high quality levels, I would not be surprised to see that medical costs per capita would be very similar to what they are today. Single payer being cheaper per capita in the US than what we have now has NEVER been substantiated. What single payer in the US would do is make it APPEAR cheaper (how many post here have talked about FREE Canadian or English healthcare) to many by placing a higher burnen on higher income earners. The Dems don’t want single payer because it will reduce overall costs, they want it because it can easily be turned into the most progressive payments system around.


Anonymous said...

That is nothing resembling an "extraordinarily good comment". It is in fact completely asinine.

First of all, it repeats the popular and never to be sufficiently derided claim that health insurance is harder to implement effectively and cheaply in the US because of a larger population. Insurance works *BETTER* in larger populations, the entire point of insurance is risk pooling. Large populations accomplish that more efficiently than small ones. That's not a matter of opinion, that's a basic reality of the math. With a larger population you can more accuralety project population wide health issue occurances and set premiums lower with less risk of catastrophicly exceeding your operating funds because of unanticipated localized health problems in the patient population. And you can leverage stronger negotiating power with care providers to keep control of cost of service. Both of these things lower insurance costs. Anyone who doesn't understand that doesn't understand the first thing about insurance provision and really shouldn't be spouting off and making an idiot of themselves on the subject.

Additionally, that study showed US care was tops in choice and quality *for those able to adequately access the system at all*. Unfortunately the number of people able to do that without bankrupting themselves is abysmally bad relative to any other indurstialized nation.

The it goes off into the scapegoating... it's the illegal aliens! It's the fat people! It's the teenage mothers! It's not the horrendously bad insurance system... oh no... that's impossible. I mean every other industrialized nation on the face of planet earth has not just lower costs, but MASSIVELY lower costs... but that's because only the U.S. ever has any serious health issues with it's population. Every other induistrialized nation on the planet all have naturally perpetually healthy cheaply cared for populations. Really! Only in the US is there ever any aspect of the patient population that's excessively costly to care for or places an unusually high burden on the system!

Etc... that article was embarassingly ignorant.

realtor in Vancouver said...

Excellent comment indeed. Some people in the US need to realize that comparing their proposed system and the Canadian system is out of the question. That's how the stupid rumors and hoaxes appear on the front pages of stupid newspapers. Plus the outcome will always be different. I'd say the American society has been always a bit spoiled when it comes to health care and been using it to solve every little problem. In the US, it's common to see the doctor when you're feeling sick after a wild night out. So first of all, cutting down the cost would mean reshaping the mentality of the whole nation, which is impossible in these days...

Take care, Jay

Medical Spa MD said...

A fantastic post. Love to have you guest post on Medical Spa MD sometime.

Michael C. Pickart, M.D., F.A.C.S. said...

Can't wait to read what you think of the BoTAX!