Health Care: U.S. vs. Canada
Summary
TLDRThe transcript captures a discussion between Senator Burr, Dr. Martin, and Ms. Pipes about the healthcare systems in Canada and the United States. Dr. Martin refutes claims that Canadian doctors are leaving the public system and advocates for improving wait times without moving to a multi-payer system. Ms. Pipes highlights that many Canadians come to the U.S. for quicker healthcare services due to long wait times. The conversation touches on the differences between both systems, the role of private insurance, and public perceptions of quality healthcare.
Takeaways
- 😀 Canadian doctors are not exiting the public system; instead, there is a net influx from the U.S.
- 🤔 The solution to reducing wait times in Canada isn't moving towards a multi-payer system.
- 📊 Studies in Australia show that private insurance increased wait times in the public system.
- 💡 Some Canadians perceive private healthcare in the U.S. as better due to higher costs, but this isn't supported by evidence.
- 🌍 Canadian pioneers lead in certain medical procedures, offering top-tier outcomes within the public system.
- 📉 42,000 Canadians seek healthcare in the U.S. due to long wait times in Canada.
- 🏥 Canada is working to reorganize its system to reduce wait times equitably for all patients.
- ⏱ The focus is on using existing resources more effectively rather than moving to a two-tier system.
- 🩺 45,000 Americans die annually due to lack of insurance, a significant contrast to Canada’s single-payer system.
- 🔗 Support for the single-payer system in Canada crosses political lines, and there is little interest in adopting the American healthcare model.
Q & A
Why are doctors exiting the public system in Canada according to Dr. Martin?
-Dr. Martin clarified that there are no doctors exiting the public system in Canada. Instead, there is a net influx of physicians from the United States into the Canadian system.
What is the impact of a multi-payer system on wait times as experienced by Australia?
-A study by Ducat et al. found that when Australia moved to a multi-payer system, wait times in the public system increased in areas where private insurance was utilized.
Why do some Canadians choose to go to the United States for healthcare?
-Some Canadians travel to the U.S. for procedures like heart valve replacements, often due to the perception of better quality or innovation, despite the availability of such procedures in Canada.
How many Canadians come to the United States each year for healthcare?
-More than 42,000 Canadians come to the United States each year for healthcare, often for MRIs and CT scans.
What does Dr. Martin suggest as a solution to wait times in Canada's healthcare system?
-Dr. Martin suggests focusing on reducing wait times in an equitable way for all, emphasizing the importance of organizing resources effectively rather than just increasing them.
What benchmarks has the Wait Time Alliance in Canada established for reasonable wait periods?
-The Wait Time Alliance in Canada has established benchmarks across various diagnoses to define what constitutes a reasonable waiting period for care.
How does Dr. Martin respond to the idea that paying more for healthcare leads to better quality?
-Dr. Martin counters the notion that paying more guarantees better healthcare quality, stating that evidence on outcomes does not support this belief.
What is the political stance of Canada's Prime Minister regarding the healthcare system?
-Canada's Prime Minister is conservative, and despite this, there is broad support across political parties for the single-payer Medicare system in Canada.
Why do Canadians not adopt the American healthcare system?
-Canadians are aware of the American healthcare system and have chosen not to adopt it, likely due to a preference for a system that guarantees healthcare to all in a cost-effective manner.
What does Dr. Martin suggest about the relationship between the Canadian and American healthcare systems?
-Dr. Martin implies that despite the proximity and similarities between Canada and the U.S., Canadians have a clear preference for their own healthcare system over the American model.
How does Dr. Martin describe the Canadian public's perception of the American healthcare system?
-Dr. Martin suggests that Canadians are familiar with the American healthcare system and have made a conscious choice to maintain their own system, indicating a preference for universal healthcare.
Outlines
🏥 Canadian Healthcare System's Strengths
Dr. Martin clarifies misconceptions about Canadian doctors leaving the public healthcare system for private practice, emphasizing that there is actually a net influx of physicians from the United States. He argues against moving to a multi-payer system, citing Australia's experience where wait times increased with the introduction of private insurance. He also addresses the perception that healthcare outside of Canada is superior, highlighting that world-class care for certain procedures is available within Canada. Dr. Martin suggests that the focus should be on improving wait times within the single-payer system rather than seeking alternatives, and he points out that the Canadian public broadly supports their healthcare system across political ideologies.
🌎 Cross-Border Healthcare and Perceptions
The discussion continues with the reasons why some Canadians choose to seek healthcare in the United States, despite the Canadian system's overall effectiveness. It is noted that approximately 42,000 Canadians travel to the U.S. annually for medical care, often due to long wait times for non-emergency procedures. The conversation touches on the Canadian public's awareness of the U.S. healthcare system and their preference for their own system, even under conservative political leadership. The dialogue suggests that Canadians are patient and value their universal healthcare system, which provides cost-effective care to all citizens.
Mindmap
Keywords
💡Public Health System
💡Wait Times
💡Single-payer System
💡Multi-payer System
💡Elective Medical Procedures
💡Private Healthcare
💡Australia’s Healthcare System
💡Cross-border Healthcare
💡Healthcare Outcomes
💡Political Influence on Healthcare
Highlights
Dr. Martin clarifies that there are no doctors exiting the public system in Canada, and there is a net influx of U.S. physicians into the Canadian system.
Dr. Martin explains that the solution to Canada's wait time challenges does not lie in moving to a multi-payer system, citing Australia's experience where public wait times increased with the introduction of private insurance.
Senator Burr asks Dr. Martin about Canadian officials seeking healthcare in the U.S., and Dr. Martin emphasizes that Toronto's Peter Munk Cardiac Centre offers world-leading outcomes for the same surgery sought in the U.S.
Dr. Martin believes that perceptions of better care in the U.S. are partly influenced by media and that paying more does not necessarily equate to better health outcomes.
Ms. Pipes states that over 42,000 Canadians come to the U.S. annually for healthcare due to long wait times, often seeking services like MRIs and CT scans.
Ms. Pipes provides an example of Brian McCreeth, who came to the U.S. for a brain tumor diagnosis because of long wait times in Canada.
Dr. Martin argues that the focus should be on reducing wait times in a way that is equitable for all, emphasizing that solutions exist within the single-payer system.
Dr. Martin compares Canadian healthcare to a security line, illustrating that it's not always about the amount of resources, but how they are organized for efficiency.
Senator Burr asks how many Canadian patients die annually while on a waiting list, but Dr. Martin counters with a U.S. statistic, stating that 45,000 Americans die each year due to lack of insurance.
Senator Burr points out the close relationship between Canada and the U.S., and questions why Canada doesn't adopt the American healthcare system if it is superior.
Dr. Martin responds that Canadian political support for single-payer healthcare spans all parties, including conservatives, and that there is no major effort to move towards the U.S. system.
Dr. Martin recalls a debate where the leader of Canada's most right-wing party held up a sign saying 'No Two-Tier,' reassuring the public that they would not dismantle the single-payer system.
Senator Burr expresses surprise that Canadians, despite being very familiar with American media and politics, continue to prefer their own healthcare system.
Ms. Pipes reiterates that 42,000 Canadians come to the U.S. for healthcare each year, but Senator Burr refocuses, asking why most Canadians still prefer their own system.
Ms. Pipes speculates that many Canadians are unaware of an alternative to their healthcare system, while Senator Burr points out the cultural difference between Americans' impatience and Canadians' acceptance of waiting.
Transcripts
Senator Burr
Dr Martin in your testimony you note
that Canadian doctors exiting the public
system for the private sector has had
the effect of increasing increasing
waiting lists for patients seeking
Public Health Care why are doctors
exiting the public system in Canada
thank you for your question Senator I I
if if I didn't express myself in a way
that would make myself understood I
apologize there are no doctors exiting
the public system in Canada and in fact
we see a net influx of Physicians from
the United States into the Canadian
system over the last number of years
what I did say was that the solution to
the wait time challenge that we have in
Canada which we do have a difficult time
with weights for elective medical
procedures does not lie in moving away
from our single-payer system towards a
multi-payer system and that's borne out
by uh the experience of Australia so
Australia used to have a single tier
system and in the 1990s moved to a
multiple payer system where private
insurance was permitted and a very
well-known study by ducat at Al was
tracked what took place in terms of wait
times in Australia as the multi-payer
system was put in place and what they
found was in those areas of Australia
where private insurance would was being
taken up and utilized weights in the
public system became longer what do you
say to a an elected official who goes to
Florida and not the Canadian system to
have a heart valve replacement it's
actually interesting because in fact the
the people who are the pioneers of that
particular surgery which Premier
Williams had and had the best health
outcomes in the world for that surgery
are in Toronto at the at the Peter Monk
cardiac center just down the street from
where I work so what I say is that
sometimes sometimes people have a
perception and I believe that actually
this is fueled in part by media
discourse that going to wear something
where you pay more for something that
that necessarily makes it better but
it's not actually borne out by the
evidence on outcomes
people prefer their system because they
know consciously they pay more no I
think it's because they judge quality
and they judge Innovation Miss uh pipes
in your testimony you noted that more
than 42 000 Canadians come to the United
States each year for health care why is
that
because they find that they're on a
waiting list in Canada for too long a
period and they feel that their health
is at stake so a lot of people in Canada
come to the U.S for MRIs CT scans there
are many examples in the media of people
like Brian mccreethe who came to the U.S
because he was told by his primary care
doctor that he might have a brain tumor
but the weight for an MRI was very long
he spent the thousand dollars came to
the U.S paid out of pocket you will see
advertisements in Canadian newspapers
for MRIs it's pretty fertile ground to
uh to Market in right Dr Martin in your
testimony you state that the focus
should be on reducing waiting times in a
way that's Equitable to for all what
length of time do you consider to be
Equitable
um when waiting for care
well in fact the wait time Alliance in
Canada sir has established benchmarks
across a variety of different diagnoses
for what's a reasonable period to wait
and what we've we've found is that
actually working within the single-payer
system we can reorganize things you know
I waited more than 30 minutes at the
security line to get into this building
today and when I arrived in the lobby I
noticed across the hall that there was a
second entry point with no lineup
whatsoever sometimes it's not actually
about the amount of resources that you
have but rather about how you organize
people in order to use your cues most
effectively and that's what we're
working to do because we believe that
when you try to address wait times you
should do it in a way that benefits
everyone not just people who can afford
to pay on average how many Canadian
patients on a waiting list die each year
do you know I don't sir but I know that
there are 45 000 in America who die
waiting because they don't have
insurance at all I live one hour away
from the Canadian border
Canadians watch American television
Canadians are very familiar with our
political system probably know more
about politics in America than most
Americans know
uh is Dr is your prime minister a
socialist
no sir our prime minister is quite
conservative he's conservative so
obviously as a conservative he wants to
implement the American Health Care
system that the Canadians are very aware
of I gather that was probably the first
thing he did when he took power is that
right
thank you
not exactly why not
support for single-payer Medicare in in
Canada is goes across all political
strike Stripes quite famously we had the
leader of the most right-wing party in a
Canadian Federal debate on television uh
hold up a sign in the middle of the
debate on which he'd written in marker
no two-tier as a means of trying to
reassure the Canadian public that if
elected he would not dismantle this in
other words you have a nation bordering
on the United States two Nations that
are probably as close together in so
many respects as any two nations in the
world
a conservative prime minister and yet
there is no effort to move to an
American Health Care system I would say
to my colleagues there's not a better
example
of maybe how people feel about two
systems they know the American system
they have a conservative prime minister
they can move in our Direction but for
whatever reason and I think sensible
reasons they understand that A system
that guarantees Health Care to all of
their people in a cost-effective way is
the way that they want to stay Miss
pipes let me ask you that question why
do the Canadians not come to the
American Health Care System well as I
mentioned in my testimony about 42 000
Canadians every year come to the U.S and
pay out a pocket for assistance that
wasn't my question no I just made that I
don't want to make that point first
second the Canadian government and the
provinces who administer the Canadian
Health Care system this started in 1974.
a lot of people in Canada have no idea
of an alternative system oh my goodness
they live an hour away from me in
Burlington Vermont they watch American
television they read American newspapers
they have no idea of what goes on in the
United States of America that is a
little bit hard for me to believe I
would say that Canadian people are very
very nice people they're not impatient
like Americans my mother said to me I
hope you're not becoming an impatient
American I am an impatient American
Americans do not want to wait Canadians
are very nice well I think it says and
then the second I miss lives I have a
limited time yes I I think the the the
answer is pretty clear the Canadians
have seen uh the American system they
prefer their own
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