Add this Page to Facebook!   Submit to Twitter   Submit to Reddit   Submit to Stumble Upon   Pin It!   Fark It!   Tell A Friend  
Printer Friendly Page Save As Favorite Save As Favorite View Article Stats
1 comment

General News

U.S., Canadian health care systems share some challenges

By (about the author)     Permalink       (Page 1 of 1 pages)
Related Topic(s): ; ; ; ; ; , Add Tags Add to My Group(s)

News 1   Interesting 1   Valuable 1  
View Ratings | Rate It

Headlined to H2 2/1/14

opednews.com

Reprinted with permission of the Association of Health Care Journalists

Second of an on-going series resulting from Trudy Lieberman's recent monthlong visit to Canada as a Fulbright Senior Specialist where she lectured about the American healthcare system and learned much about Canadian medical care.

Part I: Comparing U.S., Canadian health care systems

From http://www.youtube.com/watch?v=octFZaD_EF0: U.S. and Canadian Healthcare Share Common Challenges, Many Differences
U.S. and Canadian Healthcare Share Common Challenges, Many Differences
(image by YouTube)

B oth countries 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.

In 2011, the U.S. won the dubious honor of having the most expensive system in the world, spending about $8,500 per capita. Canada spent about $4,500, making it the third most expensive country among a group of OECD-developed nations .

Still, that number needs perspective . In 1970, a few years before Canada implemented its national health insurance system, both countries were spending about 7 percent of the GDP on health care. Thirty-nine years later the U.S. was spending 50 percent more of its national income on health care, leaving its patients with the highest out-of-pocket expenses in the world. When I explained the high out-of-pocket expenses to Canadians, that notion simply did not compute. There is some talk about imposing copays for some services as a way to help both the federal and provincial governments save money. But the idea of making people pay 50 percent of a bill or a family paying $13,000 out of pocket before insurance benefits kick in is wildly unpopular.

As in the U.S., there's much soul searching about whether the country is getting as much bang for the bucks it spends. Does the quality of care match the country's outlay? A number of studies, including the latest international comparison from The Commonwealth Fund , show that Canada and the U.S both fall down on several dimensions of care. Both Canadians and Americans were more likely to report long waits for primary care and high use of emergency rooms compared to other countries such as Germany, France and the United Kingdom. I asked Jeffrey Turnbull , M.D., F.R.C.P.C., chief of staff at Ottawa General Hospital, about criticisms of the quality of Canadian health care. He said that, when it comes to treating heart attacks, stroke, heart failure and pneumonia "we do relatively well." But when you look at the broader indices that measure the inequities, the picture is very different. "Our vulnerable populations have rates like the developing world." We can say the same for groups in the U.S.

Our two countries also share the increasing burden of providing care for their aging populations . Indeed, lack of community support is one reason why waiting lists develop at Canadian hospitals. Seniors who are admitted to acute care hospitals sometimes stay much longer than what's medically necessary because they have no place to go. The public, though, seems to be paying attention. Last summer the Canadian Medical Association polled residents to measure their priorities for long-term care . Ninety-three percent said the government should develop a comprehensive seniors' strategy. The outgoing president of the CMA said the poll results sent a strong message the public wants action. In a system that's accountable to the taxpayers who fund it, it's easier for the federal and provincial governments to listen. Contrast that with the U.S. where long-term care is barely discussed, and the CLASS Act provision in the Affordable Care Act, a fledgling program to pay for long-term care was repealed .

Health care systems are not static, as Nicholas Timmins , the former health policy editor of The Financial Times, told a group of health care journalists at an Athens meeting a year ago. But neither do they change the fundamentals much. "Countries rarely change the way they do things," Timmins told the group. Canadians may fix their system; we may fix ours, but neither country is rushing to embrace the other's. Timmins added, "What systems do face is the desire to find a way to constrain costs."

To Be Continued...

 

Trudy Lieberman, a journalist for more than 40 years, is a contributing editor to the Columbia Journalism Review where she blogs about health care and retirement at www.cjr.org. Her blogposts are at http://www.cjr.org/author/trudy-lieberman-1/ She is also a fellow at the Center for Advancing Health where she blogs about health at (more...)
 
Add this Page to Facebook!   Submit to Twitter   Submit to Reddit   Submit to Stumble Upon   Pin It!   Fark It!   Tell A Friend
The views expressed in this article are the sole responsibility of the author and do not necessarily reflect those of this website or its editors.

Writers Guidelines

Contact Author Contact Editor View Authors' Articles

Most Popular Articles by this Author:     (View All Most Popular Articles by this Author)

Steven Brill's "Time' Magazine Manifesto On Healthcare Costs Smashes Fences

Comparing U.S., Canadian health care systems

Steven Brill's Blockbuster Article "Bitter Pill: Why Medical Bills Are Killing Us" -- the aftereffects

Report Card on Social Security Trust Fund Coverage - An F for the headlines; a C- for the stories

How the Media Has Shaped the Social Security Debate -- The Press Plays a Dubious Role

Obamacare Exchange Watch: Low Healthcare Costs or California Dreaming?

Comments

The time limit for entering new comments on this article has expired.

This limit can be removed. Our paid membership program is designed to give you many benefits, such as removing this time limit. To learn more, please click here.

Comments: Expand   Shrink   Hide  
1 people are discussing this page, with 1 comments
To view all comments:
Expand Comments
(Or you can set your preferences to show all comments, always)

We often quote the fact  that in the last fe... by BFalcon on Sunday, Feb 2, 2014 at 11:27:24 PM