Tuesday, February 10, 2009

Why Does the USA Want Universal Healthcare?

Seriously, why does the USA want universal healthcare?

Why does Tom Daschle write a book appealing for a European-style healthcare system? Why does Michale Moore make a movie begging for a Canadian/European hybrid healthcare system?

You see, I work in the health insurance industry, and I see the problems with healthcare from the inside. I also know what statistics to look at that average Joes, politicians, and even doctors don't know about.

Granted, the US healthcare industry is far from "free market," but it is still not nearly as nationalized as the European and Canadian systems are. What do you say that I take you, dear reader, through the wonderful land of facts, and compare the Canadian and European systems to the current American system?

In Canada, the healthcare is so fantastic that MPs fly to California to get treated! What does it say about Canada's healthcare system when a Canadian politician, not just a commoner, pays twice for healthcare: once through Canadian taxes, and a second time out of pocket for the actual treatment in a California hospital? This was no sprained ankle that the MP had treated. No, it was breast cancer! Most Canadians of course don't have the luxury to fly to the US and pay out of pocket for cancer treatment.

Of course, the MP insists that it didn't have anything to do with speed of service or confidence in Canada's healthcare system. The MP did admit, however, that it was done for personal reasons as well as privacy concerns, which implies that one would lose privacy rights under a nationalized healthcare industry.

Speaking of cancer in Canada, their universal healthcare system isn't as universally effective at treating cancer as the US system is. Compare these numbers:

* For women, the average survival rate for all cancers is 61 percent in the United States, compared to 58 percent in Canada.
* For men, the average survival rate for all cancers is 57 percent in the United States, compared to 53 percent in Canada.


Part of America's superior cancer survival rates is due to the earlier detection that American's get for their cancer:

Early Diagnosis. It is often claimed that people have better access to preventive screenings in universal health care systems. But despite the large number of uninsured, cancer patients in the United States are most likely to be screened regularly, and once diagnosed, have the fastest access to treatment. For example, a Commonwealth Fund report showed that women in the United States were more likely to get a PAP test for cervical cancer every two years than women in Australia, Canada, New Zealand and Great Britain, where health insurance is guaranteed by the government.


Healthcare in Western Europe, and especially the UK, is often cited as a model that the USA should copy. Well sure it is, at least if you want to stop giving the world's rich and powerful people a reason to come to the US for their treatment! Western Europe, like Canada, has lower rates for cancer survival than the US:

Europe’s survival rates are lower than in the US, where 66.3 per cent of men and 62.9 per cent of women survive for five years, compared with 47.3 per cent of European men and 55.8 per cent of women. These figures may represent earlier diagnosis.


Another misconception that people often have is that a national healthcare system will guarantee that you will be cared for. Sadly, this is not the case. NHS, the UK's monopoly healthcare organization, routinely denies care for treatments that even the most stingy American insurance companies pay for. But unlike in the US, if you have a nationalized healthcare system, and you are denied care, you have no alternative - no other service provider that you can turn to (unless you are rich enough to pay out of pocket for healthcare in the US). That is why they refer to the NHS' denial of care decisions as "death sentences."

And finally, government is generally known to always perform more slowly, and at higher cost, than it promises to the citizens. The latest example is the UK's NHS medical database, which will cost at least 12.7 billion pounds (not dollars), and is already four years behind schedule. With that kind of abysmal performance, couldn't the UK hire a different service provider? No, because the NHS has a monopoly! The UK is stuck with it. In other words, the quality (or lack thereof) of the NHS services have no consequence for its revenues. No matter how badly the NHS performs, it will always have it's loyal, paying customers (even the rich people who pay out of pocket for care in the US still have to pay for the NHS system no matter what).

So why in the name of the Flying Spaghetti Monster does the USA want universal healthcare?

17 comments:

Freedom's Philosopher said...

At this point, there is an overlapping consensus that the "ideal health care system" is marked by universal access to high quality health care, at a resonable cost. Obviously, there are hidden perplexities. What is meant by: "universal access,""high quality," and "reasonable cost." In "real world health care," universal access implies either lower quality or higher costs. Last summer my wife underwent cancer treatment. Without a doubt, we experienced the highest quality treatment in the world. We pay a lot for our health insurance, but we were more more than compensated in terms of it maximizing our access to high quality care. The secret to health care reform is to reduce costs by increasing competition among providers and health insurance companies. That means getting government out of the way! We certainly do not want universal health care modelled on existing governmental institutions: FEMA, FDA, or the SEC. FREEDOM'S PHILOSOPHER

Aaron Kinney said...

Good points all around, F.P. !

Interesting the way you phrase "universal access." I think you are implying that universal accessibility to healthcare does not mean universally guaranteed state insurance coverage. I agree with you.

People think that if you dont have an insurance policy, then you dont have healthcare. They also think that the only way to give healthcare access to everyone is to force coverage onto them all. This is clearly not the case.

Simply having an open market where anyone can pick and choose their services and coverages based on what they can afford or barter for is "universal" enough.

Remember that I work at an insurance company? Well , I DECLINE THE HEALTH COVERAGE that my company offers. Why would I do such a madman thing? To save money! At my age, my medical needs are not worth a monthly policy. Ive had strep throat, a broken ankle, and a busted open bleeding scalp all while I had no insurance whatsoever. And guess what? I paid out of pocket on my modest salary and it still cost me less to pay for those emergencies out of pocket than to pay my share of the monthly employer-provided coverage.

Clearly, universal coverage provided by the government is not the answer. We need options, not a one size fits all system.

Thanks for your comment, and sorry for my rambling. :D

Freedom's Philosopher said...

Yea, I agree! The secret to health care reform is to figure out how to make health an insurable commodity (like auto accidents). Several things have to get done. We have to reel in the monopolistic pricing structure that providers enjoy: especially specialists that get paid in a "fee for service" basis. Then, we've got to force insurance companies to compete. We ought to be able to purchase health insurance online, in a national market just like we do auto insurance. When I was your age (young), not only did I forego health insurance but also auto insurance. FREEDOM'S PHILOSOPHER

Mike said...

Aaron,

I'm not disagreeing with the principal of true free market healthcare, but as a Canadian, I can tell you you are simply wrong about some of the assertions in this.

First, Belinda Stronach was not just an MP, but an heiress to an automotive parts fortune - Magna international. She was wealthy enough to get any kind of operation anywhere. At the time, she had crossed the floor from the Conservatives to the Liberal Party in a controversial defection that saved Liberal Paul Martin's minority government. Her privacy was at risk because it had been violated previously, not by the system, but by Conservative blogging stalkers.

Second, we have fully private health care in Canada. Its just that if you run fully private health care, you cannot charge the provincial insurance plans for service. So few people can afford private service that there are few doctors or clinics that practice it.

Third, despite what you might have heard, the biggest problem with Canadian healthcare is that it works pretty well. Emergency waits aren't that long, and serious injuries always go first. The quality is excellent once you receive it. It is only for chronic, long term illness and elective surgeries that we have long wait lists (mostly due to a shortage of doctors). The care is still good, the wait is long.

Fourth, in Canada we have private delivery - doctors and clinics are private enterprises. The problem is, we only have one health insurance plan - the government one. And our doctor shortage is caused by collusion between the Canadian Medial Association and the state to keep the numbers low - its a cartel.

Fifth, Canada has a hire rate of survival for heart disease and stroke and a better infant mortality rate than the US. See, I can statistic mine too...

We have lots of problems, and our system would be immensely better if it were truly free market. I just wish critics, especially ones in the US, would be honest about it. It works not too bad for most Canadians. It is not third world or Soviet style health care. When Canadians hear Americans say or imply that about our system, well, they don't take you seriously. It shows you don't know what you are talking about.

And that is the pity, because it is those people you should be trying to get to.

Here is something I wrote 2 years ago:

http://theconverted.wordpress.com/2007/03/07/universal-health-care-without-the-state/

I agree we need freer healthcare, but I would implore you to be honest about the Canadian system.

Aaron Kinney said...

Re: Mike,

First, Belinda Stronach was not just an MP, but an heiress to an automotive parts fortune - Magna international. She was wealthy enough to get any kind of operation anywhere. At the time, she had crossed the floor from the Conservatives to the Liberal Party in a controversial defection that saved Liberal Paul Martin's minority government. Her privacy was at risk because it had been violated previously, not by the system, but by Conservative blogging stalkers.Um, I think you kinda made my point for me. You are basically saying the same thing I said: rich, VIP Canadians know better than to use the Canadian healthcare system, and they pay extra for US care because it is higher quality and it allows for more privacy no matter where your stalkers are coming from.

Second, we have fully private health care in Canada. Its just that if you run fully private health care, you cannot charge the provincial insurance plans for service. So few people can afford private service that there are few doctors or clinics that practice it.Few people can afford private service? Gee I wonder why? Maybe if they werent FORCED to pay for the government health plan they could actually afford to get fancy private treatments like Stronach did? Again, you are making my point for me by admitting that "so few people can afford" the private product. Canadians arent significantly poorer than Americans, yet Canadians cant afford private healthcare at anywhere near the amount that Americans can, because Canadians are being robbed by their government and forced to pay for the substandard Canadian public health product.

Third, despite what you might have heard, the biggest problem with Canadian healthcare is that it works pretty well. Emergency waits aren't that long, and serious injuries always go first. The quality is excellent once you receive it. It is only for chronic, long term illness and elective surgeries that we have long wait lists (mostly due to a shortage of doctors). The care is still good, the wait is long.But your own government admits that your waiting lists are longer than ones in the US. Your own government reports that is has far fewer MRI and Catscan machines per 1000 people than America does. Your own government admits that your medical technology is older and outdated and needs upgrading. People in Canada are known to pay extra to have their medical procedures completed in the US rather than wait for those procedures to be done in Canada. And even worse, in Canada you are less likely to survive cancer than in the US.

Fourth, in Canada we have private delivery - doctors and clinics are private enterprises. The problem is, we only have one health insurance plan - the government one. And our doctor shortage is caused by collusion between the Canadian Medial Association and the state to keep the numbers low - its a cartel.So lets eliminate the government insurance plan then, right? That would eliminate the cartel and give choice back to the consumer!

Fifth, Canada has a hire rate of survival for heart disease and stroke and a better infant mortality rate than the US. See, I can statistic mine too...Canada does not have a higher rate of survival for heart disease and stroke, no. Sorry. But yes, Canada does have better infoant mortality rates than the US, and that is because America has more immigrants who jump the border to have their babies who, in the meantime, have not sought out prenatal care in their home country. If Canada shared a border with Mexico, it would have much worse infant mortality rates.

We have lots of problems, and our system would be immensely better if it were truly free market.Thanks, I agree :)

I just wish critics, especially ones in the US, would be honest about it. It works not too bad for most Canadians. It is not third world or Soviet style health care. When Canadians hear Americans say or imply that about our system, well, they don't take you seriously. It shows you don't know what you are talking about.Ad hominem. I work in the health insurance industry, and I see statistics from all over the world about healthcare. What extra insight do you have that I dont? I bet youre a healthy and relatively young Canadian who probably doesnt work in healthcare at all. Come talk to me when you get diagnosed with cancer and you are on a two year waiting list to have your tumor removed, and Ill help you find a hospital in the US that will do the operation for you immediately ;)

Nancy Harris said...

With various health care reform bills floating around both the House and the Senate, President Barack Obama is pulling out all the stops to get the votes that the bill needs, which is good news for the public option. President Obama continues to rally behind health care reform. I am really concerned that the fiasco of this reform may make Obama a one-term president.

Richard said...

My cousin was diagnosed with brain cancer and was operated on the next week - he live in Canada. He did however fly to the U.S. for prescription drugs.

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