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5 Myths About Canada’s Health Care System

The truth may surprise you about international health care

Myth #2: Doctors in Canada are flocking to the United States to practice.

Every time I talk about health care policy with physicians, one inevitably tells me of the doctor he or she knows who ran away from Canada to practice in the United States. Evidently, there’s a general perception that practicing medicine in the United States is much more satisfying than in Canada.

Problem is, it’s just not so. Consider this chart:

Source: “2009 International Health Policy Survey of Primary Care Physicians in Eleven Countries,” The Commonwealth Fund, November 2009.

The Canadian Institute for Health Information has been tracking doctors’ destinations since 1992. Since then, 60 percent to 70 percent of the physicians who emigrate have headed south of the border. In the mid-1990s, the number of Canadian doctors leaving for the United States spiked at about 400 to 500 a year. But in recent years this number has declined, with only 169 physicians leaving for the States in 2003, 138 in 2004 and 122 both in 2005 and 2006. These numbers represent less than 0.5 percent of all doctors working in Canada.

So when emigration “spiked,” 400 to 500 doctors were leaving Canada for the United States. There are more than 800,000 physicians in the United States right now, so I’m skeptical that every doctor knows one of those émigrés. But look closely at the tan line in the following chart, which represents the net loss of doctors to Canada.

Source: Canadian Institute for Health Information

In 2004, net emigration became net immigration. Let me say that again. More doctors were moving into Canada than were moving out.

Myth #3: Canada rations health care; that’s why hip replacements and cataract surgeries happen faster in the United States.

When people want to demonize Canada’s health care system — and other single-payer systems, for that matter — they always end up going after rationing, and often hip replacements in particular.

Take Republican Rep. Todd Akin of Missouri, for example. A couple of years ago he took to the House floor to tell his colleagues:

“I just hit 62, and I was just reading that in Canada [if] I got a bad hip I wouldn’t be able to get that hip replacement that [Rep. Dan Lungren] got, because I’m too old! I’m an old geezer now and it’s not worth a government bureaucrat to pay me to get my hip fixed.”

Sigh.

This has been debunked so often, it’s tiring. The St. Louis Post-Dispatch, for example, concluded: “At least 63 percent of hip replacements performed in Canada last year [2008] ... were on patients age 65 or older.” And more than 1,500 of those, it turned out, were on patients over 85.

The bottom line: Canada doesn’t deny hip replacements to older people.

But there’s more.

Know who gets most of the hip replacements in the United States? Older people.

Know who pays for care for older people in the United States? Medicare.

Know what Medicare is? A single-payer system.

Next: Does Canada have longer wait times than United States? »

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