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Quality of Healthcare at Least as Good in Canada as in U.S.



The most comprehensive study that was ever under taken on the two health care systems, the US and Canada’s was done jointly by Harvard University and McMasters University:

A comprehensive study by a team of 17 leading Canadian and U.S. researchers finds that the quality of care in Canada is at least as good as that in the U.S. The research, which appears in the inaugural issue of the on-line journal Open Medicine, is a rigorous statistical compendium of every direct comparison of the outcomes of U.S. and Canadian patients with identical illnesses ever published.

The researchers analyzed every study that met two pre-specified criteria: 1) a comparison of patients with identical diagnoses in Canada and the U.S.; and 2) clearly measured outcomes, such as death rate. Medical librarians collaborating in the study identified 4,923 journal articles that might meet these criteria. The researchers reviewed abstracts and titles of these articles to winnow them to 498 articles that might possibly meet the pre-specified criteria. In order to eliminate any potential bias in study selection, librarians then blacked out the results of each of these 498 studies. Only then did a second team of reviewers decide which studies should be included in the final analysis. Finally, the 38 studies fully meeting both inclusion criteria were analyzed statistically.

Overall, 14 of the 38 studies showed better outcomes in Canada, while only 5 favored the U.S. The remaining 19 studies showed equivalent or mixed results in the two nations. When the studies were combined statistically, the mortality rate was 5% lower in Canada. However, the researchers urged caution in interpreting this small Canadian advantage. Among the highest quality studies examined, 5 favored Canada while only 2 favored the U.S. The one group of patients who clearly fared better in Canada were those with end stage kidney disease.

The findings are particularly striking since few uninsured patients in the U.S. — who probably suffer the worst quality care - were included in the studies examined. Indeed, all kidney failure patients in the U.S. have insurance, Per capita health spending in the U.S. in 2006 was $7,129 — more than double Canada’s spending of $2,956 (U.S.) per capita. All Canadians are covered under that nation’s non-profit national health insurance program. The study comes on the heels of recent findings from the Joint U.S. Canada Health Survey that Canadians enjoy access to care similar to that for insured Americans, and far better than for the uninsured in the U.S.

Dr. Gordon Guyatt, Professor of Medicine at McMaster University and lead author of the study said “These results should be a wake up call to Americans. Canadian-style universal health care can deliver as good or better health outcomes at half the price.” Dr. Guyatt, who coined the term “evidence based medicine” is a leading expert on research methodology.

Dr. Steffie Woolhandler, Associate Professor of Medicine at Harvard and a study co-author commented: “Americans pay inflated prices for inferior care. The extra $4000 each American spends annually isn’t buying us better quality. Most of it is pure waste, going for paperwork and insurance and drug company profits. National health insurance would maintain or even improve quality for those who now have coverage, cover the uninsured and still cost less than we’re now spending.”

LINK

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The Canadian system came out on top despite the fact that US studies omitted the uninsured in this country… 18,000 of them die every year here because they can’t get access to the system!

This also doesn’t take into account the study by Ohio State and Harvard University that showed that 400,000 American families are forced into bankruptcy every year by a medical crisis and 75% of them had health insurance.

This is important too:

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New England Journal of Medicine Study Shows U.S. Health Care Paperwork Cost $294.3 Billion in 1999; Far More Than in Canada

BOSTON-August 20, 2003-A Special Article published in tomorrow’s New England Journal of Medicine finds that health care bureaucracy cost Americans $294.3 billion in 1999. The $1,059 per capita spent on health care administration was more than three times the $307 per capita in paperwork costs under Canada’s national health insurance system. Cutting U.S. health bureaucracy costs to the Canadian level would have saved $209 billion in 1999.

The study was carried out by researchers at Harvard Medical School and the Canadian Institute for Health Information, Canada’s quasi-official health statistics agency. The authors analyzed the administrative costs of health insurers, employers’ health benefit programs, hospitals, nursing homes, home care agencies, physicians and other practitioners in the U.S. and Canada. They used data from regulatory agencies and surveys of doctors, and analyzed Census data and detailed cost reports filed by tens of thousands of health institutions in both nations.

The authors found that bureaucracy accounted for at least 31% of total U.S. health spending in 1999 vs. 16.7% in Canada. They also found that administration has grown far faster in the U.S. than in Canada. Between 1969 and 1999, administrative and clerical personnel in the U.S. grew from 18.2% to 27.3% of the health work force. In contrast, the administrative/clerical share of Canada’s health labor force rose modestly, from 16.0% in 1971 to 19.1% in 1996. These labor force figures exclude the 1.65 million employees at U.S. insurance companies and agencies, as well as the small number of private insurance employees in Canada.

LINK

And these are 1999 numbers!

DAR
Incidentally, how we get shagged with the private for profit health-care insurance is just a slight variation on how we get shagged with the private for profit insurance for our homes and autos. I just learned this first hand this week. I have been with Allstate for 17 years and now have four properties insured with them. No claims other than we were robbed in May and had a $5,000 claim. A couple of days ago they quoted me $830 for insurance on my 5th property which are getting in August. The paper work just arrived and turns out it is now going to be $1309 per year. Why the $479 difference? Because they just now found out about this one single claim (I didn’t hide it, I thought they knew). And other insurance companies (Shelter) won’t even look at insuring our new home. Won't even give a quote. Why? Because they are all in together (as with health insurance) and I have now had this one small claim, on one property (of four), during a 17 year period. Sound familiar? What is the use of insurance if you can’t use it? What a joke.

D.

It really should be a no-brainer - except that no brains is apparently why the American public accepts our system as "best" - all you have to do is look at the profit (net profit at that) the insurance companies post every quarter & calculate in the cost of buildings & CEO 8-digit incomes. It's not Monopoly money that pays for those things.

It's just like private retirement funds vs. social security. The latter is administered by the government for something like 2% or less of the monies paid in. The former (as shown by other countries who've gone to privatized retirement funds and have regretted it) has administrative costs running 20% or higher and where that goes is easily seen in CEO salaries, etc.

Darrell - the insurance scam is pretty bad. Five years ago a co-worker of mine planning to add a 19th property was told by the company that covered his 18 rental houses that he couldn't get insurance in AR at all. They just weren't insuring property in AR any more.