Thursday, June 16, 2005

Private health care bogeymen? Think again…

In any discussion in which even a timid proposition for private health care in Canada is made, an inevitable uninvited comparison is made with American health care, effectively ending rational debate — it's like the Canadian medicare version of Godwin's Law. No wonder the Conservatives have backed off somewhere left of the Marxist-Leninist Party's position. But when opponents of private health care in Canada reflexively raise the spectre of American-style health care, what exactly are they trying to frighten us with?

The Eclectic Econoclast and Gods of the Copybook Headings point out a fascinating article by Norma Kozhaya in the National Post (no subscription required) that tries the credibility of two of the most common Canadian myths about American health care. It's strange that ignorance is so prevalent when most Canadians live within a couple hours' drive of the border — of course, this doctrinaire ignorance is shared by many Americans who value politically-motivated conventional wisdom above their own experiences.

Myth #1: Poor and uninsured Americans receive little or inadequate health care.

The uninsured have at their disposal a safety net, namely the public hospital network: This in fact constitutes a sort of informal hospital insurance. Even the uninsured can obtain health care. The Congressional Budget Office writes that "many people without insurance have access to at least some sources of health care, either through public hospitals, community health centres, local health departments, or Department of Veterans Affairs facilities." OECD researchers have made a similar observation: "Local governments, in conjunction with states, play an important role in financing the so-called safety net providers (e.g., county hospitals) that serve the indigent."

These facts are illustrated by a letter last year from Susan W. Weathers, a doctor in Texas, to the Wall Street Journal. The Canadian system, she explained, "resembles the county hospital where I work. Our patients pay little or nothing. They wait three months for an elective MRI scan and a couple of months to get into a subspecialty clinic. Our cancer patients fare better than the Canadians, getting radiotherapy within one to three weeks. The difference is that our patients are said to have no insurance (a term used interchangeably with no health care) whereas Canadians have 'universal coverage.'"
Myth #2: U.S. health care is completely privatized.
All told, the U.S. spends more on public health care than most large western countries. Public health care spending as a proportion of GDP is 6.6% in the U.S., ninth among the 30 OECD countries, and just after Canada's 6.7% of GDP. Moreover, per capita government spending is higher in the U.S. than in Canada - $2,364 compared to $2,048 at purchasing power parity, based on OECD data.
Other niggly Canadian myths are exposed in the article as well, so read the whole thing.

Cross posted at Dust my broom.