By Alan Bean
Aaron Carroll teaches at Indiana University and blogs at The Incidental Economist. He is particularly interested in the health care debate and works to dispel the fuzzy facts that commonly obscure the subject. This post, originally published in the AARP Newsletter, addresses a series of claims that inevitably arise when the Affordable Care Act comes up for discussion. Argue that Obamacare, while an improvement on the status quo, is inferior to a single payer, Canadian-style, system and the horror stories start coming.
I resent anything that disparages Canadian medicare for a couple of reasons. First, I am a Canadian with three children birthed under the Canadian system and my experience was entirely positive. Secondly, Tommy Douglas, the Father of Canadian Medicare, was my father’s pastor, Sunday school teacher and political hero. Having inherited five books by and about Douglas from my dad, I can’t claim to be entirely objective.
I admit that my personal experience is anecdotal (and dated) and that I have never made a careful comparison of the American and Canadian health care systems. So, when people start with the horror stories I don’t put up much resistance.
Well, Aaron Carroll isn’t a Canadian, has no personal connection to Tommy Douglas, and he has read the relevant studies in great detail–it’s his job. Canadians may ration health care by availability, he says, but Americans ration by cost.
If, having read Carroll’s analysis, you persist in favoring the American system, I would like to know why . . . unless it’s because you are wealthy enough to pay top dollar for health insurance and don’t care what happens to the 95% who (that?) aren’t so fortunate. In that case, it would be best to keep your thoughts between you and your God. No, better just keep them to yourself, God doesn’t like sociopathic opinions either.
The truth may surprise you about international health care
By Aaron E. Carroll, M.D., M.S.
AARP Newsletter, April 16, 2012
How does the U.S. health care system stack up against Canada’s? You’ve probably heard allegedly true horror stories about the Canadian system — like 340-day waits for knee replacement surgery, for example.
To separate fact from fiction, Aaron E. Carroll, M.D., the director of the Center for Health Policy and Professionalism Research in Indianapolis, identified the top myths about the two health care systems.
Myth #1: Canadians are flocking to the United States to get medical care.
How many times have you heard that Canadians, frustrated by long wait times and rationing where they live, come to the United States for medical care?
I don’t deny that some well-off people might come to the United States for medical care. If I needed a heart or lung transplant, there’s no place I’d rather have it done. But for the vast, vast majority of people, that’s not happening.
The most comprehensive study I’ve seen on this topic — it employed three different methodologies, all with solid rationales behind them — was published in the peer-reviewed journal Health Affairs.
Source: “Phantoms in the Snow: Canadians’ Use of Health Care Services in the United States,” Health Affairs, May 2002.
The authors of the study started by surveying 136 ambulatory care facilities near the U.S.-Canada border in Michigan, New York and Washington. It makes sense that Canadians crossing the border for care would favor places close by, right? It turns out, however, that about 80 percent of such facilities saw, on average, fewer than one Canadian per month; about 40 percent had seen none in the preceding year.
Then, the researchers looked at how many Canadians were discharged over a five-year period from acute-care hospitals in the same three states. They found that more than 80 percent of these hospital visits were for emergency or urgent care (that is, tourists who had to go to the emergency room). Only about 20 percent of the visits were for elective procedures or care.