Myth #4: Canada has long wait times because it has a single-payer system.
The wait times that Canada might experience are not caused by its being a single-payer system.
Wait times aren’t like cancer. We know what causes wait times; we know how to fix them. Spend more money.
Our single-payer system, which is called Medicare (see above), manages not to have the “wait times” issue that Canada’s does. There must, therefore, be some other reason for the wait times. There is, of course. It’s this:
Source: Organisation for Economic Co-operation and Development (OECD)
In 1966, Canada implemented a single-payer health care system, which is also known as Medicare. Since then, as a country, Canadians have made a conscious decision to hold down costs. One of the ways they do that is by limiting supply, mostly for elective things, which can create wait times. Their outcomes are otherwise comparable to ours.
Please understand, the wait times could be overcome. Canadians could spend more. They don’t want to. We can choose to dislike wait times in principle, but they are a byproduct of Canada’s choice to be fiscally conservative.
Yes, they chose this. In a rational world, those who are concerned about health care costs and what they mean to the economy might respect that course of action. But instead, they attack the system.
Myth #5: Canada rations health care; the United States doesn’t.
This one’s a little bit tricky. The truth is, Canada may “ration” by making people wait for some things, but here in the United States we also “ration” — by cost.
An 11-country survey carried out in 2010 by the Commonwealth Fund, a Washington-based health policy foundation, found that adults in the United States are by far the most likely to go without care because of cost. In fact, 42 percent of the Americans surveyed did not express confidence that they would be able to afford health care if seriously ill.
Source: “How Health Insurance Design Affects Access to Care and Costs, by Income, in Eleven Countries,” Health Affairs, November 2010.
Further, about a third of the Americans surveyed reported that, in the preceding year, they didn’t go to the doctor when sick, didn’t get recommended care when needed, didn’t fill a prescription or skipped doses of medications because of cost.
Finally, about one in five of the Americans surveyed had struggled to pay or were unable to pay their medical bills in the preceding year. That was more than twice the percentage found in any of the other 10 countries.
So feel free to have a discussion about the relative merits of the U.S. and Canadian health care systems. Just stick to the facts.
Aaron E. Carroll frequently blogs about this topic for The Incidental Economist and is the coauthor of Don’t Swallow Your Gum: Myths, Half-Truths, and Outright Lies About Your Body and Health.
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