I get into conversations about politics with my co-workers about who they like in the 2020 election. And I also ask them which particular policies of the candidates they like best. The one they like most is Medicare for All, with “for All” including illegal immigrants. When I ask them which country has got Medicare for All working, they say “Canada”. Let’s take a look at Canada’s health care system.

Here’s a nice article from Mona Charen, posted in TownHall.

She writes:

It’s true that all Canadian citizens and legal residents (though not immigrants there illegally) get “free” health care, but only in the sense that you don’t get a bill after seeing a doctor or visiting a hospital. Medical care is subsidized by taxes, but the price comes in another form as well — rationing. A 2018 report from the Fraser Institute, a Canadian think tank, found that wait times between seeing a general practitioner and a specialist average 19.8 weeks. That’s the average. There are variations among specialties. Those hoping to see an orthopedist wait an average of 39 weeks in Nova Scotia, while those seeking an oncologist wait about 3.8 weeks.

[…]Imagine the anxiety of learning that you need an MRI to find out whether the mass in your breast is anything to worry about and then being told that the next available appointment is in 10 weeks. In addition to the psychic price, Canadians who had to wait for treatment expended an average of $1,822 out of pocket last year, due to lost wages and other costs. The Fraser Institute also calculated the value of the lost productivity of those waiting for treatment — nearly $5,600 per patient, totaling $5.8 billion nationally.

[…]When there’s an artificial shortage of a good or service, a black market usually follows. I have heard from several Canadians that paying doctors bribes to jump the line is not uncommon. But Canada has another pressure reliever: Ninety percent of Canadians live within 90 miles of the U.S. border, and medical centers in Buffalo, Chicago, Rochester and elsewhere receive tens of thousands of Canadian patients every year.

Regarding that last point, I’ve written many times about socialist politicians in Canada electing to travel to the United States for care, and that’s because (as you might expect) health care outcomes for Canadians are vastly inferior to health care outcomes for Americans. And keep in mind that the delay from specialist to GP does not take into account the delay to see the GP, or the delay from seeing the specialist to actually getting treatment.

And how much are Canadians spending for the privilege of waiting 19.8 weeks to see a specialist? Well, the average cost of Canadian health care is about $13,000 per household per year, paid through taxes. What that means is that people who work pay for all the health care being provided, including the health care for people who don’t work. But when it’s time to get treatment, those who pay the bills get in line behind those who don’t pay anything.

So how good is American health care? Maybe Canadians are waiting in line because their health care is so much better than ours.

American health care

One of the best health care policy experts writing today is Avik Roy, who writes for Forbes magazine.

Here is a recent column, which I think is useful for helping us all get better at debating health care policy.

Excerpt:

If you really want to measure health outcomes, the best way to do it is at the point of medical intervention. If you have a heart attack, how long do you live in the U.S. vs. another country? If you’re diagnosed with breast cancer? In 2008, a group of investigators conducted a worldwide study of cancer survival rates, called CONCORD. They looked at 5-year survival rates for breast cancer, colon and rectal cancer, and prostate cancer. I compiled their data for the U.S., Canada, Australia, Japan, and western Europe. Guess who came out number one?

The United States came out number one, and you can click here to see the larger graph of the complete results.

Some people like to point out that the United States has a low life expectancy, but there’s a problem with those numbers.

The article continues:

Another point worth making is that people die for other reasons than health. For example, people die because of car accidents and violent crime. A few years back, Robert Ohsfeldt of Texas A&M and John Schneider of the University of Iowa asked the obvious question: what happens if you remove deaths from fatal injuries from the life expectancy tables? Among the 29 members of the OECD, the U.S. vaults from 19th place to…you guessed it…first. Japan, on the same adjustment, drops from first to ninth.

It’s great that the Japanese eat more sushi than we do, and that they settle their arguments more peaceably. But these things don’t have anything to do with socialized medicine.

Finally, U.S. life-expectancy statistics are skewed by the fact that the U.S. doesn’t have one health-care system, but three: Medicaid, Medicare, and private insurance. (A fourth, the Obamacare exchanges, is supposed to go into effect in 2014.) As I have noted in the past, health outcomes for those on government-sponsored insurance are worse than for those on private insurance.

To my knowledge, no one has attempted to segregate U.S. life-expectancy figures by insurance status. But based on the data we have, it’s highly likely that those on private insurance have the best life expectancy, with Medicare patients in the middle, and the uninsured and Medicaid at the bottom.

If we’re going to discuss health care, then let’s discuss facts. We shouldn’t be picking a health care system from the campaign speeches of politicians who tell us that we can keep our doctor, and keep our health plan, and our premiums will go down. We tried electing a charismatic deceiver in 2008, and it didn’t work out. We lost our doctors, lost our health plans, and our premiums went up astronomically. We can do better than single-payer health care. We can do better than socialism.