• How many times is enough?

    Every once in a while, someone has to wheel out the usual story on how Canada’s health care system is about to collapse.  Today, it was Reuter’s turn:

    Pressured by an aging population and the need to rein in budget deficits, Canada’s provinces are taking tough measures to curb healthcare costs, a trend that could erode the principles of the popular state-funded system.

    Before I even get into this, can we acknowledge that rising health care costs in not a Canadian problem, but a worldwide problem?  Please remember as we go through the rest of it that – today – we spend about twice per person what Canada does on health care.  If they are complaining that it costs too much, what are we doing?  And while they spend about 10% of GDP on health care, we spend 16%.  So anyone who points to their model as “unable to contain costs” should just shut up.

    Anyway, here is my favorite line:

    In some ways the Canadian debate is the mirror image of discussions going on in the United States.

    Canada, fretting over budget strains, wants to prune its system, while the United States, worrying about an army of uninsured, aims to create a state-backed safety net.

    Huh?  We already have a safety net. It’s called Medicaid.  It’s not as good as I like but it exists.  This reporter, however, seems to think that the ACA is about the safety net.  It’s not.  It’s mainly a huge plan to give taxpayer money to people to buy private insurance.  It’s an expansion of the private system, albeit with government money.  It’s not some new government plan.

    Moreover, Canada wants to contain rising costs.  Like we should.  But as they take steps to be fiscally prudent, we deride them as failures.  Here’s a United States Senator:

    What will happen in the U.S.? | Reuters: Soaring costs force Canada to reassess health model

    Soaring health costs?  As opposed to here?  Am I losing my mind?

    They quote four people in the article.  One is the Ontario Finance minister.  He says:

    “Our objective is to preserve the quality healthcare system we have and indeed to enhance it. But there are difficult decisions ahead and we will continue to make them”

    Seems reasonable enough.  I don’t disagree.  You would think, that if this was an article describing the upcoming demise of the single payer system, that there would be other politicians calling for, say, the demise of the single payer system.  But no.  Instead, we get the following three players:

    1) A senior economist at Toronto-Dominion Bank.  You read that right.

    2) A professor at University of Toronto’s Rotman School of Business.

    3) A senior economist at Scotia Capital.  What is Scotia Capital?  This is Scotia Capital:

    Scotia Capital is the marketing name covering the Scotiabank Group’s integrated global corporate and investment banking and capital markets functions. Scotia Capital’s global operations are divided into two primary business units:

    Global CapitalMarkets

    In Canada, Scotia Capital offers a full range of corporate and investment banking and capital markets products and services.

    Really?  This is who they went to for health policy expertise?  Can you possibly predict what she will advise?

    Scotia Capital’s Webb said one cost-saving idea may be to make patients aware of how much it costs each time they visit a healthcare professional. “(The public) will use the services more wisely if they know how much it’s costing,” she said.

    “If it’s absolutely free with no information on the cost and the information of an alternative that would be have been more practical, then how can we expect the public to wisely use the service?”

    Ah….  the moral hazard.  Like music to my ears.

    No health policy experts.  No politicians advocating for change.  A bank economist, a business professor, and an economist for Scotia Capital.  The article never mentions that the single payer system in Canada is wildly popular.  The article never mentions that no serious politician is running on a platform of repealing it.

    But most importantly, the article never mentions that the Canadian health care system is not like ours in any way.  No matter what headline you read, the ACA is not a single payer system.  The ACA changed very little structurally.

    Our system is still mostly private.  Ours costs way more.  Ours covers far fewer people.  And ours has similar, if not worse, outcomes.

    Our system is nothing like Canada’s.  We should be so lucky.

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