Canada has the best health care in the world, period. The US could, but won't, take care of it's people.
ROTFLMAO!
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“For more than twenty years,” write two leading boosters of the Canadian system, “Canada has been the world leader in health policy.” Plenty of Americans wholeheartedly second this opinion, including some in Congress and other positions of influence. “Like every other advanced country, we need a single-payer or consolidated-payer system to prevent both the widespread underinsurance and the cost-shifting,” writes the former editor of The New England Journal of Medicine and senior lecturer at Harvard Medical School, Marcia Angell.
My message today is quite different. The Canadian single-payer system offers only a false promise for what ails governments, patients, and doctors. Today, after 30 years of government intervention,
the Canadian system suffers from long waiting times for critical procedures, lack of access to current technology, increasing costs to taxpayers and patients, and a brain drain of doctors, who head south for better working conditions and more money. While policy talk and statistics are, unfortunately, unavoidable, I will focus on how the health system treats those it’s set up to serve, patients.
A snapshot of the system.
Let me sketch an outline of the Canadian system. Canadian governments maintain complete control of health insurance for the hospital and physician sectors of the health care system, through interventions referred to as "Medicare,” a joint program of federal and provincial governments. It is often referred to as a “single-payer system.” Unlike in Britain, for example, where the government actually runs many health facilities, the majority of hospitals and doctors’ offices in Canada are nominally independent of the government. But the piper’s payer calls the tune, and in Canada the government is the only payer that’s allowed by law. Governments control hospital capital budgets and approve what technology they can purchase and what services they can offer. In fact, Canada is the only western country in which private insurance for publicly insured procedures is actually outlawed.1 In the UK, a country with a government-run program called the National Health Service (NHS), a program that was established in 1947, the government, unlike Canada, does allow private insurance programs such as BUPA. As the NHS deteriorated, more and more individuals and groups have demanded and opted for BUPA or equivalent coverage.
Through Medicare, the Canadian federal government sets and administers the national principles and standards for provincial health care, as currently defined by the Canada Health Act. It transfers federal funds to provincial governments for health care. Provincial governments are required to contribute significant financial support to their hospital and medical insurance programs. They are also responsible for administering the programs. In the U.S. context, Canada’s Medicare is similar to US Medicaid, the system through which state governments provide health insurance for low-income Americans. Another way to think about it is as a series of extremely poorly run, monopoly HMOs. Many Americans are becoming dissatisfied with their HMOs. It is worth noting that a recent study in the British Medical Journal compared the performance of Kaiser Permanente to Britain’s NHS. It is noteworthy that Kaiser outperformed the NHS on all variables If Americans are dissatisfied with Kaiser, how would they tolerate a fully managed government system?
Incentives matter, and one need only examine the incentives of the Canadian system to predict the results: inefficient use of resources and severe rationing of expensive procedures.
Patients consider health care to be free. They pay for it for sure. Canadian doctor and author David Gratzer (currently part of the Canadian doctor brain drain to the U.S.), estimates that the system costs each Canadian 21 cents for every $1 they earn, which translates into $7,350 a year for a person earning $35,000. But they don’t pay for it when they use it. The result is an overuse—and inefficient use—of primary care facilities.
Physicians are paid fee-for-service at government set rates. The rates are low, so they perform more services. This places upward pressure on spending, so many provincial governments have capped the total amount they can bill in a year. Doctors who hit this cap simply take extended holidays, which don’t do much for their patients.
It doesn’t require a degree from Harvard’s Kennedy School of Government to see that there are cost containment problems in a system whereby consumers pay nothing at point of consumption and producers are left free to decide what to sell. The only way for the government to control spending is through global budgets. Hence, doctors annual incomes are capped and, even more important, so too are the budgets of hospitals.
Feel free to read more:
http://www.pacificresearch.org/pub/sab/ ... sally.html