Ralph Nader has come up with a list of 21 reasons why the Canadian health care system is better than the one that the US has. It is pretty good. Here are just two items.
Number 2: In Canada, the administration of the system is simple. You get a health care card when you are born. And you swipe it when you go to a doctor or hospital. End of story.
In the United States, Obamacare’s 2,500 pages plus regulations (the Canadian Medicare Bill was 13 pages) is so complex that then Speaker of the House Nancy Pelosi said before passage “we have to pass the bill so that you can find out what is in it.”
Number 11: In Canada, when you go to a doctor or hospital the first thing they ask you is: “What’s wrong?”
In the United States, the first thing they ask you is: “What kind of insurance do you have?”
The first comparison may be a little unfair, since it is comparing what the Canadian system is like at the consumer end with what the US system is like at the legislative end.
But even comparing both, what you have to go through to even sign up for the ACA is a symptom of how Byzantine the system here is, done purely in order to keep the parasitic health insurance industry in business and making obscene profits without them providing anything of value.
The issue of for-profit insurance companies is, in my view, one of the key factors contributing to the dismal current state of US health care, even with the passage of the ACA. “Paying for the health care expenses of the insured” and “maximizing profit” are objectives that are fundamentally incompatible. No other national health care system I know of allows the insurance companies to be for-profit, with some limited exceptions. For example, in Switzerland, which probably has the health care system that’s the closest in appearance to the US system, the insurance companies are not allowed to profit on the basic health care package applicable to everyone. (They can, as I understand it, make profits on supplemental coverage that isn’t part of the basic package.) Most other countries don’t even allow that: their payment systems are entirely not-for-profit.
“we have to pass the bill so that you can find out what is in it.”
Sigh. She was in the House. She wouldn’t know what was in the Senate version until THEY passed it.
As you may or may not know, in Germany we have this weird public-plus-private system, both with many insurers. The public system covers a large part of the working population and dependents, and is strongly regulated, both in what you pay and what you get for that, also in what the medical establishment gets from that. Not so the private part (though there are still some regulations).
In the public system, there’s some co-pay for medicine (I think something like 10% or €10, whatever is less, unless it’s a cheap import or genericum), the rest is free (that is, the invoice goes directly to the insurance). In the private system, not only do you get an invoice and need to pay before hopefully getting paid back from your insurance, doctors are allowed to charge more -- they determine a factor by some arcane rules and apply that to what the public insurances would pay. And yes, that means they might make, say, four times as much from a private patient. This is not supposed to make a difference in how patients are treated. How well that works depends on the doctor in question, of course.
“… done purely in order to keep the parasitic health insurance industry in business and making obscene profits without them providing anything of value.”
The insurance industry provides a great deal of value: high profits to shareholders, and fat campaign contributions to the politicians who cooked up this one sided mandate where all consumers must buy insurance that the providers are under no obligation to actually provide. That is the very definition of value here in the U. S. of A.
Interesting, even knowing quite a few Germans I’d never heard that.
How popular is the private insurance? It seems that in any system, people with money will try to find some way to buy better treatment, but that seems like a rather bizarre formula for doing so. It seems that, provided doctors choose to treat all patients equally, the incentive for having the private insurance would not be a good one.
…high profits to shareholders….
Is that true for the insurance industry? I ask, because as the recent financial melt down (and Enron debacle and similar incidents) have shown us, nowadays even share holders can get the shaft as long as the chief executives’ compensation packages remain sufficiently high. Remember, these days lots of shareholders are peons trying to save for retirement. In other words, not so high a priority.
A lot of countries have a mix of public government-run single-payer plans with a private system overlaid on top. That seems to satisfy the need for baseline uniform good quality coverage for every one, plus allow for the extras that richer people feel they need and want.
And deserve! Don’t forget the elites’ almost infinite sense of entitlement!
The two countries’ health care systems are very different-Canada has a single-payer, mostly publicly-funded system, while the U.S. has a multi-payer, heavily private system-but the countries appear to be culturally similar, suggesting that it might be possible for the U.S. to adopt the Canadian system. Much of the appeal of the Canadian system is that it seems to do more for less. Canada provides universal access to health care for its citizens, while nearly one in five non-elderly Americans is uninsured. Canada spends far less of its GDP on health care (10.4 percent, versus 16 percent in the U.S.) yet performs better than the U.S. on two commonly cited health outcome measures, the infant mortality rate and life expectancy. You really show some important points that differentiate both health system. Thanks for sharing here..
Regard: Tracy Johan.
As a Canadian, it’s always nice to hear good things about us, but please don’t think that we live in some kind of health-care nirvana. There is no single “Canadian” health care system. Health care services are delivered by the provinces and territories (13 separate jurisdictions) and there are differences between them. What federal legislation provides is that health care coverage is portable between jurisdictions, so, if you’re on holiday and fall ill or get injured, all you should have to do is present your health card at the hospital, and you’ll get treatment.
There are exceptions, of course, since there are different fee schedules and approaches to treatment, and certain services/treatments may be covered, partially covered or not covered at all, depending on the jurisdiction. Still, it is true that, if something bad happens, the default reaction here is to see how quickly you can get treatment.
The cost of health care is a big budgetary concern for all finance ministers, and we’re always having debates about what treatments to cover or what to de-list from the formulary, but no politician would ever advocate a return to a pre-medicare world, although some “think tanks” advocate adopting a U.S. approach to delivering certain health services, citing better cost controls. So far, they haven’t been too successful!