Civil Bear said:
Go!Bears said:
"I am glad that you are willing to appreciate the US has better medical care. It's something most people that are longing for socialized medicine are unwilling to grasp."
Late to the party, and I don't know what province your relatives are in, but my family's experience has been very different. They receive prompt and excellent care, worry free. Nobody would even think of coming to the US for care and the niece who lives in the US often talks about how she misses her Canadian health insurance.
I always think a a good test of anecdotal complaints about Canadian health insurance is to look and see how many politicians are advocating for the repeal of their system and adoption of ours. Let me know if you find any.
Sorry for the late reply. I'm glad to hear your family is in a location where they can get prompt care. Canada is notoriously bad in that regards, but it does vary by Province:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2585441/
https://www.fraserinstitute.org/studies/waiting-your-turn-wait-times-for-health-care-in-canada-2018
https://www.nber.org/aginghealth/fall07/w13429.html
Now I know it is easy to find plenty of articles with an agenda that advocates for Canada's single-payer system. I especially like this one from the AARP that doesn't really dispute the "myths" so much as offer explanations:
https://www.aarp.org/politics-society/government-elections/info-03-2012/myths-canada-health-care.html
To summarize:
- Myth #1: Canadians are flocking to the United States to get medical care - except when their lives are on the line.
- Myth #2: Doctors in Canada are flocking to the United States to practice - except for the top ones. And Doctors from third world countries come to Canada resulting in a net gain.
- Myth #3: Canada rations health care; that's why hip replacements and cataract surgeries happen faster in the United States - It's true Canada rations healthcare (See myth #5 below) which leads to longer wait times, but there was a US politician that said he heard you couldn't get a hip replacement in Canada after a certain age. Not true!
- Myth #4: Canada has long wait times because it has a single-payer system. - well yeah, but we could fix that by throwing more money at it.
- Myth #5: Canada rations health care; the United States doesn't. - Okay, you got me. Canada rations health care. But US patients pay more!
It's true there are a lot of things wrong with the US healthcare system, and it has been deteriorating rapidly over the last 10 years or so. But the US still leads the world quality of care. Even the WHO which ranks the US in the 30's overall admitted that. Having the best doctors, the best available equipment, the best research universities, and private medical groups that compete for customers make it possible.
As for your question about politicians advocating for the repeal of their system, I hear that quite a bit. My response is I don't know many advocating to give up power in general. Once they got it, they ain't letting go.
The main problem with the American system is the cost and that it is insurance-based and even that mostly only through employers. The premise of insurance is that you form a risk pool that can pay out a limited and predictable number of claims. The premise of fire insurance is that 1) your House is not on fire 2) you will take all necessary precautions to make sure your house does not catch fire and 3) only a few houses catch fire at any given time.
The biggest issue with medical insurance is pre-existing conditions. You cannot call up an insurance agent and say "My house is on fire, how much for fire insurance?" This was especially problematic when your insurance was only through an employer. If someone in your family developed a medical condition you could not leave your job for a better one and if you ever lost your job you likely would be denied insurance. A related issue is that young very people tended not to get insurance.
The problem of old age (insurance companies don't want to insure old people who are only going to get older and eventually die, often with a long hospital stay first) was long ago solved with a public single-payer system (Medicare).
The other big issue with medical insurance is that the contracts are incredibly complex. My wife lead a medical economics team for a major insurance company and the medical provider contracts have over 10,000 cost codes. Even for consumers trying to compare one insurance provider with another it is difficult to assess all the variables.
Insurance companies typically negotiate rates that are discounts off of standard or retail rates, so doctors and hospitals are invented to increase the standard rates so they can offer bigger discounts. The uninsured then get charged ridiculously high rates, often leading to uninsured being refused or prematurely discharged from hospitals.
The ACA, originally the Republican plan based on Romney's program as governor of Massachusetts, attempted to solve these problems and bring down the cost of insurance by creating a competitive market for medical insurance. One requirement was that insurance companies would have to offer insurance even if there are pre-existing conditions. They agreed to this because carrying medical insurance was made mandatory, ie the risk pool was expanded to include everybody, especially more young healthy people.
In order to create an "efficient" competitive market for insurance, insurance had to be commoditized so that rather than comparing apples and oranges, you had a price for apples and a price for oranges, both clearly labeled (Gold plan, Silver Plan, etc).
In some states there was also an expansion of Medicare and Medicaid to cover people with pre-existing conditions and people who could not afford the private plans.
It is not clear how well the thing would have worked even if everyone wanted it to work. However, like seemingly everything else it was politicized, demonized and sabotaged. Some parts remain but it has effectively been gutted in most parts of the US. With the recent job losses there are probably 40 million Americans without medical coverage.
I think the best/politically feasible solution for America at this point is the "public option" whereby Americans would have the option to buy private insurance or buy into Medicare. The market for private insurance would revert back to what it was before the ACA with the addition that, in addition to whatever other plans the companies want to offer, they would be required to offer standardized Platinum, Gold, Silver etc plans so that consumers could easily shop for those plans. Those rates would be posted on a website for easy comparison.