comparisons

[Old Rocks]

Overall U.S. mortality

We would have expected to see steady decreases in deaths per thousand in the mid-twentieth century, because so many new drugs and procedures were becoming available. But neither the Canadian nor the American mortality rate declined much; in fact, Canada's leveled off for an entire decade, throughout the 1960s. This was a period in which private care was increasing in Canadian hospitals, and the steady mortality rates reflect the fact that most people simply couldn't afford the new therapies that were being offered. However, beginning in 1971, the same year that Canada's Medicare was fully applied, official statistics show that death rates suddenly plummeted, maintaining a steep decline to their present rate.

In the United States, during the same period, overall mortality rates also dropped, reflecting medical advances. But they did not drop nearly so precipitously as those in Canada after 1971. But given that the United States is the richest country on earth, today's overall mortality rates are shockingly high, at 8.4 per thousand, compared to Canada's 6.5.
Canadian Single-Payer Health Care Program: Is it Better than US Health Care?

 

[Old Rocks]

The United States and Canadian health care systems: clinical care: which rate is right?.

Tu JV; Association for Health Services Research. Meeting.

Abstr Book Assoc Health Serv Res Meet. 1999; 16: 212.
Institute for Clinical Evaluative Sciences, Toronto, Ontario, M4N 3M5, Canada.

RESEARCH OBJECTIVES: There are large variations in the rate at which cardiovascular procedures are performed in the United States and Canada. However, the factors contributing to these variations are not well understood, and it has not been conclusively established whether Americans are receiving too many procedures or Canadians not enough. In this presentation, the author will discuss his perspective on this issue, using examples from published American-Canadian comparative studies. STUDY DESIGN: Several studies will be reviewed including: 1) A study comparing the clinical characteristics of patients and rates of cardiac bypass surgery in Ontario and New York State, Ann Intern Med 1997; 126:13, 2) A study comparing the rates of cardiac procedure use after a myocardial infarction in elderly American Medicare and Canadian patients from Ontario, NEJM 1997;336;1500, and 3) A study comparing the rates and outcomes of carotid endarterectomy in California, New York State, and Ontario, NEJM 1998;339:1441. PRINCIPAL FINDINGS: A common finding across all three studies are that differences in rates of procedure use between the United States and Canada appear to be principally driven by differences in supply factors (i.e., there are many more cardiac and carotid surgeons in the United States than in Canada). Although there are more American surgeons on a per capita basis, Canadian surgeons perform more procedures on average than their counterparts in the U.S. Patients in the United States receive more procedures than those in Canada, but there do not appear to be any significant long-term survival benefits. CONCLUSIONS: Supply factors appear to be a major determinant of differences in procedure use between the United States and Canadian health care systems. Although further research remains to be conducted, the Aright@ rate of cardiac procedure use may be closer to the Canadian rate than that found in the United States. IMPLICATIONS FOR POLICY, DELIVERY, OR PRACTICE: Centralized government control over the diffusion of new cardiac technology and the number of specialists in the single-payer Canadian system, appears to have more successfully controlled the dissemination of cardiac procedures when compared to market-based approaches employed in the United States.
The United States and Canadian health care systems: clinical care: which rate is right?.

 

[Old Rocks]

Mythbusting Canadian Health Care, Part II: Debunking the Free Marketeers
By Sara Robinson

February 11, 2008 - 6:55pm ET


In the previous post, I looked at ten of the most common myths that get bandied about whenever Americans drag Canada into their ongoing discussions about healthcare. In this follow-up, I'd like to address a few of the larger assumptions that Americans make about health care that are contradicted by the Canadian example; and in the process offer some more general thinking (and perhaps talking) points that may be useful in the debates ahead.

Government-run health care is inherently less efficient -- because governments themselves are inherently less efficient.
If anything could finally put the lie to this old conservative canard, the disaster that is our health care system is Exhibit A.

America spends about 15% of its GDP on health care. Most other industrialized countries (all of whom have some form of universal care) spend about 11-12%. According to the WHO, Canada spends a bit over 9% -- and most of the problems within their system come out of the fact that it's chronically underfunded compared to the international average.

Any system that has people spending more and getting less is, by definition, not efficient. And these efficiency leaks are, almost entirely, due to private greed. There is no logical way that a private system can pay eight-figure CEO compensation packages, turn a handsome a profit for shareholders, and still be "efficient." In fact, in order to deliver those profits and salaries, the American system has built up a vast, Kafkaesque administrative machinery of approval, denial, and fraud management, which inflates the US system's administrative costs to well over double that seen in other countries -- or even in our own public systems, including Medicare and the VA system.

Not incidentally: one of the benefits of single-payer health care is that it largely eliminates the entire issue of "fraud." You can only "cheat" a system that already views its primary business as rationing and withholding care. In Canada, where the system is set up to deliver health care instead of profits, and medical access is considered a right, this whole oversight machinery is far cheaper and more compact. In general, the system trusts doctors and patients to make the right choices the first time. As a result, people generally don't have to lie, cheat, and grovel to get the system to deliver the care they need. They just go and get it -- and walk out without a moment's dread about the bills.

Shareholder profit, inflated CEO salaries, and top-heavy administration -- all of which serve to work against the delivery of care, not facilitate it -- are anti-efficiencies that siphon off 20-25% of America's total health care spending. These are huge sums; yet it's mostly money down a gold-plated rathole. In the end, it doesn't provide a single bed, pay a single nurse or doctor, or treat a single patient.

We'll have rationed care
Don't look now: but America does ration care. And it does it in the most capricious, draconian, and often dishonest way possible.

Mostly, the US system rations care by simply eliminating large numbers of people from the system due to an inability to pay. Last year, one-quarter of all Americans didn't go to a doctor when they needed one because they couldn't afford it. Nearly that many skipped getting a test, treatment, prescription, or follow-up appointment recommended by a doctor. In Canada, those same numbers are in the 4-5% range; in the UK, 2-3%. Also: nearly 20% of all Americans had a hard time paying a medical bill last year; and these stresses now trigger over half of all personal bankruptcies in the country.

Furthermore, nominally having health insurance is no guarantee against financial ruin, as Sicko amply illustrated. Being cut off or denied by your insurance company is rationing, too. And there are vast numbers of fairly well-off Americans -- many of them middle-aged, and too young for Medicare -- who have pre-existing conditions that render them uninsurable at any price. They're one heart attack, one diabetic event, or one bad turn away from financial disaster. Please don't insult these people by telling them that the American system doesn't ration care

 

[WillowTree]

and still the canadians and people from all over of the world are breaking down the doors to this shithouse looking for medical treatment..



the blame america first club is now in session!

 

[mskafka]

Overall U.S. mortality

We would have expected to see steady decreases in deaths per thousand in the mid-twentieth century, because so many new drugs and procedures were becoming available. But neither the Canadian nor the American mortality rate declined much; in fact, Canada's leveled off for an entire decade, throughout the 1960s. This was a period in which private care was increasing in Canadian hospitals, and the steady mortality rates reflect the fact that most people simply couldn't afford the new therapies that were being offered. However, beginning in 1971, the same year that Canada's Medicare was fully applied, official statistics show that death rates suddenly plummeted, maintaining a steep decline to their present rate.

In the United States, during the same period, overall mortality rates also dropped, reflecting medical advances. But they did not drop nearly so precipitously as those in Canada after 1971. But given that the United States is the richest country on earth, today's overall mortality rates are shockingly high, at 8.4 per thousand, compared to Canada's 6.5.
Canadian Single-Payer Health Care Program: Is it Better than US Health Care?

Maybe it is the "obesity epidemic". You know that with obesity comes a host of healthcare problems-diabetes, heart problems, high blood pressure, and with diabetes-blindness, neuropathy which often leads to infections, septic shock and leg amputations, diabetes and hypertension are both large contributors to renal failure, and strokes. Oh the list goes on and on.

I would have to do more research to come up with another reason, but you are on to something here.

 

[mskafka]

and still the canadians and people from all over of the world are breaking down the doors to this shithouse looking for medical treatment..



the blame america first club is now in session!

American healthcare is fantastic....if you can afford it. If you have money, the sky is the limit, where healthcare is concerned. You'll get the best doctors (debatable), the best (debatable) hospitals, the most doting treatment (because most healthcare providers know that a complaint or lawsuit is inevitable, and the wealthy are the most likely to complain or sue)

 

[Old Rocks]

Costa Rican Medical Vacation"
Here is why people are making a medical vacation to Costa Rica.



Costa Rica has always been rated very high in the provision of health care.

Costa Rica has become a favored destination for elective surgery, dental care, eye surgery.

Costa Rica is receiving patients for non elective surgery, surgery that is urgent.
Surgery can be costly in North America but is a fraction of the cost in Costa Rica.

We are ready to serve you in all of your needs.

Please ask for references. Your questions will be referred to a medical specialist.

Your cost of a vacation is worth the great savings you will have for the medical care.

Medical Vacation - Costarica.org -

 

[Old Rocks]

and still the canadians and people from all over of the world are breaking down the doors to this shithouse looking for medical treatment..



the blame america first club is now in session!

Why no, I am not blaming America. I working to change America. And it can be done. I saw in done in the '60s concerning Civil Rights, and we can do it now and have a real Health Care System. And we will welcome your contribution that supports it in this nation. Your local IRS man will be glad to make certain of that.

 

[WillowTree]

and still the canadians and people from all over of the world are breaking down the doors to this shithouse looking for medical treatment..



the blame america first club is now in session!

Why no, I am not blaming America. I working to change America. And it can be done. I saw in done in the '60s concerning Civil Rights, and we can do it now and have a real Health Care System. And we will welcome your contribution that supports it in this nation. Your local IRS man will be glad to make certain of that.

no! what you will have is the same thing canada and the uk have,, the chance to pull a number and stand in line and wiat and hope it comes soon enough.. that's what you will have. or perhaps you have some other explanation for why the canadians come south for health care when the desperately need it.