Monday, August 03, 2009

CANADIAN AND THE U.S HEALTH CARE SYSTEMS COMPARED

A study by June O'Neill and Dave M. O'Neill (link) suggests that the U.S health care system provides more choice, efficiency, better delivery and capacity than the Canadian system:

"Does Canada's publicly funded, single payer health care system deliver better health outcomes and distribute health resources more equitably than the multi-payer heavily private U.S. system? We show that the efficacy of health care systems cannot be usefully evaluated by comparisons of infant mortality and life expectancy. We analyze several alternative measures of health status using JCUSH (The Joint Canada/U.S. Survey of Health) and other surveys. We find a somewhat higher incidence of chronic health conditions in the U.S. than in Canada but somewhat greater U.S. access to treatment for these conditions. Moreover, a significantly higher percentage of U.S. women and men are screened for major forms of cancer. Although health status, measured in various ways is similar in both countries, mortality/incidence ratios for various cancers tend to be higher in Canada. The need to ration resources in Canada, where care is delivered "free", ultimately leads to long waits. In the U.S., costs are more often a source of unmet needs. We also find that Canada has no more abolished the tendency for health status to improve with income than have other countries. Indeed, the health-income gradient is slightly steeper in Canada than it is in the U.S."

4 comments:

Grant said...

First of all, I just can't get enough of people constantly pretending like care isn't rationed in the US. Yes sir! Those tens of millions of people without insurance coverage? Well, they're just in that situation because they think it's really really fun! And the tens of millions more who are so under-insured that a serious illness would be financially catastrophic? Well, they're all just a bunch of thrill seekers who like living on the precipice. And the claims departments at every private insurance agency in the country who have instructions to deny payment for any expensive procedure they can find an excuse to turn down? There's no rationing happening there either! Heck no! That's... umm... fiscally conservative cost saving measures! Totally different thing!

Yup... health care resources are totally unlimited and completely un-rationed in the United States!

Also, we don't have waits in the United States! (People not receiving care at all aren't technically "waiting" for it you see. Waiting problem solved! We're BRILLIANT!)

We also have magic unicorns who fly us to work in the morning if we miss the bus!

A couple parting details:

http://www.openmedicine.ca/article/view/8/1

http://www.commonwealthfund.org/Content/Charts/Testimony/Insurance-Design-Matters-Underinsured-Trends-Health-and-Financial-Risks-and-Principles-for-Reform/Mortality-Amenable-to-Health-Care.aspx

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Rok Spruk said...

The major structural problem of the U.S health care system is the problem of third-party payment. It distorts the quality of medical care provided by Medicare and Medicaid. The long-term solution to cure the health care is to introduce private health-care accounts where employees could freely allocate funds for health insurance without employer-provided mandates. In current situation, allocating funds through Medicare is causing symptoms of "mellons-and-peaches" in medical care. In case of private health care accounts, the third party mediator would be removed from the system. In turn, employees would freely choose health-care providers and have direct control over health care spending. In addition, there would be no more "adverse selection" and information asymmetry caused by employer-provided health-care. In any case, health care costs should be beared by the consumer not by any kind of third-party payers or mediators.

Recent research also suggested that having a health insurance can be an inflicting factor of obesity. Simply stated, health insurance induces individuals to rely on insurance payments and not care about the problem of obesity. The solution, of course, to avoid moral hazard, would be to raise premium surcharge for obesity and consumption of soda and fast-food. Of course, health insurance providers should make estimates based on cost-benefit analysis. If government introduced a tax on soda and fast-food, that would be a non-sense, for it would divert consumption and open-up the shadow economy for fast-food and soda drinks.

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