OPINION EDITORIAL

May 27, 2004

Canadian single-payer health care system: high costs and shorter life expectancy

Cheryl Hymes | EFF Health Care Policy Analyst
Ted Kennedy, Hillary Clinton and other government, single-payer health care system fans need to read the Fraser Institute's recently published Critical Issues Bulletin, "2004 Report: How Good is Canadian Health Care?" If they do, they will be confronted with the truth: Canada's monopolistic, taxpayer-funded, government-run health care system is crumbling. This report should leave absolutely no doubt in anyone's mind that the U.S. does not want to copy Canada's health care system.

The Fraser Institute located in Vancouver, British Columbia published the results of a study authored by Nadeem Esmail and Michael Walker that examined twelve indicators of access to health care and health outcomes.(1) The 28 industrialized nations studied are all members of the Organization for economic Co-operation and Development (OECD), which defines itself as "countries sharing a commitment to democratic government and the market economy."

When it comes to health care expenditures as a percentage of GDP, Canada ranks highest out of the 28 industrialized OECD (2) nations included in the survey. Canadian taxpayers are not getting a very good deal for this expenditure.

Canada ranks in the bottom half of the nations in the study when it comes to life expectancy. Twenty-seven percent of Canadians report waiting four months or more for non-emergency surgery for themselves or a family member. Forty-four percent of Canadians reported that it was somewhat difficult or extremely difficult to access a specialist when needed. The survey revealed that Canadians with low incomes are more likely to have difficulties seeing a specialist, the opposite of what single-payer advocates in the US claim to want.

When looking at accessibility to physicians and availability of medical technology, the Canadian study is also troubling. Canada ranks in the bottom half of the OECD nations in the number of physicians, MRI machines, CT scanners, and lithotriptors (ultrasound) per capita. In fact, Canada tied for last place when it came to the number of lithotriptors available (.4 machines per million Canadians). The Czech Republic, Turkey and Luxembourg have more lithotriptors per capita than Canada -- not exactly the nations that come to mind as a place you want to be if you have a major medical emergency.

Canada is one of twelve OECD countries that rely exclusively on public hospitals. It is one of six countries that do not utilize cost sharing with consumers through co-pays or deductibles, with the exception of non-hospital pharmaceuticals. Survey authors Esmail and Walker noted, "Canada is the only country in the OECD that outlaws privately funded purchases of core services. Every other OECD country has some form of user-pay, private provision of health care."

What has all of this "government-will-pay-for-it" mentality done for Canadians? It has saddled our neighbors to the north with an expensive health care system that has not delivered acceptable levels of access or quality. It is noteworthy to include the stunning conclusion of the authors:

The comparative evidence is that the Canadian health care model is inferior to others in place in the OECD. It produces inferior access to physicians and technology, produces longer waiting times, is less successful in preventing death from preventable causes, and costs more than any of the other systems that have comparable objectives. The models that produce superior results and cost less than Canada's monopolistic, single-provider system have user fees; alternative, comprehensive, private insurance; and private hospitals. Canada should follow the example of these superior health care models.

This report hardly paints the picture of affordability, access and quality that single-payer fans in the US want to make us believe exists in Canada. As the report authors themselves found, private health care and user "ownership" over health care choices is the key to more cost-effective and customer driven results. In that case, we had better run towards consumer directed health plans and health savings accounts as fast as we can.

Cheryl Hymes is a health care policy analyst for the Evergreen Freedom Foundation, an Olympia-based policy research organization dedicated to individual liberty, free enterprise and limited government. Hymes is also a former Washington state representative, who served as Vice-Chair of the Health Committee during her time in the legislature.

Footnotes:

1 The Fraser Institute is an independent Canadian economic and social research and educational organization. Nadeem Esmail is Senior Health Policy Analyst and manager of Health Data Systems at The Fraser Institute. Michael Walker is the Executive Director of The Fraser Institute. Both are economists.

2 Organization for Economic Cooperation and Development.

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Evergreen Freedom Foundation P.O. Box 552, Olympia, WA 98507 Phone: (360) 956-3482, Fax: (360) 352-1874 Email: effwa@effwa.org