Stop Knocking US Health Care

from the Edmonton Journal (editorial)

There are eight developed countries that spend more public money on health care than Canada does — about one-quarter of all developed nations. According to the Organization for Economic Co-operation and Development (OECD) Switzerland, Norway, Germany, Luxembourg, Denmark, Iceland and Belgium all spend more tax dollars than we do. Sweden doesn't. Nor do France, Britain or Japan.

Sorry? You say that's only seven higher spenders, not eight. You're right. I forgot the other developed nation where governments spend more public money per capita on "free" health care than in Canada: the United States. According to the Friends of State Monopoly Health Care, the U.S. is the Great Satan, the cruelest, most heartless nation on the planet because it refuses to consign all of its citizens to treatment via socialized medicine. Yet federal and state governments in the U.S. spend about $2,200 US per capita each year providing the poor and the elderly with health care. Canada's federal and provincial governments together spend just under $1,900 US providing all of us with medicare, according to the OECD. Admittedly, it costs more money in the U.S. than in Canada to provide similar medical procedures.

This is not, though, because their system with multiple, for-profit insurers is less efficient or more bureaucratic than our single-payer, government-run system. Or because profits are evil. Rather, it costs more because care in the U.S. is provided faster, which takes more staff or more modern equipment, or both.

Health care also costs more in the U.S. because doctors there pay higher malpractice-insurance premiums, and because equipment is replaced for newer models much more often. More pre-procedure testing is performed, too, to eliminate the guesswork before treatments and surgeries are undertaken. And it costs more because their richer market will bear higher prices. But the OECD numbers have already factored in the higher American costs. Its relative international spending levels are calculated on a purchasing power parity basis. So when the OECD says the U.S. spends 20 per cent more per capita on public health care than Canada does, it is wrong to sneer and insist the difference means nothing because that extra money is sucked up in profits or higher administrative costs. The totals have already been adjusted to account for such differences.

What's more, the $1,900 per capita that Canadian governments spend has to be stretched to cover our entire population. The $2,200 spent by American governments only has to be made to cover those over 65, the indigent and the uninsured — less than half their population. Indeed, they spend nearly seven per cent of their GDP on "free" care for less then 50 per cent of their people (the rest are covered by private insurance), ' while we spend 6.5 per cent on care for 100 per cent of Canadians.

We, as a nation, may never choose to adopt American-style health care, but we should at least stop portraying American care as for the rich only, and accept that there are other ways to show compassion than herding everyone in the country onto the same Soviet-style bus. Despite the outrageous propaganda and misinformation in the new movie John Q, in which star Denzel Washington plays a working-class father who cannot afford a heart transplant for his son and is forced to hold a hospital hostage until the uncaring doctors and administrators will do the operation, the poor in the U.S. are treated, and they are often treated better and faster than the average Canadian.

I came across another intriguing set of facts on health care the other day. The Canadian Institute for Health Information says Canada experienced a 17 per cent decline in the number of licensed practical nurses per capita between 1989 and 1998. There was a 7.2 per cent drop in the number of registered nurses per capita and a 0.5 per cent decline in physicians. And, as other recent studies on the brain drain have indicated, some of this decline is attributable to cuts in health-care spending in the early to mid-1990s.

But the CIHI also reports there was a four per cent rise in the number of dentists over the same period, a 13 per cent rise in pharmacists, and increases of 25 to 59 per cent in the ranks of psychologists, physiotherapists, chiropractors and dental hygienists. It is not a coincidence that all of the health professions that witnessed declines in the 1990s are ones that derive all or most of their income from the public purse, while those that expanded are paid mostly from private sources (individuals or private insurers). If Canadians want more and better health care, faster, we must free ourselves from government health monopoly.

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I think both systems are suffering from an overdose of prescription drugs. You only have to look at the statins to see that. About half the people around me over 40 are taking them. The average 60 year-old takes something like 10 different pills, some to counteract the side-effects of other pills. I think medical schools should be branching off into preventative nutrition and other natural health specializations.

Pasteurized milk alone is estimated to cost Canadians $billions in resultant medical costs (and $billions in subsidies). The same is true in the US, including the subsidies. How soon will the NDP do something about the dairy industry here that is killing Canadians left, right and centre? How about some warning labels on milk cartons? This whole industry is geared to satisfy the producers at the expense of consumers. The market and health care systems in both countries have failed miserably on this one item alone. The latest Swedish study (just 2 days ago) identified milk as a risk factor in ovarian cancer. It has aready been associated with breast and prostate cancer - along with such things as obesity, diabetes, asthma, allergies, skin diseases, infant colic, SIDS, serious bacterial outbreaks (yes) and a host of other serious problems. Raw (unpasteurized) milk (which I have never tried) appears to be quite safe by comparison.