Universal healthcare's dirty little secrets

And the solution, of course, is to price healthcare out of the reach of the poor to prevent them from clogging up the system....

Using the countries listed as a comparison:

England has an infant mortality rate of 5, and an average life expectancy of 78.7. Canada has an infant mortality rate of 4.6 of 80.3.

These are both a tiny bit better than the US which as an infant mortality of 6.4 and an average life exptancy of 78.0.

However, the US spends $6,400 per capita on healthcare annually (this is the figure from 2006). This is about 15.3% of our GDP.

England spent $2,500 per capita on on healthcare in the same time, about 8% of its GDP.

Canada spent $3,100 per capita or 9.9% of their GDP.

The US is spending much more (more then twice as much by any measure) on health care, yet our public health is a bit worse.

Any subjective, rationale look at healthcare would lead one to believe that universal health care is a great idea.

e-brown quote:
"Canada spent $3,100 per capita or 9.9% of their GDP"

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So let's check out "Health care in Canada".


Parliament unanimously passed the Canada Health Act in 1984 and established a single-payer, publicly-financed health care system. To ensure a true government monopoly (is there any other kind?) Canadian provinces outlawed private health insurance.

Chaoulli v. Quebec UPDATE (June 9, 2005): In a 4 to 3 decision, the Canadian Supreme Court struck down Quebec's law that prohibits private medical insurance.

U.S. Patients have Greater Access to Advanced Medical Technology Than Do Canadians


* Cancer patients question why PET scan not covered
- May 28, 2007 [CBC News]

* BC Medical Association: Waiting Too Long for Hip and Knee Surgery Costs $10,000 Per Patient-Maximum Wait Times Should Be No Longer Than 6 Months
- June 28, 2006 [CCN Matthews]

* Ont. physician turns away patient for being 55+
- March 17, 2006 [CTV.ca]

* Canada inches toward private medicine
- Rebecca Cook Dube, August 8, 2005 [The Christian Science Monitor]

* Doctor defends private cancer clinic
- Gillian Livingston, July 15, 2005 [Canadian Press]

* Dogma trumps truth in health-care issues
- D'Arcy Jenish, July 7, 2005 [Ontario Business News]

* Why Canadians Purchase Private Health Insurance
- Walter Williams, June 20, 2005 [Capitalism Magazine]

* Doctor welcomes health ruling
- June 9, 2005 [CBC Montreal]

* Patients shouldn't wait more than 8 weeks for cardiac defibrillator: experts
- May 24, 2005 [Canadian Press]

* Grads fail to slow doctor shortage
- Jennifer O'Brien, May 21, 2005 [London Free Press]

* Free Canadian health care comes at cost
- April 10, 2005 [Arkansas Democrat-Gazette]

* Canada's drug tab reaches $22 billion, report suggests
- Sheryl Ubelacker, CP, April 6, 2005 [London Free Press]

* Canadian health care is free and first-class -- if you can wait
- Beth Duff-Brown, March 19, 2005 [The Associated Press]

* Pediatricians, parents warn of shortage of community-based care for children
- Colin Perkel, March 4, 2005 [The Canadian Press]

* Access to specialists difficult: study
- February 16, 2005 [CBC Calgary]

* Doctor shortages, frustrations vary from region to region, survey shows
- February 15, 2005 [Canada.com]

* Montreal leads the country in offering private health care
- Aaron Derfel, February 12, 2005 [Montreal Gazette]

* Canada falling short on medical imaging
- February 9, 2005 [Macleans.ca]

* Creative incentives required to retain older doctors
- Dr. Charles Shaver, January 20, 2005 [Toronto Star]

* MRI gap defies cash fix
- Mark Kennedy, January 14, 2005 [National Post (Canada)]

* A boy's plight, a nation's problem
- Lisa Priest, January 13, 2005 [The Globe and Mail]

* Where's proof private clinics cost more?
- Tom Brodbeck, December 4, 2004 [The Winnipeg Sun]

* Surgery backlog tops 5,500 at kids' hospitals; One-year waits common
- Aaron Derfel, December 3, 2004 [The Gazette (Montreal)]

* Hospital wait lists to get worse, Carriere says
- Chris Traber, November 14, 2004 [Yorkregion.com]

* Frustrated patients can't handle ER waits
- Jennifer Stewart and Jeffrey Simpson, October 28, 2004 [The Halifax Herald Limited]

* Private medical clinic opens in Montreal
...it answers, "an ever-increasing demand from the public for greater accessibility and quality of health services." - October 13, 2004 [CTV.ca]

* Canadians have higher death risk than Americans after heart attack: study
- Sheryl Ubelacker, September 20, 2004 [Canada.com]

* Canadian medical tourists in India
- Jeremy Copeland, September 20, 2004 [CBC News]

* Doctor shortage cripples Canada's free health care
- Clifford Krauss, September 18, 2004 [Minneapolis-St. Paul Star Tribune]

* Canada's Once-Proud Public Health System in Crisis
- David Ljunggren, September 14, 2004 [Reuters (Ottawa)]

* Hospitals to cut, again
- September 5, 2004 [Toronto Star]

* Canada's Medical Nightmare
- Robert J. Cihak, M.D., September 1, 2004 [Health Care News]

* Canada faces shortage of doctors
- August 19, 2004 [MSNBC]

* Canadians losing faith in health system: poll
- August 16, 2004 [CTV.ca]

* Ontario hospitals a health risk
- Michael Hurley, August 8, 2004 [Toronto Star]

* Need surgery? Here's how long you'll wait
"It's inhuman. The quality of my life is horrible and there's absolutely nothing I can do about it." - Jason Fekete, July 28, 2004 [Calgary Herald]

* Docs, nurses fed up
Canadian doctors and nurses are fed up with inter-governmental "bickering" that is dragging out wait times and causing more pain and suffering for patients. - July 28, 2004 [Winnipeg Sun]

* Free Health Care?
...in some cases, patients die on the waiting list because they become too sick to tolerate a procedure. - Walter E. Williams, July 24, 2004 [CATO]

* The truth about Canada's ailing health-care system
All the major candidates in Canada's recent national election acknowledged that the country's health-care system is failing Canadians. - Robert J. Cihak, July 13, 2004 [The Seattle Times]

* Health-care crisis looms, even with new money
Canada's health-care system is "five to 10 years" from the breaking point -- even with cash injections from government, says the new president of the B.C. Medical Association. - Doug Alexander, July 5, 2004 [Vancouver Sun]

* Emergency room delays a strong campaign factor
"Go into the emergency room ?- it is the most pitiful piece of work you ever seen in your life." - David Bruser, June 22, 2004 [Toronto Star]

* Canadian Health Care in Crisis
Analyst visits NC to describe how single-payer health care really works in practice. - Donna Martinez, June 17, 2004 [Carolina Journal]

* Quebec cancer patients sue over wait
Women waited months for radiation; lawsuit could cost system $50-million. - Ingrid Peritz, March 11, 2004 [The Globe and Mail]

* Health care: no waiting lists
'You get knee surgery within two days ... try and get that in human hospitals.' Canada's [private] pet health-insurance industry is projected to grow at roughly 50 per cent a year... - Robert Scalia, November 30, 2003 [Montreal Gazette]

* For some, surgery abroad a welcome answer
- Daniel Girard, November 29, 2003 [Toronto Star]

* Canadian Doctors Eyeing United States
- Clifford Krauss, October 17, 2003 [The New York Times]

* The Top Ten Things People Believe About Canadian Health Care, But Shouldn't
- Brian Lee Crowley, October 9, 2003 [Mackinac Center for Public Policy]

* Canadians' health at risk, CMA says
- Valerie Lawton, September 26, 2003 [Toronto Star]

* Burnout is now doctors' ailment
Almost half of Canadian doctors say they're burned out, emotionally exhausted and blame medicine for putting a drain on their family life. - Karen Palmer, August 20, 2003 [Toronto Star]

* New MRI clinic in row over poaching
While she insists she's not making any money off the venture, she says it provides an income allowance for her and her husband, the other principal in the company. - Theresa Boyle and Robert Benzie, July 28, 2003 [Toronto Star]

* Price Controls and Overall Drug Spending
The Canadian system, however, tends to push up overall spending on prescription drugs, despite the low prices for some brand name ones. - John Melby, July 2, 2003 [Buckeye Institute]

* Gore Endorses Canada's Medical System
- William L. Anderson, November 29, 2002 [Mises]

* How Good is Canadian Health Care?
- August 2002 [Fraser Institute]

* Canadian Health-Care System Is No Model for Prescription Drug Reform
- May 1, 2001 [Mackinac Center for Public Policy]

* The Ghost of America's Health Care Future Lives in Canada Today
- James Frogue and Robert Moffit, December 25, 2000 [Capitalism Magazine]

* Socialized Medicine: The Canadian Experience
Explores several lessons that can be drawn from the Canadian experience with socialized medicine:
o Socialized medicine, although of poor quality, is very expensive;
o Political compromise is the result;
o Socialized medicine is both a consequence and a great contributor to the idea that economic conditions should be equalized by coercion. - Pierre Lemieux [The Freeman]

* Canadian Health Care
...if Canadians knew as much as they think they do about the economic and moral workings of Medicare, they might not be as enthusiastic as they are about their cherished right to 'free' health care. - Andrei Kreptul, August 30, 2000 [Mises]

* When Patients Become Victims - The Crime of Government-Run Health Care
- Merrill Matthews Jr., Ph.D. and Kerri Houston, May 1, 2000 (PDF format)

* Socialized Medicine Leaves a Bad Taste in Patients' Mouths
- Lawrence W. Reed, February 23, 2000 [Mackinac Center for Public Policy]

* Canadians Dissatisfied With Socialized Medicine
- January 26, 2000 [NCPA]

* Memo to Al Gore: Canadian Medicine Isn't Cheap or Effective
- William McArthur, former chief coroner for British Columbia, January 28, 2000

* Loved to Death: America's Unresolved Health-Care Crisis
As Canada's national government slashes spending on medical care in order to reduce the deficit, local provinces are reducing medical staff. In Ontario, pregnant women are being sent to Detroit because no obstetricians are available. Specialists of all kinds are in short supply. Patients have to wait eight weeks for an MRI, ten weeks for referral to a specialist, and four months for heart bypass surgery. - Michael J. Hurd, November 1997 [Liberty Haven]

* Is Canadian Health care a Good Model for the U.S. to Follow?
- Michael Walker, August 1994 [Liberty Haven]

* Health of the State (commentary by a cancer survivor)
I tell you this not to alarm you, to elicit sympathy, or to bore you. I tell you because the episode has been, for me, a salutary lesson (just in case I needed one) in why the government should not be allowed anywhere near a syringe, a dressing, a scalpel, an oxygen mask, a tissue sample ?- anything to do with health.

* Michigan Shouldn't Copy Canada's Health System
Crippling strikes in Canada's monopolized system are not uncommon. In 1988, nurses in Alberta shut down virtually that province's entire health care system for six weeks. - Lawrence W. Reed, July 29, 1991 [Mackinac Center for Public Policy]

* Joshua Fleuelling of Ontario, died of asthma in January 2000.
o A victim of Mike the knife
- January 20, 2000 [Eye Review]

o Toronto Staff Report
Subject: Toronto EMS Response to Recommendations Arising from the Fleuelling Inquest and Responses to January 11, 2001 Community Services Committee Item #7 - Toronto EMS efforts to deal with overcrowding of Hospital Emergency Departments.

http://www.angelfire.com/pa/sergeman/issues/healthcare/socialized.html

Yep. Because faced with the hard overall, national data about mortality rates, the obvious retort would be a lengthy overview of anecdotal evidence.

Do you really think one could not easily gather together a comparable list of negative headlines about US health care, Miller? Or about health care in any country?What's it supposed to prove?

Ebrown's point is simple enough. You spend twice as large a proportion of your GDP on health care, yet on simple indicators like infant mortality and average life expectancy, you do worse.

Well, yeah. The US has a system oriented towards spending significant money on people who can afford insurance, offering them exceptional care (usually; like you say, there's anecdotes to the contrary) while people who are really poor don't get much more than emergency care. So of bloody -course- it has higher infant mortality and lower life expectancy, given that advanced medical care doesn't really have much of an effect on infant mortality and there's a limited return on investment for life expectancy.

The advantage of living in the US, assuming you make enough money to afford insurance, is that there are a lot of things that are likely to kill you elsewhere, but not here. People don't fly to Houston for our cancer center because they like the weather! You're much more likely to be able to get an MRI, a hip bone replacement when you get old, lasik for the eyes, what have you, without having to wait weeks or months.

The disadvantage is that there are people who don't get medical care until something terrible happens, and by that point you're usually in a lot of trouble.

So saying that the statistics which are supposed to be better in countries with universal health care... are better in countries with universal health care, is that the contention? Well, duh. Thanks for the blinding flash of the obvious. At the same time, though, there are a lot of things those health care systems don't do well; care to compare the statistics on those?

There are two separate issues here...

The first is a moral/philosophical question about what is the purpose of a public health care system. How do we balance the resources between the rich and the poor, and between the greater needs and the lesser needs. Should a rich person be able to $1 million non-life threatening knee surgery, while a poor person who needs a $500,000 operation on a critical, but curable ailment dies simply because they can't afford it.

Of course, this is one of those issues with many nuances and most of us fall between the two poles.

But I suspect that many of us will disagree about whether being wealthy or poor should effect your ability to get important but expensive medical treatment.

But the second issue seems more clear to me. The US system is clearly very inefficient. The costs to businesses, individuals and taxpayers are very high (and rising) where other systems get comparable results with a fraction of the cost.

Clearly having millions of people who are uninsured is stupid, since they end of costing much more to treat (and this cost for largly poor people is paid by both higher costs to employers and individuals and by taxes).

People with insurance go for checkups where diseases can be caught and treated early and cheaply. People without insurance end up in the Emergency rooms with fullblown critical diseases in advanced stages.

This simply doesn't make any sense no matter what position you take on the first question.

It's not the first item I'd like to do away with, it's the second.

Drew, it's not an a la carte menu. You get one or the other. Spreading the US system of care universally will -necessarily- mean that we're spending less on advanced care. Yes, yes, you can cut a bit of fat in the way of unnecessary tests and the like, right up until you don't test for something and someone drops dead of it two years later; which is more or less precisely what I'm talking about. Some of the fat in the system is doctors being careful with people's lives, so cut too deep and people actually die.

Even worse, unlike other Western nations that have instituted socialized care, there's nobody else to keep up the standard of care; we can't just bop over to Britain for the best care money can buy. I suppose we can always export THOSE jobs to India too...

Many individuals, who do have health insurance, don't take care of themselves and thus fail to be screened for diseases such as breast cancer and prostate cancer.

Too many women, who do have insurance, fail to recogonize the importance of yearly mammograms or the importance of breast self-examination. Yes, they pay the premiums for insurance, but they fail to do their own part by utilizing the healthcare system to screen for disease.