• Tag Archives Canada

  • America Outperforms Canada in Surgery Wait Times—And It’s Not Even Close

    Posted on by Azrael Comment


    hospital
    Canadian Medicare, our northern neighbor’s universal health care system, generally receives rave reviews from proponents of nationalized or socialized health care, but the Fraser Institute found that more than 63,000 Canadians left their country to have surgery in 2016.

    As Americans contemplate overturning our health system in favor of one similar to Canada’s, we must ask why so many leave.

    The Canadian system consistently ranks low or lowest across numerous metrics in the Commonwealth Fund’s extensive survey on health care. With regards to specialists and surgeries, the United States ranked best or nearly best.

    The Fraser Institute study did not examine where Canadians traveled for surgery, but given proximity and our much better metrics, most probably came here.

    Surgeries are scheduled after patients are seen by the surgeon, and most people see surgeons only after a referral by either their primary care physician in America, or their general practitioner in Canada. In the United States, 70 percent of patients are able to be seen by specialists less than four weeks after a referral. In Canada, less than 40 percent were seen inside of four weeks.

    After being advised that they need a procedure done, only about 35 percent of Canadians had their surgery within a month, whereas in the United States, 61 percent did. After four months, about 97 percent of Americans were able to have their surgery, whereas Canada struggled to achieve 80 percent.

    America is significantly outperforming Canada in surgery wait times even as it’s likely that tens of thousands of Canadians come here to use the American system.

    General surgery, procedures such as appendectomies, cholecystectomies, and hernia repairs, make up the largest portion of those who leave Canada for care. Based on the latest available date from the Organization for Economic Cooperation and Development, the total Canadian caseload for many of these procedures is about ten percent of America’s.

    America’s health system is certainly flawed and in need of reform, but there is clearly something working well enough that our system, despite already treating ten times more cases of appendicitis, can absorb the dissatisfied Canadians.

    This has been a consistent trend since at least 2014 when an estimated 52,513 Canadians left for their medical care. In 2015, the number went down slightly to 45,619. 2016 exceeded the 2015 number with an estimated 63,459 patients seeking care elsewhere.

    Moreover, both countries have had comparable rates of private health insurance coverage for the past 20 years, roughly 60-70 percent. But the Canadian private insurance market is entirely supplemental—it covers co-payments for services not covered or not entirely covered by the provincial insurance.

    Primary coverage, which is the predominant form of insurance in America, is all but illegal in Canada and would be under “Medicare for All” as well.

    In the United States, government insurance covers gaps left by the private market. Private insurance is the norm and Medicare and Medicaid provide a health insurance safety net for elderly or low-income Americans.

    In Canada, government-provided Medicare is the primary form of insurance, and private plans merely fill in gaps in coverage for those with more disposable income or employee benefits. The two systems are mirror opposites of one another.

    Health care is a product of the labor of physicians, nurses, technicians, and a whole ecosystem of health care workers. If making the government the primary payer for these services is so smart, why does the universal system next door shed patients by the tens of thousands to ours?

    American health care can be improved and should be; American health care performs about middle-of-the-pack for many other items on the Commonwealth Fund survey.

    There are many inefficiencies, often government-imposed, that increase the cost of health care and restrict the insurance market.

    The administration already has loosened some regulations that will give employers more flexibility in providing health benefits and has begun to push for price transparency, which also should bring down costs.

    Whatever the case may be, reforming American health care should focus on enabling our strengths. Under no circumstance should we tear it down and build it anew to resemble the system whose citizens escape by the tens of thousands just to be treated in a timely manner.

    This article is republished with permission from The Daily Signal. 

     

     

    Kevin Pham

    Kevin Pham, a medical doctor, is a contributor to The Daily Signal and a former graduate fellow in health policy at The Heritage Foundation.

    This article was originally published on FEE.org. Read the original article.


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  • Canada’s Universal Child Care Program Suggests Elizabeth Warren’s Plan Would Be Disastrous for Children

    Posted on by Azrael Comment

    The state does such a stellar job of nurturing and educating children from preschool through high school, we should expand its role from birth onward. That’s the new proposition unveiled this week by US Senator Elizabeth Warren of Massachusetts. On Tuesday, the Democratic presidential candidate outlined a vast federal program of free and subsidized child care for children from birth until school-entry, including creating a network of government child care centers modeled after the federal Head Start early childhood program. Warren states: “Child care is one of those things we’ve got to do for working parents and we’ve got to do for our children.”

    The popular idea that the state should do things for parents, rather than allowing parents to do things for themselves and their own children, illustrates the pervasiveness of the welfare state mentality. What is framed as helping families instead strips them of their individual power and autonomy, making them more reliant on, and influenced by, government programs.

    Warren’s program is to be financed through a “wealth tax” on the most asset-rich American households and reportedly assures that all child care workers will earn wages that are on par with those of local public school teachers. Like other attempts at government price-setting, however, the economic impact of such a program would inevitably be to drive up prices, reduce variety and competition, and lead to more widespread shortages.

    The intentions of universal, government-funded child care may be good. Supporting children and families is a worthy ambition. But as Nobel Prize-winning economist Milton Friedman warned: “One of the great mistakes is to judge policies and programs by their intentions rather than their results.” We should reject Warren’s proposal both on principle and on consequence.

    The results of similar universal, government child care programs are dismal. In 2005, economists with the National Bureau of Economic Research, including Michael Baker of the University of Toronto, Jonathan Gruber of MIT, and Kevin Milligan of the University of British Columbia, analyzed the effects of Canada’s government-subsidized, universal child care program. Similar to Warren’s proposed child care plan, the Canadian program is available to all families—not just those who are disadvantaged. The researchers discovered that demand for child care increased significantly under the government plan, as more parents abandoned informal child care arrangements with family and friends in favor of regulated child care programs.

    While demand increased, the researchers found that children’s emotional and physical health outcomes declined dramatically with the introduction of government-subsidized, universal child care. Children in the Quebec program experienced increased rates of anxiety and decreased social and motor skills compared to children elsewhere in Canada where this program was not offered. The researchers write:

    We uncover striking evidence that children are worse off in a variety of behavioral and health dimensions, ranging from aggression to motor-social skills to illness. Our analysis also suggests that the new childcare program led to more hostile, less consistent parenting, worse parental health, and lower-quality parental relationships.

    Last fall, these economists published updated findings on their analysis of Canada’s universal child care program. Their recent research revealed similarly alarming results of government-funded child care, including a long-term negative impact of the program. They assert: “We find that the negative effects on non cognitive outcomes persisted to school ages, and also that cohorts with increased child care access had worse health, lower life satisfaction, and higher crime rates later in life.” This early institutionalization of children may have enduring, undesirable consequences.

    While it’s not clear exactly what is causing the negative outcomes of Canada’s universal, government child care program, the research hints at some possibilities. A primary explanation is that the program funneled more children into government-regulated, center-based child care facilities and away from more informal child care arrangements. There was also a drop in parental care, as the opportunity cost of stay-at-home parenthood rose.

    Proponents of universal, government child care programs often tout the expansion of allegedly “high-quality” child care options, suggesting that parental care or other unregulated child care arrangements are subpar. But who determines quality? If Canada’s program is any indication, the government’s definition of “high-quality” child care may, in fact, be harming children.

    In his recent article on the economic causes of current child care shortages and correspondingly high prices, Jeffrey Tucker explains that the key to affordable, accessible daycare for all is to reduce government regulation of child care programs and providers and allow parents to choose the child care setting that best suits them and their child. Let parent preferences drive the market for child care options, not government interventions that squeeze supply, devalue informal caretaking arrangements, and unnecessarily raise the cost of stay-at-home parenthood.

    We should all heed Tucker’s conclusion: “Daycare for all is a great idea. A new government program is the worst possible way to get there.”

    Kerry McDonald


    Kerry McDonald

    Kerry McDonald (@kerry_edu) has a B.A. in Economics from Bowdoin and an M.Ed. in education policy from Harvard. She lives in Cambridge, Mass. with her husband and four never-been-schooled children. Kerry is the author of the forthcoming book, Unschooled: Raising Curious, Well-Educated Children Outside the Conventional Classroom (Chicago Review Press). Follow her writing at Whole Family Learning.

    This article was originally published on FEE.org. Read the original article.



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