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Study on US vs Canadian Health Care

JamesMadison
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7/6/2012 8:06:03 PM
Posted: 4 years ago
I found this interesting 2007 study comparing the US and Canadian health care systems. Here is the abstract:

"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."

A few interesting points from this study:

1.) Americans are actually more satisfied with the quality of their own health care than are Canadians. Among Americans age 18-64, 51.3% report being very satisfied with their own health care services, compared to only 41.5% of Canadians from the same age group. For those over 65, 63.8% of Americans report being very satisfied with their health care compared to 55.4% in Canada. It should be noted that being satisfied with one's own heath care is different from being satisfied with the health care system as a whole.

2.) America has higher cancer mortality rates than Canada. However, this is because of America's higher incidence rate. America is actually more effective at curing cancer, as shown by it's lower mortality to incidence ratios (.39 and .43 for females and males compared to .42 and .47 in Canada).

3.) American health care offers far more access to preventative health care measures. 74.9% of American women report having a Mammogram in the past 2 years compared to only 54.7% of Canadian women. For men, the difference is even more striking. 54.2% of American men report ever having had a PSA test for prostate cancer compared to only 16.4% of Canadian men. Similiar results emerge when looking at PAP smears (for women) as well as colonoscopy's (for both men or women).

4.) When looking at different types of diseases, it appears that, for most diseases, they are more common in America, but Americans are also more likely to get treatment for the diseases.

5.) Waiting times truly are much longer in Canada. 57% of Canadians report waiting more than four weeks to see a specialist compared to 23% of Americans. 82% of Canadians report waiting more than four weeks to get elective surgery comapred to 42% of Americans. Finally, the median wait time for knee replacement surgery is 12 weeks in Canada compared to 5 weeks in America.

6.) Medical technology is much more available in America than Canada. There are 32 CT scanners and 27 MRIs per million population in America vs 11.3 CT scanners and 5.5 MRIs per million population in Canada.

7.) One of the great supposed attributes of the Canadian health care system is its ability to equalize health outcomes. However, as the authors of the study point out in the abstract, "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.".

It turns out that Canada actually has MORE health inequality than America.

8.) Although it is not part of the study, I am sure many people will bring up the larger cost of the American health care system. I have pointed out in the past that, while it is true that American health care costs more, Canadian health care costs have been rising faster. Real per capita health spending rose an average of 5.6% in the US from 2000 to 2010 vs 5.8% in Canada, according to OECD data.

The main point here is the Canadian system is not the excellent success story that some make it out to be.

Here is a link to the study:

http://www.nber.org...
As a general rule, you'll find that, when a conservative is talking about policy, history, economics, or something serious, liberals are nowhere to be found. But, as soon as a conservative mentions Obama's birthplace or personal life, liberals are everywhere, only to dissappear again when evidence enters the discussion.
Contra
Posts: 3,941
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7/6/2012 8:18:13 PM
Posted: 4 years ago
http://www.debate.org...
"The solution [for Republicans] is to admit that Bush was a bad president, stop this racist homophobic stuff, stop trying to give most of the tax cuts to the rich, propose a real alternative to Obamacare that actually works, and propose smart free market solutions to our economic problems." - Distraff

"Americans are better off in a dynamic, free-enterprise-based economy that fosters economic growth, opportunity and upward mobility." - Paul Ryan
Lasagna
Posts: 2,440
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7/6/2012 8:23:47 PM
Posted: 4 years ago
At 7/6/2012 8:06:03 PM, JamesMadison wrote:
I found this interesting 2007 study comparing the US and Canadian health care systems. Here is the abstract:

"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."

A few interesting points from this study:

1.) Americans are actually more satisfied with the quality of their own health care than are Canadians. Among Americans age 18-64, 51.3% report being very satisfied with their own health care services, compared to only 41.5% of Canadians from the same age group. For those over 65, 63.8% of Americans report being very satisfied with their health care compared to 55.4% in Canada. It should be noted that being satisfied with one's own heath care is different from being satisfied with the health care system as a whole.

2.) America has higher cancer mortality rates than Canada. However, this is because of America's higher incidence rate.

That's disturbing. I personally see much more benefit in discussing why it is we keep screwing ourselves rather than discussing policy choices to remedy it afterwards.

America is actually more effective at curing cancer, as shown by it's lower mortality to incidence ratios (.39 and .43 for females and males compared to .42 and .47 in Canada).

3.) American health care offers far more access to preventative health care measures. 74.9% of American women report having a Mammogram in the past 2 years compared to only 54.7% of Canadian women. For men, the difference is even more striking. 54.2% of American men report ever having had a PSA test for prostate cancer compared to only 16.4% of Canadian men. Similiar results emerge when looking at PAP smears (for women) as well as colonoscopy's (for both men or women).

4.) When looking at different types of diseases, it appears that, for most diseases, they are more common in America, but Americans are also more likely to get treatment for the diseases.

5.) Waiting times truly are much longer in Canada. 57% of Canadians report waiting more than four weeks to see a specialist compared to 23% of Americans. 82% of Canadians report waiting more than four weeks to get elective surgery comapred to 42% of Americans. Finally, the median wait time for knee replacement surgery is 12 weeks in Canada compared to 5 weeks in America.

6.) Medical technology is much more available in America than Canada. There are 32 CT scanners and 27 MRIs per million population in America vs 11.3 CT scanners and 5.5 MRIs per million population in Canada.

7.) One of the great supposed attributes of the Canadian health care system is its ability to equalize health outcomes. However, as the authors of the study point out in the abstract, "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.".

It turns out that Canada actually has MORE health inequality than America.

8.) Although it is not part of the study, I am sure many people will bring up the larger cost of the American health care system. I have pointed out in the past that, while it is true that American health care costs more, Canadian health care costs have been rising faster. Real per capita health spending rose an average of 5.6% in the US from 2000 to 2010 vs 5.8% in Canada, according to OECD data.

The main point here is the Canadian system is not the excellent success story that some make it out to be.


Here is a link to the study:

http://www.nber.org...
Rob
DanT
Posts: 5,693
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7/6/2012 8:27:01 PM
Posted: 4 years ago
At 7/6/2012 8:18:13 PM, Contra wrote:
http://www.debate.org...

That doesn't differentiate between people with insurance and people without insurance, nor does it make clear how much it is impacted by the ownership of insurance.

There are also environmental factors which effect the cost; such as how many people are sick and what their illnesses are. If everyone in Canada had AIDs, and everyone in the US was illness free, healthcare costs wold be much cheaper in the US. If everyone in the US had irritable bowl syndrome and everyone in Canada had Crohn's disease, than Canada would have a higher healthcare cost; even though both would have similar disorders.
"Chemical weapons are no different than any other types of weapons."~Lordknukle
Contra
Posts: 3,941
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7/6/2012 8:29:34 PM
Posted: 4 years ago
At 7/6/2012 8:27:01 PM, DanT wrote:
At 7/6/2012 8:18:13 PM, Contra wrote:
http://www.debate.org...

That doesn't differentiate between people with insurance and people without insurance, nor does it make clear how much it is impacted by the ownership of insurance.

There are also environmental factors which effect the cost; such as how many people are sick and what their illnesses are. If everyone in Canada had AIDs, and everyone in the US was illness free, healthcare costs wold be much cheaper in the US. If everyone in the US had irritable bowl syndrome and everyone in Canada had Crohn's disease, than Canada would have a higher healthcare cost; even though both would have similar disorders.

Having a federal plan that makes universal coverage through an expansion in Medicaid and with having insurance covering the majority of people, you still get an imperfect simulation of single payer health insurance.
"The solution [for Republicans] is to admit that Bush was a bad president, stop this racist homophobic stuff, stop trying to give most of the tax cuts to the rich, propose a real alternative to Obamacare that actually works, and propose smart free market solutions to our economic problems." - Distraff

"Americans are better off in a dynamic, free-enterprise-based economy that fosters economic growth, opportunity and upward mobility." - Paul Ryan
JamesMadison
Posts: 381
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7/6/2012 8:34:51 PM
Posted: 4 years ago
At 7/6/2012 8:18:13 PM, Contra wrote:
http://www.debate.org...

A bit misleading. The study I cited also points out that similiar percentages of Americans and Canadians report having unmet health care needs. The difference is that most Americans with unment health needs report not being able to get health care because of cost. Canadians, on the other hand, report not getting health care needs fulfilled because of either waiting time or nonavailability.
As a general rule, you'll find that, when a conservative is talking about policy, history, economics, or something serious, liberals are nowhere to be found. But, as soon as a conservative mentions Obama's birthplace or personal life, liberals are everywhere, only to dissappear again when evidence enters the discussion.
bossyburrito
Posts: 14,075
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7/6/2012 8:47:16 PM
Posted: 4 years ago
At 7/6/2012 8:18:13 PM, Contra wrote:
http://www.debate.org...

What I was about to say to this:" but Americans are also more likely to get treatment for the diseases."
#UnbanTheMadman

"Some will sell their dreams for small desires
Or lose the race to rats
Get caught in ticking traps
And start to dream of somewhere
To relax their restless flight
Somewhere out of a memory of lighted streets on quiet nights..."

~ Rush
bossyburrito
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7/6/2012 8:49:50 PM
Posted: 4 years ago
At 7/6/2012 8:34:51 PM, JamesMadison wrote:
At 7/6/2012 8:18:13 PM, Contra wrote:
http://www.debate.org...

A bit misleading. The study I cited also points out that similiar percentages of Americans and Canadians report having unmet health care needs. The difference is that most Americans with unment health needs report not being able to get health care because of cost. Canadians, on the other hand, report not getting health care needs fulfilled because of either waiting time or nonavailability.

What does "nonavailability" even mean?
On a national level, there are no restrictions based on what your plan covers. You can walk into a hospital ANYWHERE in the country.
#UnbanTheMadman

"Some will sell their dreams for small desires
Or lose the race to rats
Get caught in ticking traps
And start to dream of somewhere
To relax their restless flight
Somewhere out of a memory of lighted streets on quiet nights..."

~ Rush
JamesMadison
Posts: 381
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7/6/2012 8:53:01 PM
Posted: 4 years ago
At 7/6/2012 8:49:50 PM, bossyburrito wrote:
At 7/6/2012 8:34:51 PM, JamesMadison wrote:
At 7/6/2012 8:18:13 PM, Contra wrote:
http://www.debate.org...

A bit misleading. The study I cited also points out that similiar percentages of Americans and Canadians report having unmet health care needs. The difference is that most Americans with unment health needs report not being able to get health care because of cost. Canadians, on the other hand, report not getting health care needs fulfilled because of either waiting time or nonavailability.

What does "nonavailability" even mean?
On a national level, there are no restrictions based on what your plan covers. You can walk into a hospital ANYWHERE in the country.

Well, there are a lot of health services that are in low supply in Canada.
As a general rule, you'll find that, when a conservative is talking about policy, history, economics, or something serious, liberals are nowhere to be found. But, as soon as a conservative mentions Obama's birthplace or personal life, liberals are everywhere, only to dissappear again when evidence enters the discussion.