Canadian healthcare system just as good as US, but at a fraction of the cost.

[NorthYorker]

http://www.wtnh.com/Global/story.asp?S=6384111&nav=3YeX
The benefits of universal health care



Posted Apr. 17, 2007
6:30 PM

(WTNH) _ The United States has the most expensive health care system in the world, but are we getting more for our money?

A team of Canadian and U.S. researchers conducted a review of studies comparing American to Canadian health care.

The studies examined the end results in patients treated for different types of diseases, from kidney failure to cancer to various surgical procedures. They found that the Canadian system provided just as good care at a fraction of the cost.

Canada may even have the edge in quality: 14 studies favored the Canadian system, and just 5 favored the United States. The remaining 19 studies found no overall difference.

But the United States far outstrips Canada on health care spending - U.S. per capita health care costs totaled over $7000 in 2006, more than double Canadian costs. Researchers conclude that the Canadian system proves that high quality
universal health care is possible for much less money than the United States currently spends.

The U.S. currently has about 45-million Americans without insurance.

[Bullseye]

The problem with costs in the U.S. are that there are thousands of administration centres, where as it's centrally administered in Canada, that's the major difference.

[aquariaguy]

Yup, we have a way better system in Canada. Just like Europe. People gotta quit complaining about the wait times. Not only that, but our drugs are cheaper too! Once you see the US system and how many people get messed up before they see a doctor, you'll realize. I see it first hand.

http://www.thestar.com/article/204163

Canadian health system fares well in study
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Apr 17, 2007 08:08 PM
Anne-Marie Tobin
Canadian press

Health outcomes for patients in Canada are as good as or better than in the United States, even though per capita spending is higher south of the border, suggest Canadian and U.S. researchers who crunched data from 38 studies.

The findings were published in the inaugural edition of Open Medicine, a new online medical journal launching Wednesday in the aftermath of a rift last year between some editors and the publisher of the Canadian Medical Association Journal.

"In looking at patients in Canada with a specific diagnosis compared to Americans with the same diagnosis, in Canada patients had at least as good an outcome as their American counterparts – and in many situations, a better health outcome," said one of the 17 authors, Dr. P.J. Devereaux, a cardiologist and clinical epidemiologist at McMaster University in Hamilton.

"And that is important because in the United States, they're currently spending a little over $7,100 per individual on health care annually, whereas in Canada we're spending a little over $2,900 per individual annually," he said in a telephone interview from Brantford, Ont.

The study covered data on patient populations in the United States and Canada from 1955 to 2003. To conduct their meta-analysis, researchers identified almost 5,000 titles and abstracts. Of these, 498 appeared potentially eligible on initial review. Eventually, 38 studies were deemed to be eligible.

Researchers began by asking the question: Are there differences in health outcomes (mortality or morbidity) in patients suffering from similar medical conditions treated in Canada versus those treated in the United States?

"Overall, Canada did better, and in fact we found a statistically significant five per cent mortality advantage to people with diagnoses in Canada compared to their counterparts in the United States," Devereaux said.

Because of the extreme variability in study-to-study results, the researchers suggested caution was appropriate in interpreting this finding.

Overall, 14 of the 38 studies showed better outcomes in Canada, while five favoured the U.S. The other 19 studies showed equivalent or mixed results in the two countries.

Canada really stood out in one area – lower risk-adjusted death rates for dialysis care.

"What it (the study) shows is that despite an enormous investment in money we do not see better health outcomes (in the U.S.)," Devereaux said.

"And importantly, where our two systems do diverge is that America has a mixture of private insurance in terms of the funding for health care whereas in Canada we have medicare system for hospital and physician services. The medicare system allows us enormous efficiencies in terms of cost saving relative to private insurance."

He said the Canadian health-care system does have issues and needs improvement, "but certainly using medicare funding and not-for-profit delivery is the best way to actually maximize health outcomes and in a cost-effective manner."

The public is barraged by people saying Canada's health-care system has problems and the solution is to move toward allowing two-tiered medicine, and for-profit health-care delivery, he said.

The researchers "wanted decisions made based on evidence, and not based on beliefs and ideologies," Devereaux added.

Few uninsured patients in the U.S., who probably suffer the worst quality care, were included in the studies examined.

Some explanations for the results include the fact that American health care has administrative inefficiencies that public funding – without multiple competing insurance companies – eliminates. And because drug prices are controlled, Canada saves on prescription drug costs.

[direct-x]

Bah, try explaining this to my mother who has been waiting 8 months to meet with a surgeon to consult about fixing two herniated discs in her back. Her appointment is scheduled for August 2008. She will then possibly get a date for surgery.

Needless to say she is going to consult the private sector.

[Flame_lily]

I have no idea how the studies were done but they seem fairly broad. Would sharp differences be seen once you start stratifying the population e.g. uninsured low income urban dwellers in the US vs Canadian counterparts with universal healthare or insured upperclass American who have instant access to state-of-the-art technologies vs same type of Canadians who have to deal with the wait times?

[BadDrafter]

Drugs are much cheaper, the drugs I take to stay alive are 3x as expensive in the United States and my wallet thanks me for that. I’m not covered for ‘pre existing conditions' so I pay out of pocket and I get shoppers optimum points to boot!

My problem with the healthcare system was not the wait times but the sheer incompetence, getting diagnosed wrong all the time and bureaucracy associated with it.

Just trying to get a second opinion from another specialist and getting off the deadly drugs he was prescribing me and on to a more modern, cleaner, prescription required pulling some strings and yes paying some money. This would not have been possible if my mom didn’t know a doctor who knew another specialist.

I tried to get my family doctor to refer me to another specialist and the one I was currently seeing (hospital assigned, I didn’t ask for this clown!) blocked it because he felt insulted. He then called me an A-hole. There is little option for those who are facing those roadblocks with our current system.

The quack specialist was giving me drugs that it turns out he was given an incentive from the drug company to prescribe (it was turning my skin yellow and causing blindness and spasms). He was also going to give me surgery for a condition I do not have! Thank God that never happened!

My problem started comming back early last year and if I did not find the other specailist I would be dead today. The quack gave me an appointment for March 2007 back in 2005. Fcuk the system. I had it fixed early last year two weeks after it started comming back with the other specialist. The funny thing is that they both work in the same hospital and know eachother. You just have to know the right people.

It’s broken in more places than just wait times.

[NorthYorker]

The problem with costs in the U.S. are that there are thousands of administration centres, where as it's centrally administered in Canada, that's the major difference.
That plus profits private sector have to pay to shareholders. I'd say "private sector advantage" is almost non-existent in healthcare insurance business (all those huge BlueCrosses are as bulky and dinosaurish as ministry of health), but private sector adds admin costs and profits on the top of running similarly-sized system. Size matters more than ownership here.

try explaining this to my mother who has been waiting 8 months to meet with a surgeon to consult about fixing two herniated discs in her back. Her appointment is scheduled for August 2008. My wife's friend in SF is struggling since 2005 to get her insurance provider to pay for MRI. She is insured through her husband's employer (HP). Yahoo groups can supply you unlimited number of anecdotal evidence about similar cases.

My problem with the healthcare system was not the wait times but the sheer incompetence, getting diagnosed wrong all the time and bureaucracy associated with it. I feel for you but fail to understand how private ownership of healthcare providers can prevent cases like yours. Kickback to a-hole doctor from drug company are at least as likely in States.

[BadDrafter]

I feel for you but fail to understand how private ownership of healthcare providers can prevent cases like yours. Kickback to a-hole doctor from drug company are at least as likely in States.

More choice in doctors. I would like a system where I can see at least three specialists the same way I would if my car had a serious problem to get estimates and not get messages like "sorry, your records indicate that you are already seeing a specialist, I cannot help you".

[afong56]

The quack specialist was giving me drugs that it turns out he was given an incentive from the drug company to prescribe (it was turning my skin yellow and causing blindness and spasms). He was also going to give me surgery for a condition I do not have! Thank God that never happened!

no disrespect to your personal medical issues, which are serious, but i would guess that these two incidents probably occur even more frequently in the u.s., especially the hard selling on particular scripts.

[BadDrafter]

no disrespect to your personal medical issues, which are serious, but i would guess that these two incidents probably occur even more frequently in the u.s., especially the hard selling on particular scripts.

Which is why I'm glad I don't live there. But we still need to fix our system.

Edit: I motion that this thread be moved to the political forum.

[Riffer]

This came up a few years ago and a close look at the research showed that the US numbers included the costs to finance the building of the hospitals and the Canadian didn't. This made up the entire difference. It was assumed, that since the Canadian hospitals were built by the government, the cost was zero. Of course, we all know this isn't "free" money. The taxpayers bear the burden. The studies should, at least, have imputed a cost based on the governments debt rate, as well as an additional factor for the cost of the government infrastructure require to support the medical system.

They are still interesting studies.

[konfusion666]

Edit: I motion that this thread be moved to the political forum.

I hope not, then the CPC fanclub will take over the thread and non-CPC-members usually stop posting... :lol:



This came up a few years ago and a close look at the research showed that the US numbers included the costs to finance the building of the hospitals and the Canadian didn't. This made up the entire difference. It was assumed, that since the Canadian hospitals were built by the government, the cost was zero. Of course, we all know this isn't "free" money. The taxpayers bear the burden. The studies should, at least, have imputed a cost based on the governments debt rate, as well as an additional factor for the cost of the government infrastructure require to support the medical system.


Err, and you are sure that NYer's linked study doesn't take into account those factors?

[st7860]

for the noobs out there in case you didn't know in the US the hospitals are required to admit you and do 'something'.

they can't just boot you out the door if you don't have money.

[slowpoke]

for the noobs out there in case you didn't know in the US the hospitals are required to admit you and do 'something'.

they can't just boot you out the door if you don't have money.

I thought they had to admit you for something life-threatening otherwise they refer you to a "charity" hospital. (could be wrong though).

[st7860]

I thought they had to admit you for something life-threatening otherwise they refer you to a "charity" hospital. (could be wrong though).

yes, something like that. if its an emergency they can't really deny anything.

prescription drugs are a totally different matter however.

[CSK'sMom]

Only public hospitals are required to provide care in the US, not for-profit privately owned hospitals. The burden on the public hospitals is overwhelming currently in places like California and as a result some are or are threatening to close their ER's....

[aquariaguy]

for the noobs out there in case you didn't know in the US the hospitals are required to admit you and do 'something'.

they can't just boot you out the door if you don't have money.

If it's life threatening they will admit you. They will hunt you down for the money after. I mean, if you don't have any to pay, you're screwed and they are screwed too, but if you just a normal person working a decent job, it will hurt you - a lot.

[DSTU]

Bah, try explaining this to my mother who has been waiting 8 months to meet with a surgeon to consult about fixing two herniated discs in her back. Her appointment is scheduled for August 2008. She will then possibly get a date for surgery.

Needless to say she is going to consult the private sector.

Instead of whining about it, contact other hospitals to see if they can do the surgery. Go to small towns where there is no wait times.

[Riffer]

I hope not, then the CPC fanclub will take over the thread and non-CPC-members usually stop posting... :lol:




Err, and you are sure that NYer's linked study doesn't take into account those factors?

Err, and you are sure that it does?

edit:

The article doesn't give sources, but I wonder if this is an updating of the Woolhandler et al studies from 2003. They do an update every few years. This deals only with the administration costs. regardless, here is the link as well as one to HJ Aaron's refutation:

http://content.nejm.org/cgi/content/full/349/8/768?ijkey=56c94e5bf792acf364c3148b2b1dc8eedef38ac9

http://content.nejm.org/cgi/content/full/349/8/801?ijkey=da7f43f43f4fe7f2600f7c442369969f9a23ae88&keytype2=tf_ipsecsha#T1