[Peace-discuss] Oh, Canada!

[Robert Dunn]

 Please remove me from this list. My inbox is getting too full!


Thank you,

 

Robert Dunn
> Date: Sat, 19 Sep 2009 00:42:28 -0500
> From: galliher at illinois.edu
> To: peace-discuss at anti-war.net
> Subject: [Peace-discuss] Oh, Canada! 
> 
> [We had some disobliging things to say about Canada on News from Neptune (UPTV 
> ch. 6, 7-8pm and soon on <www.newsfromneptune.com>) tonight, but -- to show 
> we're fair and balanced -- nota bene, below. --CGE]
> 
> Canadian Health Care, Even With Queues, Bests U.S.
> By Pat Wechsler
> Sept. 18 (Bloomberg)
> 
> Opponents of overhauling U.S. health care argue that Canada shows what happens 
> when government gets involved in medicine, saying the country is plagued by 
> inferior treatment, rationing and months-long queues.
> 
> The allegations are wrong by almost every measure, according to research by the 
> Organization for Economic Cooperation and Development and other independent 
> studies published during the past five years. While delays do occur for 
> non-emergency procedures, data indicate that Canada’s system of universal health 
> coverage provides care as good as in the U.S., at a cost 47 percent less for 
> each person.
> 
> “There is an image of Canadians flooding across the border to get care,” said 
> Donald Berwick, a Harvard University health- policy specialist and pediatrician 
> who heads the Boston-based nonprofit Institute for Healthcare Improvement. 
> “That’s just not the case. The public in Canada is far more satisfied with the 
> system than they are in the U.S. and health care is at least as good, with much 
> more contained costs.”
> 
> Canadians live two to three years longer than Americans and are as likely to 
> survive heart attacks, childhood leukemia, and breast and cervical cancer, 
> according to the OECD, the Paris- based coalition of 30 industrialized nations.
> 
> Deaths considered preventable through health care are less frequent in Canada 
> than in the U.S., according to a January 2008 report in the journal Health 
> Affairs. In the study by British researchers, Canada placed sixth among 19 
> countries surveyed, with 77 deaths for every 100,000 people. That compared with 
> the last-place finish of the U.S., with 110 deaths.
> 
> Infant Mortality
> 
> The Canadian mortality rate from asthma is one quarter of the U.S.’s, and the 
> infant mortality rate is 34 percent lower, OECD data show. People in Canada are 
> also 21 percent more apt to survive five years after a liver transplant.
> 
> Yet the Canadian “bogeyman,” as U.S. President Barack Obama called it at an Aug. 
> 11 gathering in Portsmouth, New Hampshire, may have “all but defeated” the idea 
> of a public option in the U.S., said Uwe Reinhardt, a health-care economist at 
> Princeton University in Princeton, New Jersey.
> 
> Senate Finance Committee Chairman Max Baucus, Democrat from Montana, introduced 
> on Sept. 16 compromise health-care legislation that, unlike other House and 
> Senate bills, omits a government-backed choice for the uninsured living in the 
> U.S. who can’t afford private coverage.
> 
> Insurance Mandate
> 
> Private insurers, the pharmaceutical industry and the medical profession fear 
> the “market power” of a public plan, Reinhardt said. They “deployed certain 
> think tanks to find horror stories around the world that can be used to persuade 
> Americans a public health plan in the U.S. would bring rationing.”
> 
> Given that Congress is likely to pass a mandate to cover the uninsured, 
> Americans forced to buy policies will be left with no alternative to coping with 
> “double-digit rate increases” on commercial premiums, Reinhardt said.
> 
> “Both systems ration medical care,” he said. “In Canada, they make people wait. 
> In the U.S., we make people pay.”
> 
> Fifty-four percent of chronically ill Americans reported skipping a test or 
> treatment, neglecting to go to a doctor when sick, or failing to fill a 
> prescription because of the cost, according to a 2008 survey by the Commonwealth 
> Fund, a foundation that focuses on health care, and pollster Harris Interactive. 
> That was more than twice the number in Canada, data from those New York-based 
> groups showed.
> 
> Payment Worries
> 
> As the price of health care in the U.S. has risen three to four times faster 
> than the rate of inflation, surveys show that Americans have become concerned 
> they won’t be able to pay medical bills. Forty-three percent of consumers in a 
> June poll by the University of Michigan in Ann Arbor said they worried they 
> might not be able to afford care, even with insurance.
> 
> “Canadians value fairness, and they cannot conceive of a system in which someone 
> can’t get health care,” said Wendy Levinson, a Canadian who runs the department 
> of medicine at the University of Toronto and worked in the U.S. from 1979 to 2001.
> 
> The U.S. spent $7,290 on health care for each person in 2007, 87 percent more 
> than Canada’s $3,895, according to the latest OECD data. The U.S. also devoted 
> the highest percentage of gross domestic product to health care, 16 percent, 
> OECD numbers show. Canada’s expenditure was 10.1 percent.
> 
> Canada’s system consists of 10 provincial and three territorial nonprofit 
> insurance plans that cover all citizens, including those with pre-existing 
> conditions. It operates like Medicare, the U.S. program for the elderly and 
> disabled. In Canada, the government uses taxpayer funds to pay claims by 
> doctors, who mostly work in private practice or for a hospital and are paid fees 
> for their services.
> 
> Effect of Technology
> 
> Care is free where it’s provided, as in a doctor’s office, except for dentistry, 
> nursing home stays, prescription drugs outside hospitals, and rehabilitation 
> services. The elderly and low-income residents get help with pharmaceutical 
> purchases.
> 
> Technology partly explains the cost discrepancy between the two nations. There 
> are 67 percent more coronary-bypass procedures in the U.S. than in Canada and 18 
> percent more Caesarean sections, OECD data show. In 2006, the U.S. had more than 
> four times the number of magnetic resonance imaging units - - 26.5 for every 
> million residents compared with 6.2 for every million in Canada -- making 
> Americans three times more likely than Canadians to get a scan, according to the 
> OECD.
> 
> In the U.S., technology is “overused” because doctors have to justify equipment 
> purchases with revenue, according to Gerard Anderson, a professor of public 
> health and medicine at Johns Hopkins University in Baltimore. Canada in the 
> 1960s was about as expensive as the U.S., he said.
> 
> No. 1 in Cost
> 
> “The real difference has been their ability to control technology costs,” said 
> Anderson, who directed reviews of health systems for the World Bank and 
> developed U.S. Medicare payment guidelines for the Health and Human Services 
> Department. “The only thing the U.S. is consistently No. 1 in when it comes to 
> international comparisons with Canada and other OECD countries is cost.”
> 
> Less technology and, according to a 2007 report from the World Health 
> Organization, 20 percent fewer doctors in Canada than in the U.S. have led to 
> longer lines north of the border.
> 
> In 2008, 20 percent of chronically ill Canadians surveyed by the Commonwealth 
> Fund reported waiting three months or more to see a specialist. Five percent of 
> Americans polled said they had to wait that long.
> 
> Television Commercial
> 
> Washington-based lobbying groups including Americans for Prosperity and 
> FreedomWorks have seized upon the delays, arguing that Obama’s proposal for a 
> public option would eventually put private insurers out of business and force 
> everyone to live with government-paid coverage and substandard care. 
> FreedomWorks is led by Dick Armey, a former Republican congressman from Texas.
> 
> An educational foundation affiliated with Americans for Prosperity paid $3.3 
> million to run a 60-second television commercial on U.S. stations in which Shona 
> Holmes, a 45-year-old native of Waterdown, Ontario, accused the Canadian 
> health-care system of almost causing her to die by delaying critical treatment, 
> according to Amy Menefee, a spokeswoman for the foundation. The ad ran for three 
> weeks and was repeated on Sept. 9 after the president’s speech.
> 
> The TV spot first aired in May. Holmes, a mother of two and a self-employed 
> family mediator, said in the ad that she went to the U.S. for care. She traveled 
> 2,237 miles (3,599 kilometers) to the Mayo Clinic in Scottsdale, Arizona, and 
> spent $97,000 for treatment of a benign brain tumor rather than wait for 
> insurance-paid care in Canada, she said in a telephone interview.
> 
> Bridge to Canada
> 
> “I felt strongly I could speak out because I’ve seen both systems,” Holmes said. 
> “I have seen how government involvement plays very negatively.”
> 
> Obama administration officials are trying to use the public option as “a bridge” 
> to a system like Canada’s since “they realize it isn’t politically acceptable to 
> go directly to that,” said Phil Kerpen, the director of policy for Americans for 
> Prosperity.
> 
> In Ontario, where Holmes lives, the average waiting time for surgery to remove a 
> tumor was 99 days in the second quarter, according to the Ontario Health 
> Insurance Plan’s Web site. If a patient was willing to go closer to Ottawa, the 
> wait was 36 days at Pembroke Regional Hospital Inc. in Pembroke, 460 miles from 
> Waterdown and 93 miles northwest of the Canadian capital. Closer to Waterdown, a 
> patient could go to St. Joseph’s Healthcare Hamilton, less than 10 miles away, 
> with a 56-day wait.
> 
> Ontario Appeal
> 
> Holmes began speaking out publicly, she said, after she couldn’t get Ontario in 
> July 2005 to speed removal of her craniopharyngioma, a type of slow-growing 
> cystic tumor that can put pressure on the brain or optic nerve. She is now 
> pushing for the province’s insurance plan to reimburse her for the money she 
> spent on surgery, tests and follow-up, she said in the interview.
> 
> Andrew Morrison, a spokesman for the Ontario plan, said Canadians need approval 
> before getting care outside the country if they want to be reimbursed. He 
> declined to comment on the Holmes case. Lori Coleman, registrar for the 
> Toronto-based Health Services Appeal and Review Board, which handles complaints 
> about the Ontario plan’s eligibility and payment decisions, also declined to 
> comment.
> 
> Even with the waits, a majority of Canadians balk at the idea of turning 
> government insurance over to private hands. In a July Harris/Decima poll, 55 
> percent of respondents said improvement should be made through the public plan, 
> while 12 percent favored a private solution.
> 
> Doctor Visits
> 
> In both the U.S. and Canada, 26 percent of people interviewed told the 
> Commonwealth Fund survey of chronically ill adults they got a same-day 
> appointment with a doctor when they were sick -- the lowest number in any of the 
> eight countries polled by the foundation. Thirty-four percent of the Canadians 
> said they had to wait six days or more, compared with 23 percent of the Americans.
> 
> Canadians visited their doctors more frequently: 5.9 visits per person compared 
> with four for those in the U.S., according to 2005 OECD data.
> 
> The U.S. leads industrial countries in the portion of the health-care dollar 
> devoted to processing claims and paying providers, the Commonwealth Fund said.
> 
> Private-insurance administrative costs in the U.S. are 12.7 cents of a dollar, 
> and as high as 18 cents for some companies, said Karen Davis, president of the 
> Commonwealth Fund. Government plans, including Medicare and Medicaid, spend 5.8 
> cents excluding costs of private drug plans, she said. In Canada 4.2 cents is 
> spent on administration.
> 
> “If we lowered our administrative costs to that of the lowest three countries 
> with mixed public-private health-care systems, we could save $50 billion a 
> year,” Davis said. “This would go a long way toward financing coverage for the 
> uninsured.”
> 
> To contact the reporter on this story: Pat Wechsler in New York at 
> pwechsler at bloomberg.net
> Last Updated: September 18, 2009 12:22 EDT
> 
> http://www.opednews.com/populum/linkframe.php?linkid=97622
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