11.04.2005

"quietly imploding"

I get so tired of hearing the Canadian health care system slandered by Americans who don't know what the hell they're talking about. It's not like they make valid points that can be discussed and debated. They simply don't know what they're talking about, because they are informed solely by myths.

As onomatopoeia said (I recently quoted him here): "Sure the Canadian system has its own problems, but if you want to know what those problems are, ask any Canadian, not an American."

The way most Americans talk about Canada's health care, you'd think everyone south of the 49th parallel had affordable, accessible, expert care. We know far too many lack the first two criteria. What about the third?

From the Washington Post, with thanks to Redsock:
Americans pay more when they get sick than people in other Western nations and get more confused, error-prone treatment, according to the largest survey to compare U.S. health care with other nations.

The survey of nearly 7,000 sick adults in the United States, Australia, Canada, New Zealand, Britain and Germany found Americans were the most likely to pay at least $1,000 in out-of-pocket expenses. More than half went without needed care because of cost and more than one-third endured mistakes and disorganized care when they did get treated.

Although patients in every nation sometimes run into obstacles to getting care and deficiencies when they do get treated, the United States stood out for having the highest error rates, most disorganized care and highest costs, the survey found.

"What's striking is that we are clearly a world leader in how much we spend on health care," said Cathy Schoen, senior vice president for the Commonwealth Fund, a private, nonpartisan, nonprofit foundation that commissioned the survey. "We should be expecting to be the best. Clearly, we should be doing better."

Other experts agreed, saying the results offer the most recent evidence that the quality of care in the United States is seriously eroding even as health care costs skyrocket.

"This provides confirming evidence for what more and more health policy thinkers have been saying, which is, 'The American health care system is quietly imploding, and it's about time we did something about it,' " said Lucian L. Leape of the Harvard School of Public Health.

The new survey, the eighth in an annual series of cross-national surveys conducted by Harris Interactive for the fund, is the largest to examine health care quality across several nations during the same period. The survey was aimed at evaluating care across varying types of health care systems, including the market-driven U.S. system and those that have more government controls and subsidies.

The survey, published in the journal Health Affairs, questioned 6,957 adults who had recently been hospitalized, had surgery or reported health problems between March and June of this year.
Read the article here.

15 comments:

Expat Traveler said...

The biggest problem is that the US government is behind the medical industry and is only there to make money. That's why people who are against the FDA get hushed. That's also why when there are cures for diseases the government lashes out against you. You don't have a right to speak. People in the states have a rude awakening in the future.

L-girl said...

The FDA has problems, now that it functions on behalf of the government instead of the people (like all the agencies that were originally set up to protect consumers). But the FDA is not at the root of the problem. You'd have to look at the ties of the government to the insurance industry and the American Medical Association to see that.

That's also why when there are cures for diseases the government lashes out against you.

Not sure what you mean by this?

deang said...

I can't help thinking that much of the problem with US health care is that doctors and providers are more motivated by money and status than by what should be the calling of their profession, serving people in need. It's not the government that's the problem, it's the privatization of government based on the claim that everything should be run like a business, for profit. In order to make a profit, you have to reduce services in order to minimize expenditures. Thus, people suffer.

L-girl said...

Dean, you're right, that's the root.

My reference to the government's ties to the insurance industry is about why things don't change, despite widespread public discontent.

The insurance companies reap huge profits from the status quo. They give huge sums to election campaigns, so they "own" the people who could change things.

This is only one factor, of course, there are others. But one reason national health insurance is always portrayed as a terrible thing is because too many people profit off the system the way it is, and too many politicians depend on that profit.

RobfromAlberta said...

But one reason national health insurance is always portrayed as a terrible thing is because too many people profit off the system the way it is

And this is why you will never see socialized medicine in the US, it would cause unimaginable harm to the economy. The insurance industry in the US is enormous. Dismantling something that large would put tens of thousands of people out of work and cost hundreds of billions of dollars. You really want to be sure about something like that.

L-girl said...

it would cause unimaginable harm to the economy.

Rob, you know better than that. Remember when Toyota chose Ontario for its new plant over Alabama? The primary reason was Canada's single-payer health care system. If employers didn't have to pick up the tab for employee health care - or run in circles trying to avoid it - the US economy would improve.

That's only one of many ways that national health insurance (not "socialized medicine" - you know that!) would improve the economy. Tens of millions of people without access to health care, and everything that stems from that, is not good for the economy.

Some people would profit less, it's true. But many more would profit more.

I know you admire the US, but you can't seriously extend that admiration to the way it handles its citizens health care, can you?

RobfromAlberta said...

On the contrary, I think the American health care system is an abomination and certainly, in the long run, a single-payer, universal health care system would be a boon to American society. But the job is too big and too expensive to accomplish. You are basically talking about dismantling one of the largest industries in the country. Can you imagine the hardship if the US government decided to end automobile manufacturing or pharmaceutical production? That is what we are talking about here. I'm afraid the US crossed the Rubicon decades ago as far as health insurance is concerned.

James said...

It's not the government that's the problem, it's the privatization of government based on the claim that everything should be run like a business, for profit.

Of course, part of the reason that's a problem is that one of the major parties works very hard to promote that idea... :P

In order to make a profit, you have to reduce services in order to minimize expenditures. Thus, people suffer.

The very concept that amount of profit is not always the best metric for success seems alien to some people.

With health care, the "our primary responsibility is to our shareholders" attitude can be especially disgusting. If a hospital lets down its shareholders, they have a little less money. If it lets down their customers, they die. It should be no contest.

orc said...

The private US heathcare system isn't sustainable over the long run, so it's going to collapse sooner or later. A good reason to force it to collapse now is that (this is assuming the United States had a sane government, which it does not) you can attempt to mitigate the side-effects of the collapse. (Think of a controlled demolition of a skyscraper vs. an uncontrolled collapse.) If the United States waits until the day when the healthcare system starts to actively implode, there won't be _time_ to do anything but scramble around trying to put out fires.

L-girl said...

On the contrary, I think the American health care system is an abomination and certainly, in the long run, a single-payer, universal health care system would be a boon to American society.

I thought you did. So I was confused. Later I thought, maybe he was being sarcastic...

But the job is too big and too expensive to accomplish.

I despair of it ever happening politically, but I can't think that it can't happen, if there was the political will.

Too many negatives in that sentence...

With health care, the "our primary responsibility is to our shareholders" attitude can be especially disgusting.

Yes! Truly.

If a hospital lets down its shareholders, they have a little less money. If it lets down their customers, they die. It should be no contest.

This reminds me - totally off-topic - of people calling "sport" hunting a contest. Let's see, you lose the contest, you go home without a deer. The deer loses, it dies. Hmmm, some contest.

The private US heathcare system isn't sustainable over the long run, so it's going to collapse sooner or later. A good reason to force it to collapse now is that (this is assuming the United States had a sane government, which it does not) you can attempt to mitigate the side-effects of the collapse.

That's a very good point, and of course an excellent parenthetical thought.

Lone Primate said...

You are basically talking about dismantling one of the largest industries in the country.

Seems to me that insurance companies in Canada are making a tidy profit selling us insurance policies "above and beyond" that Medicare offers. Private room? Private insurance. Now are you telling us those canny Yankees can't ace in spades what we slothlike Canucks, and so many others elsewhere, have managed, and come out smelling like roses? ;)

And besides... are you really going to side with insurance companies when they say their right to make a profit trumps an American citizen's right to access the health care system, and without fear of bankruptcy? Come on... devil's advocate, cure thyself.

Lone Primate said...

This reminds me - totally off-topic - of people calling "sport" hunting a contest. Let's see, you lose the contest, you go home without a deer. The deer loses, it dies. Hmmm, some contest.

There ought to be a draw... if you get a hunting license, you always have a 1:5 chance of being "drafted" to be sprayed with buck pheremones and released in the wild to be gored by enraged stags who think you're after their does. If you make it to a logging road (and don't get run over by a truck barreling along at 125 km/h), you win. :)

L-girl said...

Lone Primate, I like the way you think. :)

RobfromAlberta said...

Seems to me that insurance companies in Canada are making a tidy profit selling us insurance policies "above and beyond" that Medicare offers.

Yes, I'm sure Canada's tiny private health care industry is quite profitable, but the situation is precisely the opposite in the US. We are privatizing a procedure here and there and the insurance companies move in to fill the niche. There is modest, but steady growth as the population grows (and grows older). In the US, you are talking about moving in the other direction and on a monumental scale.

Remember, many of the same companies that provide medical insurance and holding liabilities in other sectors as well. When half the insurance companies in the US go out of business because of lost medical insurance policies, what happens to all that liability? There is a huge house of cards here. The entire US economy depends on insurance and the insurance industry depends on private health care.

Lone Primate said...

When half the insurance companies in the US go out of business because of lost medical insurance policies, what happens to all that liability?

It'll be assumed by the other half, obviously. You're making it sound like insurance companies insure houses and cars at a loss as a courtesy to people for buying medical insurance. I really doubt that's the case. No policy exists for long if it isn't, at least statistically, a money-maker. If insurance company A goes under on the basis of its medical line alone, it wasn't running its other lines properly and probably couldn't have been counted on in the first place. Insurance company B, which does run such policies on a paying basis, will be happy to take on the new business. Hey, that's the American way, isn't it?

You're giving a solid American line here. That would be understandable if you were an American who never looked beyond the lower 48 and didn't know any better. But you're not. You're Canadian. You KNOW that we, and virtually every other developed country on Earth, has managed to institute some level of public-payer health care without having its insurance industry sucked into a black hole. So why this patently false line of American propaganda? Why are you trying to get us to believe that the rest of us could manage something that the United States -- the country that likes the rest of the world to believe it perfected venture capitalisim -- can't?