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U.S. health system costs four times more to run than Canada’s single-payer system

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The per-capita cost of administering healthcare is more than four times higher in the U.S. than in Canada, where a single-payer system has been in place since 1962. 
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By MELISSA HEALYSTAFF WRITER 
JAN. 7, 2020
3:26 PM

In the United States, a legion of administrative healthcare workers and health insurance employees who play no direct role in providing patient care costs every American man, woman and child an average of $2,497 per year.

Across the border in Canada, where a single-payer system has been in place since 1962, the cost of administering healthcare is just $551 per person — less than a quarter as much.

That spending mismatch, tallied in a study published this week in the Annals of Internal Medicine, could challenge some assumptions about the relative efficiency of public and private healthcare programs. It could also become a hot political talking point on the American campaign trail as presidential candidates debate the pros and cons of government-funded universal health insurance.

Progressive contenders for the Democratic nomination, including Sen. Bernie Sanders of Vermont and Sen. Elizabeth Warren of Massachusetts, are calling for a “Medicare for All” system. More centrist candidates, including former Vice President Joe Biden and former South Bend, Ind., Mayor Pete Buttigieg, have questioned the wisdom of turning the government into the nation’s sole health insurer.

It’s been decades since Canada transitioned from a U.S.-style system of private healthcare insurance to a government-run single-payer system. Canadians today do not gnash their teeth about co-payments or deductibles. They do not struggle to make sense of hospital bills. And they do not fear losing their healthcare coverage.

To be sure, wait times for specialist care and some diagnostic imaging are often criticized as too long. But a 2007 study by Canada’s health authority and the U.S. Centers for Disease Control and Prevention found the overall health of Americans and Canadians to be roughly similar.

Some Canadians purchase private supplemental insurance, whose cost is regulated. Outpatient medications are not included in the government plan, but aside from that, coverage of “medically necessary services” is assured from cradle to grave.

The cost of administering this system amounts to 17% of Canada’s national expenditures on health.

Edited by 90DayFinancier

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Better healthcare costs more.  That’s why Canadians come here and pay out of pocket.  I’m not saying it’s worth 4 times what Canadians pay, but obviously THEY think it is.  Or perhaps they just don’t want to wait 20 weeks to be seen.  Me?  I can get an appointment in about one week or less.

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The US system is obviously unsustainable, the way I am coughing tonight it may not matter to me but I would be interested in knowing what will happen.


“If you know the enemy and know yourself, you need not fear the result of a hundred battles. If you know yourself but not the enemy, for every victory gained you will also suffer a defeat. If you know neither the enemy nor yourself, you will succumb in every battle.”

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9 minutes ago, Boiler said:

The US system is obviously unsustainable, the way I am coughing tonight it may not matter to me but I would be interested in knowing what will happen.

Get better, have you tried Brandy and honey?  Also salty black licorice (the real Dutch stuff) helps relax the throat muscles.

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Dequacaine works but I have run out. And seemingly not available in the US, maybe Canada.


“If you know the enemy and know yourself, you need not fear the result of a hundred battles. If you know yourself but not the enemy, for every victory gained you will also suffer a defeat. If you know neither the enemy nor yourself, you will succumb in every battle.”

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3 hours ago, Boiler said:

the way I am coughing tonight

Feel better soon, si man.

And that's the lung and the short of it.


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Our Health Care system is messed up. Wouldn't it be great if Congress could be working on this, instead of the never ending Trump investigations 

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11 minutes ago, Nature Boy 2.0 said:

Our Health Care system is messed up. Wouldn't it be great if Congress could be working on this, instead of the never ending Trump investigations 

The Republicans had the house, Senate and  Presidency and did zip. Wasn't there a repeal and replace thing going on for a while?

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2 hours ago, Nature Boy 2.0 said:

Our Health Care system is messed up. Wouldn't it be great if Congress could be working on this, instead of the never ending Trump investigations 

 

  They had an amazing chance to do this 8 years ago and they screwed it up. Unfortunately the only way it gets done is if one party controls all of congress, cause they are not going to work together on anything. Both parties want 90% of the same thing on health care, but they won't compromise on the other 10% if it makes the other side look like it won the deal.


995507-quote-moderation-in-all-things-an

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2 hours ago, Steeleballz said:

 

  They had an amazing chance to do this 8 years ago and they screwed it up. Unfortunately the only way it gets done is if one party controls all of congress, cause they are not going to work together on anything. Both parties want 90% of the same thing on health care, but they won't compromise on the other 10% if it makes the other side look like it won the deal.

It's interesting that people are relying on the federal government to "fix" this problem. It's the states and local communities that should be more involved in things like this, they have a better chance of representing the interests of their demographics than the federal government.


Trump 2020 / 2024 / 2028 / 2032 / 2036 / 2040 / 2044 / 2048 / 2052 / 2056 / 2060+

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11 hours ago, Burnt Reynolds said:

Deleted a massively long post (that went far into personal examples in my life)... but tl;dr version-> Both sides' arguments are jokes.

 

Canada's universal isn't great because its universal. It's because its cost-effective, generally meets expectations, and is reactive. This is precisely how a business should be run. That being said, there are inefficiencies (because its government) that wind up adding cost as well. The left fail to grasp that Canada's system would not wind up implemented in the US, so this fetish for foreign style healthcare is just that, a fetish, not based on reality.

 

Also, Canadians aren't sitting there running to the US to get amazing care while people suffer in wait lines. This and the "wait time" caricature are among the worst ones I see from the right. The care I've gotten in Canada has been virtually the same as I got in the US, except there's no hesitation about preventative care here, so you don't have people being so scared of the cost of healthcare they're foregoing essential preventative+routine care because they're worried about affording to not be sick. I've had surgeries here, my family has as well, essential surgeries, and they did not wait even remotely "20 weeks". The most I had to wait was 2-3 and it was for a surgery that wasn't essential, as in, was irritating me and certainly covered but was not something that was going to cause me to die waiting for.

I'm not there, so you have more first hand knowledge than I, but google says the average wait time for an appointment is 20+ weeks.

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1 hour ago, ALFKAD said:

I'm not there, so you have more first hand knowledge than I, but google says the average wait time for an appointment is 20+ weeks.

It would be intellectually dishonest for me to pretend my experience is for the entirety of Canada. It's for two provinces -- Ontario and Alberta. I think this is more of an honest discussion because while the federal government sets certain rules, prices, and regulations, the provinces are in charge of the location, distribution, and their own contributions to that. What I've found interesting is my quality of care in Alberta (under universal) has been better despite significantly less taxes than in Ontario. It shows that there's no need for such ridiculous tax rates as seen in some other provinces. You've seen a sample of my disposable income. 

 

If I compared what I've experienced in years in California, and Ontario/Alberta (Canada), on the healthcare front, I would unequivocally say my experience in Canada is leaps and bounds beyond in the US. It's not just because of the concept of "universal", nor the "equality" of treatment regardless of what someone makes, but from a business perspective, Canada has been pretty decent at controlling costs. However, a lot of it depends on people in charge of it being motivated for it to succeed. It's not ideal, but they make it work.

 

But, the people suggesting that this be implemented in the US really don't understand that you can't just take one thing in another country, run vastly different, different relationship with freedoms, different relationship with government (Canada is more of a collectivist country so more open to social programs), and just copy+paste it in the US and boom, problem solved. Because of these differing relationships, it seems best to me that things relative to universal be handled on a state/local (county/city) level. Then, everyone gets what they want, and if what they want isn't there, they have the freedom of movement to move elsewhere. 

 

For the people who suggest US healthcare is fine as it is (as in, without universal, but with the insurance industry and the litany of regulations and mandates), let me ask you.. what do you think of the fact that over a third of the country (quickly rising toward half) is already covered by taxpayers, whether it be federal, state, or county/city level government coverage? What about the growing debt load taken on by municipalities and states because they're forced to cover the uninsured? Taxpayers are clearly paying regardless. I am definitely for a market driven solution where people have a direct relationship with providers and cut out the middlemen, but even in the most conservative states, this simply doesn't happen anymore. What I see in conservative states, like Alabama, Texas, Kentucky, West Virginia, Kansas, and so on, is they are more and more in favor of a type of universal. If people on the right don't see where things are trending, there's going to be virtually zero balance to a universal care when its forced by leftist parties, the left are going to get their way, and it's going to suck badly. This idea of pretending that healthcare is even a private "market" in its current state (in 2020) is largely a joke. As it stands, the Republicans basically look set on giving the left their way and then playing defense.

Edited by Burnt Reynolds

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18 hours ago, ALFKAD said:

Better healthcare costs more.  That’s why Canadians come here and pay out of pocket.  I’m not saying it’s worth 4 times what Canadians pay, but obviously THEY think it is.  Or perhaps they just don’t want to wait 20 weeks to be seen.  Me?  I can get an appointment in about one week or less.

I have heard this argument many, many times from Americans but as a Canadian, I have NEVER thought my healthcare was inadequate and neither has anyone in my family or friends. Especially not to go across the border and pay thousands (as we would if I did not have insurance). My mother had breast cancer, had great care (her doctor was at princess margaret hospital in toronto), her doctor happened to be an American working there actually, my grandmother had thyroid cancer, received great care and both are and have been in remission. My grandfather had a stroke, had great care, uncle had stomach cancer, had nothing but good things to say. I've been to the doctor a multitude of times and sure, some doctors are better than others, but that is everywhere, is it not? The wait times were also never bad and are on par with what I have experienced here. I can acknowledge however, that I am from Toronto, a huge city, so maybe my experience is better than lets say, someone in rural saskatchewan, but again, I am sure that is the same here in the middle of nowhere vs new york city.

 

I am not disagreeing with you, I'm just curious where its coming from as I've never heard it personally from any Canadians/family/friends or seen stats on it. 

 

That being said, I am not really sure what the us should do about their system. Its obvious it needs some work (honestly most places do, Canada's is not perfect as dental/vision are not included), but it does seem evident that there is a significant portion of the american population that does not agree with the sentiment of medicare for all, so that should be thought about as well

Edited by mandsophia

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3 hours ago, mandsophia said:

I have heard this argument many, many times from Americans but as a Canadian, I have NEVER thought my healthcare was inadequate and neither has anyone in my family or friends. Especially not to go across the border and pay thousands (as we would if I did not have insurance). My mother had breast cancer, had great care (her doctor was at princess margaret hospital in toronto), her doctor happened to be an American working there actually, my grandmother had thyroid cancer, received great care and both are and have been in remission. My grandfather had a stroke, had great care, uncle had stomach cancer, had nothing but good things to say. I've been to the doctor a multitude of times and sure, some doctors are better than others, but that is everywhere, is it not? The wait times were also never bad and are on par with what I have experienced here. I can acknowledge however, that I am from Toronto, a huge city, so maybe my experience is better than lets say, someone in rural saskatchewan, but again, I am sure that is the same here in the middle of nowhere vs new york city.

 

I am not disagreeing with you, I'm just curious where its coming from as I've never heard it personally from any Canadians/family/friends or seen stats on it. 

 

That being said, I am not really sure what the us should do about their system. Its obvious it needs some work (honestly most places do, Canada's is not perfect as dental/vision are not included), but it does seem evident that there is a significant portion of the american population that does not agree with the sentiment of medicare for all, so that should be thought about as well

I appreciate yours and Burnt's input.   It's nice to hear about it from folks that actually experience it who  are believable, rather than what is written on some website.  I have never visited a doc while in Canada, so all I know is what I read.  What you describe sounds pretty much like what I've experienced here in the US.

 

One thing that would be interesting to find out is how much you paid for universal up in Canada (I'm assuming via payroll deductions?) vs what you have to pay here in the US via insurance premiums.

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