Health Outcomes in Canada v US

[Toro]

For informational purposes.

A systematic review of studies comparing health outcomes in Canada and the United States

Of the 38 studies included in the analysis, 10 were considered to be of the highest quality because they enrolled broad populations and included extensive statistical adjustments. Results of five of those favoured Canada, two favoured the United States and three showed equivalent or mixed results.

Of the 28 remaining studies that did not meet one of the criteria, nine favoured Canada, three favoured the United States and 16 showed equivalent or mixed results.

The only specific medical condition in which medical results consistently favoured one country was end-stage renal disease. Canadian patients fared better in those cases.

When all the studies were combined, the 17 doctors and researchers involved in the meta-analysis found Canadians had a five per cent lower death rate than people in the United States."



After adjustment for the case mix and treatment variables, the mortality rate for end-stage renal
disease was 47% higher in the U.S. than in Canada.
Compared with their American counterparts, low-income Canadians had a significant survival
advantage for 13 of the 15 kinds of cancer studied.

One-year mortality rates following myocardial infarction were virtually identical for both countries (34.3% U.S. vs. 34.4% Canada) however:
• U.S. patients were far more likely to undergo expensive and invasive treatments such as coronary angiography (34.9% U.S. vs. 6.7% Canada); percutaneous transluminal coronary angioplasty (11.7% U.S. vs. 1.5% Canada); and coronary-artery bypass surgery (10.6% U.S. vs. 1.4% Canada).

Canadians had lower rates of unadjusted in-hospital mortality (1.4% Canada vs. 2.2% U.S.). There
was no difference between the countries after controlling for demographic and clinical differences.
• The average length of a hospital stay in Canada was 16.8% longer
• Adjusted costs of CABG in the U.S. were 82% higher than in Canada
• Average in-hospital treatment costs were nearly twice as much in the U.S. ($20,673 U.S. vs. $10,373
Canada / Median: $16,036 U.S. vs. $7,880 Canada).
• Administrative costs consumed more of the total cost of treatment in the U.S.
Manitoba had lower mortality rates for patients 65 and older three years after both low-mortality
(18.52% U.S. vs. 15.31% Canada) and moderate-mortality (19.19% U.S. vs. 16.63% Canada)
procedures. There was no difference on high-mortality procedures (41.50% U.S. vs. 41.82%
Canada).
On seven diseases / procedures for which data are available for both countries, Canada survival
rates were superior to the U.S. for four (colorectal cancer: 113 Canada vs. 108 U.S.; childhood
leukemia: 118 vs.110; kidney transplants 113 vs. 100; and liver transplants 123 vs. 102), about the
same on two (cervical cancer: 106 Canada vs. 108 U.S.; and non-Hodgkins lymphoma: 107 vs.
109), and worse on one (breast cancer: 104 Canada vs. 114 U.S.).

A systematic review of studies comparing health outcomes in Canada and the United States | Guyatt | Array

And

Circulatory disease deaths per 100,000:
Canada: 219
United States: 265

Child maltreatment deaths per 100,000:
Canada: 0.7
United States: 2.2

Digestive disease deaths per 100,000:
Canada: 17.4
United States: 20.5

Infant mortality rate per 1,000 live births
Canada: 5.08
United States: 6.3

Intestinal diseases death rate
Canada: 0.3%
United States: 7.3%

Proability of not reaching age 60:
Canada: 9.5%
United States: 12.8%

Respiratory disease child death rate per 100,000
Canada: 0.62
United States: 40.43

Heart disease deaths per 100,000:
Canada: 94.9
United States: 106.5

HIV deaths per million people:
Canada: 47.423
United States: 48.141

Sadly, No! » Also, You Are More Likely To Be Killed By A Sasquatch There

 

[Annie]

More info:

Hoover Institution - Hoover Digest - Here’s a Second Opinion

Medical care in the United States is derided as miserable compared to health care systems in the rest of the developed world. Economists, government officials, insurers, and academics beat the drum for a far larger government role in health care. Much of the public assumes that their arguments are sound because the calls for change are so ubiquitous and the topic so complex. Before we turn to government as the solution, however, we should consider some unheralded facts about America’s health care system.

1. Americans have better survival rates than Europeans for common cancers. Breast cancer mortality is 52 percent higher in Germany than in the United States and 88 percent higher in the United Kingdom. Prostate cancer mortality is 604 percent higher in the United Kingdom and 457 percent higher in Norway. The mortality rate for colorectal cancer among British men and women is about 40 percent higher.

2. Americans have lower cancer mortality rates than Canadians. Breast cancer mortality in Canada is 9 percent higher than in the United States, prostate cancer is 184 percent higher, and colon cancer among men is about 10 percent higher.

3. Americans have better access to treatment for chronic diseases than patients in other developed countries. Some 56 percent of Americans who could benefit from statin drugs, which reduce cholesterol and protect against heart disease, are taking them. By comparison, of those patients who could benefit from these drugs, only 36 percent of the Dutch, 29 percent of the Swiss, 26 percent of Germans, 23 percent of Britons, and 17 percent of Italians receive them.

4. Americans have better access to preventive cancer screening than Canadians. Take the proportion of the appropriate-age population groups who have received recommended tests for breast, cervical, prostate, and colon cancer:

Nine out of ten middle-aged American women (89 percent) have had a mammogram, compared to fewer than three-fourths of Canadians (72 percent).

Nearly all American women (96 percent) have had a Pap smear, compared to fewer than 90 percent of Canadians.

More than half of American men (54 percent) have had a prostatespecific antigen (PSA) test, compared to fewer than one in six Canadians (16 percent).

Nearly one-third of Americans (30 percent) have had a colonoscopy, compared with fewer than one in twenty Canadians (5 percent).
5. Lower-income Americans are in better health than comparable Canadians. Twice as many American seniors with below-median incomes self-report “excellent” health (11.7 percent) compared to Canadian seniors (5.8 percent). Conversely, white, young Canadian adults with below-median incomes are 20 percent more likely than lower-income Americans to describe their health as “fair or poor.”

6. Americans spend less time waiting for care than patients in Canada and the United Kingdom. Canadian and British patients wait about twice as long—sometimes more than a year—to see a specialist, have elective surgery such as hip replacements, or get radiation treatment for cancer. All told, 827,429 people are waiting for some type of procedure in Canada. In Britain, nearly 1.8 million people are waiting for a hospital admission or outpatient treatment.

7. People in countries with more government control of health care are highly dissatisfied and believe reform is needed. More than 70 percent of German, Canadian, Australian, New Zealand, and British adults say their health system needs either “fundamental change” or “complete rebuilding.”

8. Americans are more satisfied with the care they receive than Canadians. When asked about their own health care instead of the “health care system,” more than half of Americans (51.3 percent) are very satisfied with their health care services, compared with only 41.5 percent of Canadians; a lower proportion of Americans are dissatisfied (6.8 percent) than Canadians (8.5 percent).

9. Americans have better access to important new technologies such as medical imaging than do patients in Canada or Britain. An overwhelming majority of leading American physicians identify computerized tomography (CT) and magnetic resonance imaging (MRI) as the most important medical innovations for improving patient care during the previous decade—even as economists and policy makers unfamiliar with actual medical practice decry these techniques as wasteful. The United States has thirty-four CT scanners per million Americans, compared to twelve in Canada and eight in Britain. The United States has almost twenty-seven MRI machines per million people compared to about six per million in Canada and Britain.

10. Americans are responsible for the vast majority of all health care innovations. The top five U.S. hospitals conduct more clinical trials than all the hospitals in any other developed country. Since the mid- 1970s, the Nobel Prize in medicine or physiology has gone to U.S. residents more often than recipients from all other countries combined. In only five of the past thirty-four years did a scientist living in the United States not win or share in the prize. Most important recent medical innovations were developed in the United States.

Despite serious challenges, such as escalating costs and care for the uninsured, the U.S. health care system compares favorably to those in other developed countries.

For notes, charts and other stuff:

http://www.ncpa.org/pub/ba649

 

[Toro]

Good find Annie

Here is an article about the myths of Canadians medicare.

...
Lesson No. 1: A single-payer system would eliminate most U.S. coverage problems.

On costs, Canada spends 10% of its economy on healthcare; the U.S. spends 16%. The extra 6% of GDP amounts to more than $800 billion per year. The spending gap between the two nations is almost entirely because of higher overhead. Canadians don't need thousands of actuaries to set premiums or thousands of lawyers to deny care. Even the U.S. Medicare program has 80% to 90% lower administrative costs than private Medicare Advantage policies. And providers and suppliers can't charge as much when they have to deal with a single payer.

Lessons No. 2 and 3: Single-payer systems reduce duplicative administrative costs and can negotiate lower prices.

Because most of the difference in spending is for non-patient care, Canadians actually get more of most services. We see the doctor more often and take more drugs. We even have more lung transplant surgery. We do get less heart surgery, but not so much less that we are any more likely to die of heart attacks. And we now live nearly three years longer, and our infant mortality is 20% lower.

Lesson No. 4: Single-payer plans can deliver the goods because their funding goes to services, not overhead.

The Canadian system does have its problems, and these also provide important lessons. Notwithstanding a few well-publicized and misleading cases, Canadians needing urgent care get immediate treatment. But we do wait too long for much elective care, including appointments with family doctors and specialists and selected surgical procedures. We also do a poor job managing chronic disease. ...

Lesson No. 5: Canadian healthcare delivery problems have nothing to do with our single-payer system and can be fixed by re-engineering for quality. ...

Compounding the confusion is traditional American ignorance of what happens north of the border, which makes it easy to mislead people. Boilerplate anti-government rhetoric does the same. The U.S. media, legislators and even presidents have claimed that our "socialized" system doesn't let us choose our own doctors. In fact, Canadians have free choice of physicians. It's Americans these days who are restricted to "in-plan" doctors.

A Canadian doctor diagnoses U.S. healthcare - Los Angeles Times

 

[Annie]

Good find Annie

Here is an article about the myths of Canadians medicare.

...
Lesson No. 1: A single-payer system would eliminate most U.S. coverage problems.

On costs, Canada spends 10% of its economy on healthcare; the U.S. spends 16%. The extra 6% of GDP amounts to more than $800 billion per year. The spending gap between the two nations is almost entirely because of higher overhead. Canadians don't need thousands of actuaries to set premiums or thousands of lawyers to deny care. Even the U.S. Medicare program has 80% to 90% lower administrative costs than private Medicare Advantage policies. And providers and suppliers can't charge as much when they have to deal with a single payer.

Lessons No. 2 and 3: Single-payer systems reduce duplicative administrative costs and can negotiate lower prices.

Because most of the difference in spending is for non-patient care, Canadians actually get more of most services. We see the doctor more often and take more drugs. We even have more lung transplant surgery. We do get less heart surgery, but not so much less that we are any more likely to die of heart attacks. And we now live nearly three years longer, and our infant mortality is 20% lower.

Lesson No. 4: Single-payer plans can deliver the goods because their funding goes to services, not overhead.

The Canadian system does have its problems, and these also provide important lessons. Notwithstanding a few well-publicized and misleading cases, Canadians needing urgent care get immediate treatment. But we do wait too long for much elective care, including appointments with family doctors and specialists and selected surgical procedures. We also do a poor job managing chronic disease. ...

Lesson No. 5: Canadian healthcare delivery problems have nothing to do with our single-payer system and can be fixed by re-engineering for quality. ...

Compounding the confusion is traditional American ignorance of what happens north of the border, which makes it easy to mislead people. Boilerplate anti-government rhetoric does the same. The U.S. media, legislators and even presidents have claimed that our "socialized" system doesn't let us choose our own doctors. In fact, Canadians have free choice of physicians. It's Americans these days who are restricted to "in-plan" doctors.

A Canadian doctor diagnoses U.S. healthcare - Los Angeles Times

Toro, thanks for the above acknowledgment and let me give it back for this. Problem I have with the LA Times article is there's a lack of data backing it up. What I can see is dicey, as the following shows:

...Lesson No. 4: Single-payer plans can deliver the goods because their funding goes to services, not overhead.

The Canadian system does have its problems, and these also provide important lessons. Notwithstanding a few well-publicized and misleading cases, Canadians needing urgent care get immediate treatment. But we do wait too long for much elective care, including appointments with family doctors and specialists and selected surgical procedures. We also do a poor job managing chronic disease.

However, according to the New York-based Commonwealth Fund, both the American and the Canadian systems fare badly in these areas. In fact, an April U.S. Government Accountability Office report noted that U.S. emergency room wait times have increased, Yet, Americans with insurance do not hit up the emergency rooms for immediate care, it's not necessary and not the locale of first choice. BTW, that includes our elderly on medicare.and patients who should be seen immediately are now waiting an average of 28 minutes. The GAO has also raised concerns about two- to four-month waiting times for mammograms.

On closer examination, most of these problems have little to do with public insurance or even overall resources. Despite the delays, the GAO said there is enough mammogram capacity. I've never heard of complaints of lack of capacity for mammogram, MRI, CT, etc., in the US.

These problems are largely caused by our shared politico-cultural barriers to quality of care. In 19th century North America, doctors waged a campaign against quacks and snake-oil salesmen and attained a legislative monopoly on medical practice. In return, they promised to set and enforce standards of practice. By and large, it didn't happen. And perverse incentives like fee-for-service make things even worse.

Using techniques like those championed by the Boston-based Institute for Healthcare Improvement, providers can eliminate most delays. In Hamilton, Ontario, 17 psychiatrists have linked up with 100 family doctors and 80 social workers to offer some of the world's best access to mental health services. And in Toronto, simple process improvements mean you can now get your hip assessed in one week and get a new one, if you need it, within a month.

Lesson No. 5: Canadian healthcare delivery problems have nothing to do with our single-payer system and can be fixed by re-engineering for quality.

U.S. health policy would be miles ahead if policymakers could learn these lessons. But they seem less interested in Canada's, or any other nation's, experience than ever. Why?

American democracy runs on money. Pharmaceutical and insurance companies have the fuel. Analysts see hundreds of billions of premiums wasted on overhead that could fund care for the uninsured. But industry executives and shareholders see bonuses and dividends.

Compounding the confusion is traditional American ignorance of what happens north of the border, which makes it easy to mislead people. Boilerplate anti-government rhetoric does the same. The U.S. media, legislators and even presidents have claimed that our "socialized" system doesn't let us choose our own doctors. In fact, Canadians have free choice of physicians. It's Americans these days who are restricted to "in-plan" doctors.

Unfortunately, many Americans won't get to hear the straight goods because vested interests are promoting a caricature of the Canadian experience.

I've seen little here to make me think the Canadian model works better than the American, more to the point, even Canadians complain about the differences between regions.

 

[Diuretic]

As the man said, vested interests don't want Americans to know the truth about alternative health care systems. A damn shame.

 

[Annie]

As the man said, vested interests don't want Americans to know the truth about alternative health care systems. A damn shame.

How about addressing the specifics, which both Toro and I attempted to do?

 

[Diuretic]

As the man said, vested interests don't want Americans to know the truth about alternative health care systems. A damn shame.

How about addressing the specifics, which both Toro and I attempted to do?

Why? You've both already done it.

What I was reflecting on was the essence of the article, the thrust of its argument.

There is much disinformation being spread about the issue, you only have to read the crackpot euthanasia threads to see that.

The disinformation campaign is part of the rearguard action by vested interests. The actual truth about various forms of healthcare isn't being discussed because it's to complex, there are too many variables to make a nice neat argument that the fifteen minute attention span will be able to understand.

Health care is one of the big political and social issues in any society.

As a topic it deserves better than to be subjected to calumny. The vested interests have been successful in wrapping it inside ideology so that facts won't count in what passes for public discussion.

The ideologues of the right will reflexively come out against any form of health care reform without examining the claims being made when any suggested reform is held up to be "socialistic". That's all that has to happen.

The insurance companies and other vested interests have enlisted the ideologues as footsoldiers in their fight to protect their profits.

Now please go on with the specifics, I'll read with interest.

 

[PLYMCO_PILGRIM]

For even more information, to go along with TORO's post

[ame=http://www.youtube.com/watch?v=aEXFUbSbg1I&feature=channel_page]YouTube - John Stossel - Sick in America - Part 1 (of 6)[/ame]

[ame=http://www.youtube.com/watch?v=BpsEAVbCkMM&feature=channel_page]YouTube - John Stossel - Sick in America - (2 of 6)[/ame]

[ame=http://www.youtube.com/watch?v=refrYKq9tZQ&feature=channel_page]YouTube - John Stossel - Sick in America - Part 3 (of 6)[/ame]

[ame=http://www.youtube.com/watch?v=QzhiG0dcwN8&feature=channel_page]YouTube - John Stossel - Sick in America - Part 4 (of 6)[/ame]

[ame=http://www.youtube.com/watch?v=Xsp_Jh5EIT0&feature=channel_page]YouTube - John Stossel - Sick in America - Part 5 (of 6)[/ame]

[ame=http://www.youtube.com/watch?v=E_KCLm9cekU&feature=channel_page]YouTube - John Stossel - Sick in America - Part 6 (of 6)[/ame]

 

[Toro]

I've seen little here to make me think the Canadian model works better than the American, more to the point, even Canadians complain about the differences between regions.

Canadians complain about everything though. Its what we do.

Otherwise, despite the problems, Canadians are generally happy with their system. No political party can get elected to office in Canada by saying they will scrap Medicare.

 

[Toro]

U.S. Cancer Care Is Number One - Brief Analysis #596

 

[JimH52]

Infant Mortality and Life Expectancy for Selected Countries, 2007 — Infoplease.com

 

[Political Junky]

For even more information, to go along with TORO's post

YouTube - John Stossel - Sick in America - Part 1 (of 6)

YouTube - John Stossel - Sick in America - (2 of 6)

YouTube - John Stossel - Sick in America - Part 3 (of 6)

YouTube - John Stossel - Sick in America - Part 4 (of 6)

YouTube - John Stossel - Sick in America - Part 5 (of 6)

YouTube - John Stossel - Sick in America - Part 6 (of 6)

Stossel is a libertarian hack.
A libertarian is a republican who wants to smoke dope and get laid.

 

[code1211]

As the man said, vested interests don't want Americans to know the truth about alternative health care systems. A damn shame.

How about addressing the specifics, which both Toro and I attempted to do?

Why? You've both already done it.

What I was reflecting on was the essence of the article, the thrust of its argument.

There is much disinformation being spread about the issue, you only have to read the crackpot euthanasia threads to see that.

The disinformation campaign is part of the rearguard action by vested interests. The actual truth about various forms of healthcare isn't being discussed because it's to complex, there are too many variables to make a nice neat argument that the fifteen minute attention span will be able to understand.

Health care is one of the big political and social issues in any society.

As a topic it deserves better than to be subjected to calumny. The vested interests have been successful in wrapping it inside ideology so that facts won't count in what passes for public discussion.

The ideologues of the right will reflexively come out against any form of health care reform without examining the claims being made when any suggested reform is held up to be "socialistic". That's all that has to happen.

The insurance companies and other vested interests have enlisted the ideologues as footsoldiers in their fight to protect their profits.

Now please go on with the specifics, I'll read with interest.

I have no specifics and no expertise in medicine. I do know a little about about efficiency and cost control.

I am amazed that this whole debate is revolving around paying the cost of the current system and converting that entire system into something that it currently is not. If the goal is to make health care affordable for those who cannot afford it, why not establish a network of walk-in clinics? In a department store that employs a live pianist, you will pay more than if you shop at WalMart.

Why not a WalMart of medicine?

We have a pretty extensive and far flung communications system. In most cases in a clinic, the blood pressure and weight and temperature are collected by nurses and relayed to the doctor. Does that doctor have to be down the hall or could he be in a studio at the hub of an interstate or even international network?

The nurse could tell the doc what the smells are and if the "feel" is right or wrong. The Doc can see anything he wants via HD TV and he could also see x-rays, ultra sounds or EKG's.

If we want to put the costs inside of a box, we need to think outside of the box. So far, there is a whole lot of demagoguing and precious little thinking.

 

[Chris]

Our system sucks, pure and simple. It is incredibly expensive and immoral.

Other countries have better systems especially the French and the Swedes.

 

[JimH52]

Our system sucks, pure and simple. It is incredibly expensive and immoral.

Other countries have better systems especially the French and the Swedes.

That is what the stats say.

 

[editec]

Sadly those who care about the facts already have a fairly good idea of how dismally national HC outcomes statistics make our HC system appear.

And for the idealogues on the right?

No amount of reality-based information will ever overcome their faith based belief system that what we have now is serving us well.

 

[PLYMCO_PILGRIM]

For even more information, to go along with TORO's post

YouTube - John Stossel - Sick in America - Part 1 (of 6)

YouTube - John Stossel - Sick in America - (2 of 6)

YouTube - John Stossel - Sick in America - Part 3 (of 6)

YouTube - John Stossel - Sick in America - Part 4 (of 6)

YouTube - John Stossel - Sick in America - Part 5 (of 6)

YouTube - John Stossel - Sick in America - Part 6 (of 6)

Stossel is a libertarian hack.
A libertarian is a republican who wants to smoke dope and get laid.

Well you identified him then skipped the isolate step and went straight to marginalizing him.

That wont work




My friend Brandon from Canada and I were talking on a car forum earlier (i work with cars and its my other passion) and he brought up our health care debate.

He said to me "Yeah well i broke my neck 2 years ago and it only cost me $1000.00 to get it fixed at the hospital....in america what would it have cost $100,000 or $200,000 or what?"

I told him if I had broke my neck it would have cost me the $100 ER co-pay and then the insurance would have paid the rest for me.

He was like WHAT!?!!?!?!

 

[Political Junky]

For even more information, to go along with TORO's post

YouTube - John Stossel - Sick in America - Part 1 (of 6)

YouTube - John Stossel - Sick in America - (2 of 6)

YouTube - John Stossel - Sick in America - Part 3 (of 6)

YouTube - John Stossel - Sick in America - Part 4 (of 6)

YouTube - John Stossel - Sick in America - Part 5 (of 6)

YouTube - John Stossel - Sick in America - Part 6 (of 6)

Stossel is a libertarian hack.
A libertarian is a republican who wants to smoke dope and get laid.

Well you identified him then skipped the isolate step and went straight to marginalizing him.

That wont work




My friend Brandon from Canada and I were talking on a car forum earlier (i work with cars and its my other passion) and he brought up our health care debate.

He said to me "Yeah well i broke my neck 2 years ago and it only cost me $1000.00 to get it fixed at the hospital....in america what would it have cost $100,000 or $200,000 or what?"

I told him if I had broke my neck it would have cost me the $100 ER co-pay and then the insurance would have paid the rest for me.

He was like WHAT!?!!?!?!

What did your Canadian friend spend $1,000. for? They have no copay.

 

[JimH52]

Stossel is a libertarian hack.
A libertarian is a republican who wants to smoke dope and get laid.

Well you identified him then skipped the isolate step and went straight to marginalizing him.

That wont work




My friend Brandon from Canada and I were talking on a car forum earlier (i work with cars and its my other passion) and he brought up our health care debate.

He said to me "Yeah well i broke my neck 2 years ago and it only cost me $1000.00 to get it fixed at the hospital....in america what would it have cost $100,000 or $200,000 or what?"

I told him if I had broke my neck it would have cost me the $100 ER co-pay and then the insurance would have paid the rest for me.

He was like WHAT!?!!?!?!

What did your Canadian friend spend $1,000. for? They have no copay.

Without health insurance, in the US a person who has suffered a broken kneck could go bankrupt.

 

[Old Rocks]

As the man said, vested interests don't want Americans to know the truth about alternative health care systems. A damn shame.

How about addressing the specifics, which both Toro and I attempted to do?

Yes, you both did. But Toro also addressed outcomes of both systems, whereas your posts mostly addressed the problems within the Canadian system. Outcomes count, and the Canadian system, in spite of it's very apperant flaws, still has better outcomes at much less cost than out system.