Canada's Burning! - strain on medical resources caused by 1999-2000 North American influenza epidemic

Washington Monthly, July, 2000 by Theodore Marmor, Kip Sullivan

That's too bad. There is a real health-care crisis in this country and if America is going to solve it, citizens must understand the differences between democratically controlled and corporate-controlled healthcare systems. And if Americans are to understand those differences, reporters must consistently report the whole truth--not little truths, semi-truths, and falsehoods. They must give us a full and fair comparison between Canada's system of universal health insurance and our own. If they did that, the average American would finally be able to understand what we really can learn from Canada.

RELATED ARTICLE: Comparing the United States and Canada: The scientific evidence

Most studies comparing the quality of health care in one country to another rely on a few crude barometers--typically, infant mortality rates, average longevity, and percent of the populace without insurance. By all of these measures, America's health-care system is inferior to Canada's. our infant mortality rate (the percent of babies who do not survive to their first birthday) was 8.0 per 1,000 live births in 1995, 19th in the industrialized world, while Canada's rate was 6.0 (13th). We ranked 20th in male longevity and 19th in female longevity while Canada ranked fourth in both categories. We insure 84 percent of our citizens; Canada insures 100 percent of hers.

Since 1971, the year Canada completed the phase-in of its single-payer system, approximately 30 scientific studies comparing the quality of medical care in the United States and Canada have appeared. These 30 studies indicate that quality of care in Canada is as good as or better than that in the United States (for Americans who can afford to see a doctor, that is). Here are representative examples of those studies:

* A study conducted jointly by Canadians and Americans found that Canadian mortality rates were lower for eight of 10 types of surgery (including bypass surgery), slightly higher for open prostatectomy, and almost identical for hip fracture repair (Roos et al, Health Affairs, 1992);

* A study conducted by the U.S. General Accounting Office reported that Canadians are five percent more likely to survive lung cancer than Americans, four percent less likely to survive breast cancer, and equally likely to survive colon cancer and Hodgkin's disease (Gorey et al., American Journal of Public Health, 1997);

* A study of the quality of care of patients with end-stage renal disease concluded, "Manitoba patients were more than twice as likely to receive kidney transplants as U.S. ... patients. No patients in Manitoba used reprocessed dialyzers, compared with 57 percent of U.S. ... patients. After adjustment for all casemix and treatment variables, the mortality rate was 47 percent higher in the United States" (Hornberger et al., Medical Care, 1997);

* A 1997 poll of citizens of five nations found that Canadians and Americans were equally likely to say their hospital services are excellent, but that Canadians were more likely to say their physician services are excellent (37 percent) than Americans were (29 percent) (Commonwealth Fund, 1998);