Taking the Fear Out of “Socialized” Medicine

How familiar with some or all of these statements are you?

“Waiting times in Canada and other countries with “socialized” medicine are hours longer to see a physician than they are in America.”

“Doctors are fleeing countries with “socialized” medicine and coming to America in droves.”

Doctors are less satisfied practicing in countries with “socialized” medicine than the U.S.”

Countries with “socialized” medicine ration medical care leaving many without access to  needed health care.”

Of course these are comments that you hear over and over again by right-wing talking heads, many who are fed bogus data from the health care industry in this country.

Pediatrician Aaron Carroll is a health services researcher and Associate Professor of Pediatrics at Indiana University School of Medicine. He blogs at The Incidental Economist  where he focuses on research and reform with the U.S. Health care industry in this country.  He currently has a page that puts in graphic detail the data that disputes the above claims by those who have attacked “Obamacare”

Dr. Aaron Carroll

That page, found here, illustrates that most people who oppose “socialized medicine” only know what  the for-profit health care system in this country wants them to know.  Take a look at these  graphs and the information below each one to understand that we have more to gain by implementing a single-payer health care system than opposing one or sustaining the status quo.

1) Doctors in Canada are not flocking to the US to practice

So when emigration “spiked,” 400-500 doctors were leaving Canada for the United States.  There are more than 800,000 physicians in the U.S. right now, so I’m skeptical that every doctor knows one of those emigres. But I’d especially like you to pay attention to the yellow line, which is the net loss of doctors to Canada.

In 2003, net emigration became net immigration. Let me say that again. More doctors were moving into Canada than were moving out.

2) Canadians are not flocking here to get care

Look, I’m not denying that some people with means might come to the United States for care.  If I needed a heart/lung transplant, there’s no place I’d rather be.  But for the vast, vast majority of people, that’s not happening.  You shouldn’t use the anecdote to describe things at a population level.  This study showed you three different methodologies, all with solid rationales behind them, all showing that this meme is mostly apocryphal.

3) Doctors are not less satisfied practicing in Canada than the US

How satisfied are physicians with their practice?  It’s not a perfect measure, but it’s an important one:

Given the rhetoric of how much physicians hate reform, you would think doctors were very happy before reform passed.  You’d be wrong.  With the exception of Austria and Germany, fewer doctors were satisfied with practicing medicine [in the US] than any other surveyed country.

4) Claiming that hip replacements and cataract surgeries happen faster in the US does not prove that a single payer system doesn’t work

When people want to demonize single payer systems, they always wind up going after rationing, and more often than you’d think with hip replacements…

It’s not true.  They don’t deny hip replacements to the elderly.  But there’s more.

Do you know who gets most of the hip replacements in the United States?  The elderly.

Do you know who pays for care for the elderly in the United States?  Medicare.

Do you know what Medicare is?  A single-payer system.

5) Canada’s wait times aren’t due to its being a singe-payer system

The wait times that Canada might experience are not caused by its being a single payer system.

Do you know who pays for care for the elderly in the United States?  Medicare.

Do you know what Medicare is?  A single-payer system.

So our single-payer system manages not to have the wait times issue theirs does. There must be some other reason for the wait times. There is, of course. It’s this:

Canada isn’t some dictatorship. They aren’t oppressed. In 1966, the democratically elected government enacted their single-payer health care system (also known as Medicare). Since then, as a country, they have made a conscious decision to hold down costs. One of the ways they do that is by limiting supply, mostly for elective things, which can create wait times. Their outcomes are otherwise comparable to ours.

Please understand, the wait times could be overcome. They could spend more. They don’t want to. We can choose to dislike wait times in principle, but they are a byproduct of Canada’s choice to be fiscally conservative.  They chose this. In a rational world, those who are concerned about health care costs and what they mean to the economy might respect that course of action. But instead, we attack.

6) Since Canada adopted their single payer system, infant mortality has dropped below that of the US

3

Many people have told me that infant mortality used to be higher in Canada than in the US, but since the passage of (Canadian) Medicare, that hasn’t been the case.  The chart above, which I made from OECD data, would tend to agree.

I know the usual knocks against infant mortality as a population metric of quality.  But I’d like to hear a good alternate explanation (if one exists) for the trend you see above.  Links to evidence or data supporting your theory will get you extra points.

7) In Canada, they may “ration” by making some people wait for some things, but here in the US we also “ration” – by cost

About one-third of Americans report that they didn’t go to the doctor when sick, didn’t get recommended care when needed, did not fill a prescription, or skipped doses of medications in the last year because of cost.

How scary now is “socialized” medicine, or perhaps an even better question, how bad and broken is the American Health Care System where more doctors are leaving for countries with single-payer plans and where mortality rates are lower than the U.S.?

 

As a footnote it was revealed today (6/7/11) that Conservative British Prime Minister “promises not to create an ‘American style private’ health system” as the British government attempts to “avoid a crisis” in future funding of the National Health Service” as Cameron sees it.

The belief that single payer plans are embraced only by radical liberals is put to rest with this announcement.  It should be noted too that Cameron’s good fortune to win the PM seat was based in part on his campaign promise “to protect the National Health System from privatization.”

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