The cost of healthcare for average Canadian households
I found two interesting studies from Canada’s Angus Reid Institute describing single payer health care in Canada. I’m very interested in find out what things are like in countries that have true government-run health care. A typical Canadian family pays $13,000+ per year per household for healthcare, or about $585,000 over their working lives. What are they getting for all that money?
The study finds more than 2 million Canadians aged 55 and older face significant barriers when accessing the health care system in their province, such as being unable to find a family doctor or experiencing lengthy wait-times for surgery, diagnostic tests, or specialist visits.
Moreover, most Canadians in this age group have at least some difficulty getting the care they want or need in a timely manner.
The study focuses on the health care experiences of older Canadians, as well as their assessments of the quality of care they receive.
According to the article, 31% of respondents (aged 55 and older) rated access to the government’s healthcare system as “easy”. 48% had “moderate” problems with access, and 21% had “major” problems with access.
Remember: in the Canadian system, you pay your money up front in taxes, and then they decide how much healthcare you will get later – and how soon you will get it. If you worked from ages 20 to age 65, then your household will have paid 45 x $13,000 = $585,000 into the system, in order to get “moderate” problems with accessing healthcare after you’re aged 55.
And the Canadian system DOES NOT cover prescription drugs.
This second part of the study finds one-in-six Canadians (17%) in the 55-plus age group – a figure that represents upwards of 1.8 million people – say that they or someone else in their household have taken prescription drugs in a way other than prescribed because of cost.
One-in-ten (10%) have decided to simply not fill a prescription because it was too expensive, and a similar number (9%) have decided not to renew one for the same reason. One-in-eight (12%) have taken steps to stretch their prescriptions, such as cutting pills or skipping doses.
Some 17 per cent of Canadians 55 and older have done at least one of these things, and that proportion rises among those who have greater difficulty accessing other aspects of the health care system.
In a previous blog post, I reported on how Canadians have to wait in order to see their GP doctor. If that doctor refers them to a specialist, then they have to wait to see the specialist. And if that specialist schedules surgery, then they have to wait for their surgery appointment. The delays can easily go from weeks to months and even years. The MEDIAN delay from GP referral to treatment is 19.5 weeks.
But remember – they paid into the system FIRST. The decisions about when and if they will be treated are made later, by experts in the government. This is what it means for a government monopoly to run health care. There are no free exchanges of money for service in a competitive free market. Costs are controlled by delaying and withholding treatment. And no one knows this better than elderly Canadians themselves. But by the time they realize how badly they’ve been swindled, it’s too late to get their money back out. You can’t pull your tax money out of government if you are disappointed with the service you receive. There are no refunds. There are no returns.
Price of healthcare per Canadian household (Source: Fraser Institute)
I post a lot of research from Canada’s Fraser Institute, but they are not the only think tank that publishes research on the efficiency and costs of single payer health care in Canada. This time, I found a report from the Heritage Foundation, where they go over quality of care, taxes, out of pocket costs, coverage, rationing, waiting lists, staff shortages, substandard equipment, and outdated drugs.
Canadians pay slightly less in out of pocket costs:
The OECD calculates that Canadians spend 1.6 percent of GDP on out-of-pocket health spending, compared to 1.9 percent in the U.S.
[…]While these numbers are very close, they are actually getting closer. Since 1970, U.S. out-of-pocket spending as a percentage of total medical spending has been falling steadily, from 33 percent in 1970 to about 10 percent in 2017.19
Meanwhile, Canadian out-of-pocket spending has been falling much slower, so that by 2016 it totaled 15 percent of total medical spending—a higher proportion than in the U.S.20
As a result, Statistics Canada warned in early 2020 that the percentage of Canadians experiencing large out-of-pocket burdens is growing, writing that “[b]etween 1998 and 2009…the percentage of households spending more than 10% of their total after-tax income on health care rose by 56%.”
Canadians pay more in federal and state taxes:
Federal taxation excluding social security contributions, then, comes to 28 percent of GDP in Canada, compared to just 19 percent in the U.S.—meaning 51 percent more.
[…]This excess taxation is largely a result of health spending, which has bloated provincial budgets to nearly three times the taxes of U.S. states.
Provincial taxes have grown to nearly the same level as federal taxation. Meanwhile, provincial health costs have risen to fully 37 percent of provincial budgets in 2016—up from 33 percent in 1993 – —and range as high as 42 percent.
Canada’s Fraser Institute has estimated this excess tax burden from public health costs at roughly $9,000 for a household of two adults with or without children or $750 per month in additional taxes.
When I wanted an MRI I was scheduled the same week
Canadians wait far longer for treatment than Americans:
Medical waiting times have become a national crisis in Canada, and continue to worsen. The average wait time for medically necessary treatment between referral from a general practitioner and a consultation with a specialist was 8.7 weeks in 2018, 136 percent longer than in 1993. Patients then have to wait again between seeing the specialist and the actual treatment, another 11 weeks on average, 97 percent longer than in 1993.
From referral to treatment, then, it takes an average of 19.8 weeks (see Chart 2) to be treated, in addition to the original wait to see the family doctor in the first place—this for “medically necessary” treatment, not cosmetic surgery.
In contrast, nearly 77 percent of Americans are treated within four weeks of referral, and only 6 percent of Americans report waiting more than two months to see a specialist.
As for appointments, a 2017 survey of American physicians in the 15 largest U.S. cities found that it took just 24 days on average to schedule a new-patient physician appointment, including 11 days for an orthopedic surgeon and 21 days for a cardiologist.
As a result of these long waits, by one recent estimate, at any given moment, over one million Canadians—3 percent of the entire population—are waiting for a medical treatment.
These lists can average six months, and often much longer in rural areas, which tend to suffer from doctor shortages so severe that many do not even have a family doctor. Overall, 15 percent of Canadians did not have a regular health care provider in 2017.
The shortages ripple through the system; one doctor in Ontario called in a referral to the local hospital, only to be told there was a four-and-a-half year wait to see a neurologist.
In Canada, people die or become inoperable on waiting lists:
A Montreal man was finally called for his long-delayed urgent surgery two months after he had died. One 16-year-old boy in British Columbia waited three years for an “urgent” surgery, during which time his condition deteriorated so much that he became a paraplegic.
Canadians have to travel abroad to countries with functioning health care systems in order to be treated:
These cases are, unfortunately, not isolated; a survey of specialists found that average wait times exceed what is deemed clinically “reasonable” for fully 72 percent of conditions in Canada. The situation continues to worsen every year: In 1994, the average gap between clinically reasonable delay and actual delay was only four days, and by 2018 had grown to 23 days.
[…]With one million waiting, many Canadians turn in desperation to U.S. health care—the very system some U.S. policymakers propose to transform. In 2017 alone, Canadians made 217,500 trips to other countries for health care, of which 52,500 were to the U.S., paying out of pocket to skip the waiting.
While the average employer-sponsored private insurance plan in Canada covers between 10,000 and 12,000 drugs, most public plans in Canada only cover 4,000. Canada has 35 percent fewer acute care beds than the U.S., and only one-fourth as many magnetic resonance imaging (MRI) units per capita—indeed, it has fewer MRI units per capita than Turkey, Chile, or Latvia.
[…]Some common treatments are simply unavailable to Canadians. For new pharmaceuticals, for example, Canada’s policy of forcing down prices so that American consumers essentially pay for Canada’s research and development has led to years-long delays for Canadian patients.
[…]Cutting corners on facilities and using outdated drugs show up in Canadian mortality rates. Thirty-day in-hospital mortality rates in Canada are 20 percent higher than in the U.S. for heart attacks, and nearly three times the U.S. level for strokes. Cancer age-standardized mortality is 10 percent higher in Canada than in the U.S.—despite far healthier lifestyles.
[…]When it comes to personnel, Canada underspends on medical staff and doctors, ranking 29th out of 33 among high-income countries for doctors per 1,000 population, accounting for a large part of those wait times. Canada has half as many specialist physicians per capita as the U.S.
[…]With such shortages and waiting lists, Canadian emergency rooms are packed. So packed that Canadians sometimes just give up and go home. Of Canadian ER visitors who are seen, 29 percent report wait times of over four hours, three times the U.S. level.
[…]Canadian seniors are 65 percent more likely to have visited the emergency room (ER) four or more times in the past year than American seniors.
Ultimately, nearly 5 percent of Canadian ER visitors end up leaving without ever being treated, giving up on a medical system that is perennially “free” but out of stock at the moment. In one study at two ERs in Alberta, 14 of the 498 walkaways were subsequently hospitalized, and one died within the week.
And keep in mind how things work in a single payer system. You pay up front through your taxes. The harder you work, the more you pay into the system. When you want treatment, you just get in line behind people who never paid one dime into the system – like all those low-skill refugees that Canada imports from Middle Eastern countries to build up the socialist voting bloc.
Price of healthcare per Canadian household (Source: Fraser Institute)
I post a lot of research from Canada’s Fraser Institute, but they are not the only think tank that publishes research on the efficiency and costs of single payer health care in Canada. This time, I found a report from the Heritage Foundation, where they go over quality of care, taxes, out of pocket costs, coverage, rationing, waiting lists, staff shortages, substandard equipment, and outdated drugs.
Canadians pay slightly less in out of pocket costs:
The OECD calculates that Canadians spend 1.6 percent of GDP on out-of-pocket health spending, compared to 1.9 percent in the U.S.
[…]While these numbers are very close, they are actually getting closer. Since 1970, U.S. out-of-pocket spending as a percentage of total medical spending has been falling steadily, from 33 percent in 1970 to about 10 percent in 2017.19
Meanwhile, Canadian out-of-pocket spending has been falling much slower, so that by 2016 it totaled 15 percent of total medical spending—a higher proportion than in the U.S.20
As a result, Statistics Canada warned in early 2020 that the percentage of Canadians experiencing large out-of-pocket burdens is growing, writing that “[b]etween 1998 and 2009…the percentage of households spending more than 10% of their total after-tax income on health care rose by 56%.”
Canadians pay more in federal and state taxes:
Federal taxation excluding social security contributions, then, comes to 28 percent of GDP in Canada, compared to just 19 percent in the U.S.—meaning 51 percent more.
[…]This excess taxation is largely a result of health spending, which has bloated provincial budgets to nearly three times the taxes of U.S. states.
Provincial taxes have grown to nearly the same level as federal taxation. Meanwhile, provincial health costs have risen to fully 37 percent of provincial budgets in 2016—up from 33 percent in 1993 – —and range as high as 42 percent.
Canada’s Fraser Institute has estimated this excess tax burden from public health costs at roughly $9,000 for a household of two adults with or without children or $750 per month in additional taxes.
When I wanted an MRI I was scheduled the same week
Canadians wait far longer for treatment than Americans:
Medical waiting times have become a national crisis in Canada, and continue to worsen. The average wait time for medically necessary treatment between referral from a general practitioner and a consultation with a specialist was 8.7 weeks in 2018, 136 percent longer than in 1993. Patients then have to wait again between seeing the specialist and the actual treatment, another 11 weeks on average, 97 percent longer than in 1993.
From referral to treatment, then, it takes an average of 19.8 weeks (see Chart 2) to be treated, in addition to the original wait to see the family doctor in the first place—this for “medically necessary” treatment, not cosmetic surgery.
In contrast, nearly 77 percent of Americans are treated within four weeks of referral, and only 6 percent of Americans report waiting more than two months to see a specialist.
As for appointments, a 2017 survey of American physicians in the 15 largest U.S. cities found that it took just 24 days on average to schedule a new-patient physician appointment, including 11 days for an orthopedic surgeon and 21 days for a cardiologist.
As a result of these long waits, by one recent estimate, at any given moment, over one million Canadians—3 percent of the entire population—are waiting for a medical treatment.
These lists can average six months, and often much longer in rural areas, which tend to suffer from doctor shortages so severe that many do not even have a family doctor. Overall, 15 percent of Canadians did not have a regular health care provider in 2017.
The shortages ripple through the system; one doctor in Ontario called in a referral to the local hospital, only to be told there was a four-and-a-half year wait to see a neurologist.
In Canada, people die or become inoperable on waiting lists:
A Montreal man was finally called for his long-delayed urgent surgery two months after he had died. One 16-year-old boy in British Columbia waited three years for an “urgent” surgery, during which time his condition deteriorated so much that he became a paraplegic.
Canadians have to travel abroad to countries with functioning health care systems in order to be treated:
These cases are, unfortunately, not isolated; a survey of specialists found that average wait times exceed what is deemed clinically “reasonable” for fully 72 percent of conditions in Canada. The situation continues to worsen every year: In 1994, the average gap between clinically reasonable delay and actual delay was only four days, and by 2018 had grown to 23 days.
[…]With one million waiting, many Canadians turn in desperation to U.S. health care—the very system some U.S. policymakers propose to transform. In 2017 alone, Canadians made 217,500 trips to other countries for health care, of which 52,500 were to the U.S., paying out of pocket to skip the waiting.
While the average employer-sponsored private insurance plan in Canada covers between 10,000 and 12,000 drugs, most public plans in Canada only cover 4,000. Canada has 35 percent fewer acute care beds than the U.S., and only one-fourth as many magnetic resonance imaging (MRI) units per capita—indeed, it has fewer MRI units per capita than Turkey, Chile, or Latvia.
[…]Some common treatments are simply unavailable to Canadians. For new pharmaceuticals, for example, Canada’s policy of forcing down prices so that American consumers essentially pay for Canada’s research and development has led to years-long delays for Canadian patients.
[…]Cutting corners on facilities and using outdated drugs show up in Canadian mortality rates. Thirty-day in-hospital mortality rates in Canada are 20 percent higher than in the U.S. for heart attacks, and nearly three times the U.S. level for strokes. Cancer age-standardized mortality is 10 percent higher in Canada than in the U.S.—despite far healthier lifestyles.
[…]When it comes to personnel, Canada underspends on medical staff and doctors, ranking 29th out of 33 among high-income countries for doctors per 1,000 population, accounting for a large part of those wait times. Canada has half as many specialist physicians per capita as the U.S.
[…]With such shortages and waiting lists, Canadian emergency rooms are packed. So packed that Canadians sometimes just give up and go home. Of Canadian ER visitors who are seen, 29 percent report wait times of over four hours, three times the U.S. level.
[…]Canadian seniors are 65 percent more likely to have visited the emergency room (ER) four or more times in the past year than American seniors.
Ultimately, nearly 5 percent of Canadian ER visitors end up leaving without ever being treated, giving up on a medical system that is perennially “free” but out of stock at the moment. In one study at two ERs in Alberta, 14 of the 498 walkaways were subsequently hospitalized, and one died within the week.
And keep in mind how things work in a single payer system. You pay up front through your taxes. The harder you work, the more you pay into the system. When you want treatment, you just get in line behind people who never paid one dime into the system – like all those low-skill refugees that Canada imports from Middle Eastern countries to build up the socialist voting bloc.
WINTERY KNIGHT 