Monday, February 27, 2006


I don't write much about Canada's health care system, probably because I don't think of it much. Basically, all I've ever had to do to get health insurance was fill out a small form and get my picture taken. I really, really like that.

So it kind of bugs me that the only impression a reader of the New York Times would ever get of Canada's medicare system is one of rot and decay. Seriously. In over a decade of irregularly reading the Times, I've never seen a single article that said a good thing about our system. Meanwhile, the American system (which, as even enlightened Americans will admit, is objectively worse) is never subjected to the same kind of criticism.

That's why I wasn't surprised by the latest Times article which basically talks about how great this new private health care in Canada is. (Thanks for the tip, Max!) The headline itself is enough to give you an idea of the author's bias: "As Canada's Slow-Motion Public Health System Falters, Private Medical Care Is Surging". Way to be objective there.

I'd love for the Times to talk about the huge and growing numbers of entirely uninsured people in the US, or the much, much larger number of under-insured people. Something close to 50 million people have no insurance whatsoever, despite higher average spending in the US. If we add up the uninsured and underinsured, I'd be willing to bet that 1/3 to 1/2 of Americans lack proper access to proper medicine.

Let me rephrase that. Despite the fact that America spends more on health care than we do, there are more uninsured Americans then there are Canadians.

The argument does cut both ways, by the way. As Ezra notes, Canada spends more on health care than other countries, and gets poorer service for its money than France or Japan. And yes, Japan and France do allow restricted private health care. Which is why I'm not convinced that private health care will ruin Canadian medicine. The big difference is that France and Japan don't live right next door to the world's most inefficient and predatory insurance industry, always on the prowl for new customers.


Anonymous said...

That's the message America wants to tell.That our medicare is folding. Use us as a bad example so Americans won't want medicare.

Mike said...

Well, Japan and France also deliver healthcare directly to citizens while Canada is essential fee-for service private with a since fee payor. In other words, in Canada doctors and some diagnostic clinics are are private businesses that charge fixed, negotiated rates to the government for services. In Japan and France, doctors and diagnostics are salaried employees of the state. In France, they have 2x the doctors and pay them 1/2 as much.

By all means, lets convert to that system if you dare, but it will be harder to sell than the current one - its far more "socialist" than what we have.

Also, you may want to look at how the mix of public and private ruined Australia and nearly ruined Britain. There are more countries in the world than France and Japan.

Anonymous said...

US economic blog Angry Bear has made extensive comparisons between the health care systems of several industrial nations, looking at every metric one might think off, and came to the conclusion that US health care is among the least efficient.

Here's perhaps the most interesting part of it.

I believe Canada would benefit from a supplementary private system... if it's done carefully, in a balanced way, it could improve service and accessibility for everyone. Private care is probably something Ottawa can't really stop from happening. I just hope that the kneejerk opposition to the term "two-tiered" expressed (in varying degrees) by all the federal parties won't get in the way in such a manner that they screw it all up... which is also probably quite easy to do.

It's not like we don't already have a two tiered system. Let's list some of the things that are health care that aren't covered (in general) by OHIP: