Universal Health Care - Canada's Solution

(posted 10/17/2011) - During a recent conversation with my cousin we stumbled into an area in which we held opposing views -- mainly the efficiency of national health care service in neighboring Candada.

I took the position that Canada's universal health care was more efficient and cost affective than the US model in which patients either pay retail, negotiate before service, or shop for insurance from competing companies with various plans and qualifiers well in advance of making health claims. My cousin's counter argument was that after researching Canada's health care system and talking with dissatisfied users it was clear that it was forcing patients to wait too long for treatments; they were coming to the US in significant numbers.

Here's the information that I believe refutes such claims. Note that no health service will ever be 100% satisfactory to all patients -- I'm looking at relative levels of service between the Canadian and US plans, not absolutes.

The following excerpts are found in the Wikipedia page linked here: http://en.wikipedia.org/wiki/Health_care_in_Canada .

Canadians strongly support the health system's public rather than for-profit private basis, and a 2009 poll by Nanos Research found 86.2% of Canadians surveyed supported or strongly supported "public solutions to make our public health care stronger."

A 2009 Harris/Decima poll found 82% of Canadians preferred their healthcare system to the one in the United States, more than ten times as many as the 8% stating a preference for a US-style health care system for Canada; while a Strategic Counsel survey in 2008 found 91% of Canadians preferring their healthcare system to that of the U.S.

The amount Canadians spend on health care in 1997 dollars has increased every year between 1975 and 2009 from $39.7 billion to $137.3 billion or a more than doubling of per capita spending from $1,715 to $4089.

Total spending in 2007 was equivalent to 10.1% of the gross domestic product which was slightly above the average for OECD countries, and below the 16.0% of GDP spent on health care in the United States. The proportion spent on hospitals and physicians has declined between 1975 and 2009 while the amount spent on pharmaceuticals has increased.

Canada has a publicly funded medicare system, with most services provided by the private sector. Each province may opt out, though none currently do. Canada's system is known as a single payer system, where basic services are provided by private doctors (since 2002 they have been allowed to incorporate), with the entire fee paid for by the government at the same rate (My note: Canadians can and do buy supplemental services at a premium, and may opt to use US medical services at times -- but they still love their universal health care system, and use it primarily).

Health care costs per capita vary across Canada with Quebec ($4,891) and British Columbia ($5,254) at the lowest level and Alberta ($6,072) and Newfoundland ($5,970) at the highest. It is also the greatest at the extremes of age at a cost of $17,469 per capita in those older than 80 and $8,239 for those less than 1 year old in comparison to $3,809 for those between 1 and 64 years old in 2007.

On the subject of treatment wait times in Canada: Health Canada, a federal department, publishes a series of surveys of the health care system in Canada based on Canadians first-hand experience of the health care system.

Although life-threatening cases are dealt with immediately, some services needed are non-urgent and patients are seen at the next-available appointment in their local chosen facility.

The median wait time in Canada to see a special physician is a little over four weeks with 89.5% waiting less than 90 days.

The median wait time for diagnostic services such as MRI and CAT scans is two weeks with 86.4% waiting less than 90 days.

The median wait time for surgery is four weeks with 82.2% waiting less than 90 days.

A study by the Commonwealth Fund found that 57% of Canadians reported waiting 30 days (4 weeks) or more to see a specialist, broadly in line with the current official statistics. A quarter (24%) of all Canadians waited 4 hours or more in the emergency room.

My note: I believe any rational evaluation of Canada's public health care system would conclude that it is more cost effective than that of the US, while providing better patient outcomes on average. If you want large group statistics to support the above conclusion - just look at the table comparing the US with single payer based countries at the bottom of the wikipedia page referenced at the beginning of this article.

Every country's citizens can pay for additional services outside the umbrella of their nation's universal health care program The more wealthy sometimes do chose that option; and that fosters the myth in the US that our solution to health care is preferable. The exceptions however do not prove the rule. By far the majority of folks who have experienced universal health care prefer it to the US health care payment model.