Regarding Health Care In The United States?
1991-1992 Harry Singer Foundation National Essay Contest
Neighborly Advice
The health care system of the United States is currently in serious trouble. Ninety percent of Americans say that they are dissatisfied with their health care system. Americans spend 12.2 percent of their gross national product on medical care annually, more than any other country, and have the best medical technology and resources in the world. Unfortunately, this medical care is not accessible to the 37 million uninsured Americans and the additional 50 million Americans who do not have complete coverage. Besides incomplete coverage, Americans also complain about the spiraling costs, the baffling insurance arrangements, and the frustrating paperwork. While other western nations' health-spending stabilized during the 80s and inflation in the United States raised only 4.7% each year, health care costs increased by 10.4% annually and insurance premiums went up 20% each year. Inflation is inevitable in the American medical market since the consumers must rely on the sellers of the medical services to tell them how much to buy, while government programs or insurance companies pick up much of the tab.
Since the United States is the last major industrial nation to address the topic of health care, we can learn from the experience of others. Other countries have controlled medical inflation by taking advantage of a universal medical system. A single purchaser bargains with providers and prices are set each year. In 1989, while the United States spent $2,683 for each American's health care, Canada spent $1,918, and Japan spent a mere $1,179. Besides having an inexpensive national health care program, Japan also has the longest life expectancy for both males and females, and the lowest infant mortality rate. Although Japan has the most efficient national health plan, the United States cannot adopt its program easily since the two countries are so culturally and historically different. The same may be said about every industrialized country in the world except for one, Canada.
Since Canada and the United States are so similar, the United States can easily remodel its' health care program after Canada's. Culturally, Canada is very similar to the United States, after all, 90 percent of all Canadians live within 100 miles of the American border. Canada and the United States share a common language and political roots; both have diverse populations, similar distributions of living standards, and increasingly integrated economies. The United States is especially adaptable to the Canadian program since Canada, before it consolidated its national health insurance in 1971, had a nearly identical medical care system as the United States.
Canada's health care program pays for universal access to ordinary medical care, maintains a high level of quality, is administratively efficient, and restrains the growth of health care costs far more efficiently than anything that has ever been tried in the United States. In their system, annual negotiations between provincial governments and providers of care determine hospital budgets and physicians' fees. As in the United States, most hospitals in Canada are also nonprofit community institutions, physicians practice under a fee for services system, and patients are able to choose their own doctors. The difference between the Canadian and American systems is that Canadian doctors bill the province instead of the patient. Under the Canadian system, disagreements in insurance claims, gaps in coverage, definitions of insurance services, complex eligibility tests, and bureaucratic incomprehensibility are nonexistent. If the United States decided to adopt a Canadian-style plan, the administrative savings alone would be enough to pay for all of the uninsured Americans' medical needs.
Despite these benefits, many Americans refuse to accept the Canadian medical care system. Americans become concerned that the universal medical system will result in lower quality health care whenever Americans hear horror stories about the rationing of care and the waiting lists for operations and examina- tions. Americans also worry that the many restrictions will infringe upon the doctor-patient relationship and decrease doctors' salaries, causing them to leave the United States. Although these concerns are understandable, they are hardly valid.
The threat of a universal medical insurance reducing the quality of health care has no basis. The quality of health care in the United States will no be harmed but will actually improve. While the U.S. ranks sixth. Since medical care in the United States is so expensive, uninsured Americans visit doctors half as much as insured Americans, even if their problems are serious. 7.5 percent of Americans stated in a poll that they didn't get needed medical attention due to financial difficulties. Under a universal medical program, the third who would be unable to pay under our current system would receive necessary medical attention if a crisis strikes.
Americans often carp about the rationing of medical care and the long waiting lists to certain procedures. What Americans fail to see is that the current system in America also rations patients. The only difference is that in America the wealthiest go first and in Canada the neediest, as determined by a physician, go first. Although the waiting lists are inconvenient, they don't seem to be harming individuals as a whole as shown by the equal survival rates for major operations in the United States and Canada. This system lowers hospital costs since Canadian hospitals are usually about 95 percent full, whereas the hospitals in the United States are only 60 percent full. In addition, Canadians get more physician services than Americans do as a whole, all at a lesser cost.
The restrictions in Canada don't appear to be a problem for most Canadian physicians. Although the restrictions to physicians may infringer upon doctor-patient relationships for some individuals, the vast majority are unaffected. Although American doctors may make a little less money than they do currently, they will still remain the highest paid professionals in the nation as they are in Canada. Sixty-nine percent of Canadian physicians gave their national health plan a good or excellent rating. Despite a lower income, some physicians even prefer the Canadian system since they are able to help all of their patients regardless of their ability to pay. Another problem that Canadian doctors don't have to face is the demoralization of American doctors by insurers and paperwork in the United States.
Although Canada's health care system is not without its flaws, it is an improvement over the United States' current system. Ninety percent of Americans are dissatisfied with their health care and 69 percent claim that they are willing to adopt Canada's program, whereas only 10 percent of Canadians are unhappy with their system and a mere 3 percent claim to be willing to trade medical systems with the United States. These statistics seem to show that although Americans realize that their country's health program is in need of reform, Americans remain stubborn in their ways and refuse to learn from their neighbors, claiming that the United States is unique and cannot be compared to others.
The entire concept is ridiculous. Canada's program is far superior to our current one and is highly adaptable to the United States. If Americans don't learn from their neighbors soon, the health care system in the United States will continue falling apart and eventually collapse.