Crossing Borders for Health Care
As the health care reform debate shapes up, the special interest are yet again doing their best to scare people. It’s 1994 all over again. The latest ad features a Canadian woman who claims she would have died of brain cancer had she not ventured across the border, to be saved by the US healthcare system. And we see this argument pulled out of the hat over and over again, whenever we talk about the failings of the US healthcare system (such as 80 million either uninsured or seriously underinsured). Whatever the merits of this particular woman’s case, the general argument itself has no merit whatsoever.
An academic study in the Health Affairsjournal finally puts this myth to bed (hat tip to Paul Krugman). Bottom line:
“Results from these sources do not support the widespread perception that Canadian residents seek care extensively in the United States. Indeed, the numbers found are so small as to be barely detectible relative to the use of care by Canadians at home…Canadians coming south with their own money to purchase U.S. health care—appear to be handfuls rather than hordes.”
Jonathan Cohn puts it all in perspective:
“For those who’d like a review: Canadian health care has strengths and weaknesses. The strengths include superb primary care, administrative simplicity, and the kind of cradle-to-grave financial security virtually no Americans enjoy now. The weaknesses include some long waits for specialty care–although statistics suggest Canadians are not, on the whole, ending up in worse health than Americans because of them.
The real lie here, though, is in ads’ broader implication: That, by reforming health care, “Washington” (a.k.a. President Obama and his allies) would import “Canadian-style healthcare” and, as a result, deny people life-saving treatment. This is demonstrably false.
Remember, Canada has a single-payer plan–one in which the government insures everybody directly, with virtually no role for private insurance. No politician with serious influence is talking about creating such a plan here (even though, for the record, I think such a plan could work pretty well if designed properly). In addition, Canada spends far less than we do on health care. That means fewer resources which, in turn, contributes to waiting lists. No politician with serious influence is talking about reducing spending to Canadian levels (although, to be clear, we should be spending less than we do now).
Reformed health care in the U.S. would, in all likelihood, look more like what you find in France, the Netherlands, or Switzlerand. These countries don’t have problems with chronic waiting times. In fact, access to some services–particularly primary and emergency care–is easier and quicker than it is in the U.S. But these countires also make sure everybody has insurance coverage–and generous coverage at that. In other words, they get the best of all worlds. Not surprisingly, their people are far happier with their health care systems than we are with ours.”
One final point: Canadians might not be running south to the US, but Americans seem to be running south to Mexico– almost one million Californians go to Mexico each year for affordable medical care.