Commentaries, International Health Systems
In their recent “Report on Business” commentary, authors Charles Lammam and Stephen Kirchner of the Fraser Institute urge the Province of Ontario to adopt an Australian model of pension provision instead of expanding the Canada Pension Plan as proposed in the Ontario Retirement Pension Plan.
I’m a U.S. family physician who has decided to relocate to Canada. The hassles of working in the dysfunctional health care “system” in the U.S. have simply become too intense.
In many countries, bereaved families get condolence cards and flowers. In the U.S., the survivors are also deluged with hospital bills and insurance paperwork. That paperwork isn’t merely an insult. It costs U.S. society a fortune.
The latest Commonwealth Study ranked Canada’s health care system a dismal second to last in a list of eleven major industrialized countries. We had the dubious distinction of beating out only the Americans. This latest poor result is already being used by those bent on further privatizing health care.
Both Canada and the United States are historically and practically steeped in fee-for-service medicine, and much of the power to control prices rests in the hands of the medical establishment. While provincial governments have periodic negotiations with medical and hospital groups, and there are global budgets for hospitals that try to constrain costs, the system is relatively expensive.
We know that the U.S. has the most expensive health care in the world. But beyond noting that dubious achievement, we seldom ask why. On my recent visit to Canada as a Fulbright scholar, I stopped by to pose that question to one of their leading health care experts, David Dodge, an economist who has served as federal deputy health minister and seven terms as governor of the Bank of Canada.
Here’s a fact most Canadians probably don’t know: Canadians live longer than people in the United States. Specifically, women in Canada live an average of 83 years, compared to 80 in the United States; men live over 78 years on average compared to 75 in the United States. Why is this the case? There are clear links between mortality rates and the way countries invest in healthcare and improving social conditions.
One thing Americans and Canadians can agree on is that we don’t want each other’s health care systems. In truth, most Americans don’t know how Canada’s system works and Canadians don’t know much about the U.S. system.
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