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Comparisons part of health battle

To no one’s surprise, the debate over U.S. President Barack Obama’s health-care plan has Canada as a central player, as opponents warn of the evils of socialized medicine.

Critics are on the offensive, hitting the circuit and airing attack ads, including one that features a Waterdown, Ont. woman, Shona Holmes, talking about how wait times caused her to travel to the U.S. to undergo surgery for a benign tumor, paying $97,000 for the treatment.

Supporters of the status quo are happy to point out any and all flaws in the Canadian system. They’re not doing this, of course, to make the U.S. system better, but to hold onto their massive profits. Study after study has shown that the country’s convoluted system of private insurers, HMOs and for-profit hospitals provide costly care while working to limit who receives that care. Even under that stilted system, 45 million Americans are without health insurance.

As Nobel prize-winning economist Paul Krugman has noted, U.S. insurance companies spend a significant amount of money finding ways to deny coverage to people, and to deny the claims of those they do insure. In a system such as Canada’s and France’s, for instance, everybody is covered, so there is no need to spend millions on evasive tactics, he argues.

His assessment of the situation runs contrary to what supporters of private medicine, both here and in the U.S., tell us. Americans, we’re told, have quick and easy access to medical tests and treatments. Canadians, on the other hand, have long waiting times for even basic services.

A study released by Statistics Canada and the U.S. National Center for Health Statistics, Joint Canada/United States Survey of Health, paints a different picture.

“Overall, more Americans reported that they had experienced an unmet health care need … compared with Canadians (13% versus 11%). There was no difference in the proportion who reported unmet health care needs between Canadians and insured Americans.

The top reasons for unmet health care needs differed between the two countries: waiting time was most often reported in Canada and cost was most often reported in the United States.”

Cost is indeed a big issue. Certainly Canadians pay an indirect price for health care: the system consumes more than one tax dollar in five, and spending is rising exponentially. Such increases are not sustainable. Still, Americans spend more on health care. The service is better … for those who can afford it. One of the largest arguments in favour of our universal system is reduced administrative costs associated with a host of profit-driven private insurers.

Harvard researchers attempted to quantify the financial differences.

“The estimated per capita cost of health care administration was US$1,059 in the U.S. and US$307 in Canada. These costs accounted for 31% and 17% of health care spending in the U.S. and Canada, respectively. The average overhead cost for U.S. private insurers was 11.7%; in contrast, this figure was 3.6% for U.S. Medicare and 1.3% for provincial insurance plans.”

Yes, we have longer wait times, but access is universal. The U.S. has an overcapacity of health-care facilities and services, making for ease of access for those who can afford it.

Advocates of the current U.S. health care system – and there are some on this side of the border – revel in every delay in our system: every additional day that somebody’s mother has to wait for a knee or hip replacement, the case for a speedier alternative grows stronger, as do the U.S. attack ads.

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