Canadians tend to mock Americans’ ignorance of our country and the rest of the world. We do know more about their country than they know about ours. But we also tend to be unsophisticated when it comes to the rest of the world.
The U.S.-based Commonwealth Fund released their latest comparison of seven health systems on June 25th. Predictably, the U.S. system rated last overall and that was the focus of the fund’s report and the U.S. and international coverage. But Canada was second last. We were last for overall quality, effective care and timeliness of access. We scored second last on efficiency. The report compared Canada with other countries 18 times in the text. These included two favourable comparisons and 16 unfavourable ones.
Read my op ed in the July 4th Toronto Star on how Canada is playing in the wrong league when we only compare ourselves to the US. Download it here.
I’m touring Alberta next week and the US Senate Finance committee may vote for a health bill
There is lots of exciting health policy doings on both sides of the border. In Ontario the Ehealth problems have caused health minister David Caplan to resign and left boards and CEOs quivering in anticipation of being the opposition’s next target.
In Alberta, the government has cut public coverage for a variety of services and is claiming the current economic crisis means the end of the single payer system. See my op-ed, “Repair Medicare, don’t privatize” in today’s Edmonton Journal: I will be speaking in several Alberta locations next week. Here’s my schedule or check with the Alberta Friends of Medicare
Tuesday, October 13th
Edmonton
3 p.m. Media availability with Michael Rachlis @ Polish hall 10960 104th St. NW Edmonton
7 p.m. Town Hall Meeting @ Polish hall
Wednesday, October 14th
Medicine Hat.
7 p.m. Town Hall meeting @ Public Library 414 First Street S.E.
Thursday, October 15th
Lethbridge
11:30 a.m. media availability @ the Ramada hotel, 2375 Mayor Magrath Drive South
2 - 4 p.m. Speak @ University of Lethbridge
7 p.m. Town Hall meeting @ Southminister United Church, 1011 4th Avenue South
Friday, October 16th
Calgary
12: noon Speak to Health Services Association of Alberta pubic engagement conference @ Sheraton Cavalier Hotel. 2620 32nd Avenue NE
1 p.m. media availability @ Sheraton Cavalier Hotel Calgary.
Meanwhile in the Excited States…
The health policy debate continues apace in the United States. The first bill to be voted on will likely be the Senate finance committee bill. It reflects the right wing of the Democratic Party and doesn’t include a public option. The endgame may well focus on two aspects. First, what public support will be offered for the formation of health care cooperatives which could turn into a public option through the back door if everything went exactly right - or wrong according to your perspective? Cleveland Democratic representative, Dennis Kucinich is hoping the new legislation will incorporate his plan for states to choose a single payer option. But will the health insurance industry let this one pass. A good rule is whatever the insurance industry will tolerate won’t be effective.
Second, how tough will congress be on insurance regulation? US health insurance companies will have to be regulated tightly if costs are to be controlled and coverage expanded. This mean community rating for premiums, no rejection for so-called pre-existing conditions, limited variability in the type of policies offered to better facilitate meaningful comparisons, etc, etc. That’s how countries like the Netherlands and Switzerland manage single-payer efficiencies and universal coverage. Of course it costs them in the long run. Switzerland’s system is the second most expensive after the US.
My prediction is: The insurance companies have been careful to appear supportive of Obama’s principles for a health bill but this weekend they have started to show their true colours. After watering down the president’s initial intentions pretending they would support the final diluted product, they are now going to war against the compromise. Today the America’s Health Insurance Plans released a PricewaterhouseCoopers report which asserts that the current bills being discussed will massively increase in health insurance premiums.
The companies like Obama’s plans to give them extra customers through a universal mandate for all US citizens to purchase health insurance. But, my guess is that the eventual legislation will have enough loopholes that the less than scrupulous companies (and that seems to be quite a few of the big ones) will use to get around the intent of universal coverage.
Resources for understanding the bewildering US health policy debate include:
Nobel laureate, Princeton Professor, and very occasional debate partner of yours truly (once actually) Dr. Paul Krugman’s prolific blog. I wish I could blog as much as this fellow. And he still has time to write a regular column in the NY Times and teach first year through PhD students and author three books in the past two years. Search his blog by topic and you will get the best evidenced material on health care economics, policy, and politics. In person, he’s like the kid you knew when you were growing up who was the smartest kid in school except he’s pretty much the smartest person in the whole country.
By the way, you can watch the entire debate which took place in New York on September 16, 2008 on YouTube. Dr. Krugman, Emory University ER doc, Dr. Art Kellerman, and I show that New Yorkers like a single-payer system.
The Commonwealth Fund is a private non profit organization based in New York City. The organization’s mission statement includes the goal, “…to promote a high performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society’s most vulnerable, including low-income people, the uninsured, minority Americans, young children, and elderly adults.”
This website has excellent academic-level analysis of the US health care debate. The Fund also sponsors, in my view, the most useful international comparative research.
Physicians for a National Health Program represents 17,000 doctors, medical students, and other health professionals. PNHP has advocated for a US single payer system since 1987.
Here are some other sites of interest to folks interested in a progressive perspective on the US health care debate
Best wishes from Toronto on Simcoe Day, honouring John Graves Simcoe, the first British Governor of Lower Canada — what is now Ontario. Your Canadian factoid for today: Simcoe led the new Colonial Assembly to pass the first anti-slavery legislation in the British Empire in 1793.
I continue to have a small supportive role in the US health debate. Unfortunately, the US seems incapable of learning the lessons that Canada and other countries have for their health policy debate. In fact, I have written an op-ed titled “What Americans could learn from the Canadian health care system and why you probably won’t” that should be in a major American daily shortly. Stay posted.
July 20, 2009, I was featured in an economics blog written by Ian Austen, the New York Times Canadian reporter. Interestingly the Times Canadian reporter no longer lives in Canada. Check out “Should Canada’s Health System Become More Like America’s?” by Ian Austen.
I was also quoted in a two part series on Canadian health care in the St. Petersburg Times:
In the meantime, if you’re an American, good luck with the daunting task of trying to get even a public option out of the American health policy debate. It looks like a single payer system may never be seriously considered. If you’re a Canadian, thank your stars we have our Medicare! Enjoy the nice weather while it’s here.
I hope you’re all enjoying summer. During the past year, I have been a minor player in the US health debate. I did a teleconference June 16th with 200 folks from Progressive Democrats of America. Download my slide presentation on what Americans can learn from the Canadian healthcare system.
I was invited to be part of a debate about the US health care system September 16, 2008 at Rockefeller University NYC. My team included the 2008 winner of the Nobel Economics prize and New York Times columnist Paul Krugman and Emory University Professor Dr. Art Kellerman. We won! You can watch my presentation below, or watch the entire debate on YouTube.