Monday, February 27, 2006

The Great Debate

I mean universal health care vs. private enterprise, of course.

To focus the debate, let’s just call it Canadian health care vs. US health care.

Too often this debate assumes that every difference in health care between the two countries is based on the financing scheme of the health system, and that every problem either country encounters would be fixed by switching to the other scheme. I reject those assumptions.

There are cultural differences between the two countries that reflect in their approaches to health care. Somebody should do a study or something, but here’s my guess (apologies for cultural stereotyping). Canadians are more cautious and more patient. They want cleaner hospitals and longer hospital time after surgery, but they'll put up with waiting lists and they don’t need the most cutting edge equipment. Americans, on the other hand, want immediate care, and they want the latest procedures and equipment. They can put up with the highest incidence of hospital staph infections in the world, and they can take being booted out of bed the day after major surgery.

Each system has its own strengths and weaknesses. Both provide high quality care, and neither is the clear winner in quality of care.

The one thing that lets me raise Canada's glove in victory is the cost of delivering the care. For exactly the same care---the same medical test, the same drug, the same operation---regardless of who pays for it, Americans pay a whack more dough than Canadians. Why is this? The middle man. There are a ton of profit takers in the US: the company that owns the hospital, the HMO, the company hired to fill out all the forms for the HMO. Canada’s creaky old government-run system is, based on hard dollars and cents, a whole lot more efficient.

Oh yeah, and also everyone is covered with no fees.

See also: The Health of Nations: Oh Canada!


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