American Health Care Reformers Can Learn from Canada, Britain

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Our country should work toward providing universal access to health care. While a nationalized, government HMO could prompt tax increases, inflation and a decline in quality, we can enact policies to dramatically expand health care access for Americans.

When we reform health care, we should follow key principles. First and foremost, reforms should enhance your relationship with your doctor. Insurance companies already interfere with your care — a government HMO might do worse. Second, reforms should reward the development of better treatments and cures. Americans support treating diseases like diabetes but are passionate about a cure. Finally, reforms should be sustainable because so many senior citizens will depend on them. The worst thing we can do is to enact a program we cannot afford.

In considering U.S. health care reforms, many Americans look to Canada or Britain as models. Canadians have a different view. While more than 60 percent of Americans are actually satisfied with their health care plans, only 55 percent of Canadian seniors are satisfied. More than 90 percent of Americans facing breast cancer are treated in less than three weeks, while only 70 percent of Canadians get such quick treatment — meanwhile thousands of Canadians come to U.S. hospitals instead. The average Briton waits in line even longer: 62 days. Britain has fewer oncologists than any other Western European country. It is no wonder that Britain ranks 17 out of 17 industrialized countries for surviving lung cancer. Similar statistics tell the tale of lower quality care for coronary heart disease (94 percent of Americans treated vs. 88 percent of Canadians) and emphysema (73 percent of Americans treated vs. 53 percent of Canadians).

The most dramatic differences come in the field of cancer where Britain’s most-respected medical journal, the Lancet, published the results of a very broad review of European and American survival rates. In short, here is what the Lancet reported in September 2007:

Cancer Survival Rate

American men: 66 percent
European men: 47 percent

American women: 63 percent
European Women: 56 percent

Of the 16 cancers studied, only Sweden showed survival rates nearing American rates of more than 60 percent.

Diabetes is one of the principal causes of senior health care problems. In the U.S., 93 percent of Americans are treated within six months, while in Canada less than half (43 percent) see a doctor in the same time. In Britain, it is worse — only 15 percent of British diabetics are seen within six months. More than 80 percent of American women received a mammogram, while only 73 percent of Canadians received one. Hip replacements offer a stark contrast. In the U.S., more than 90 percent of seniors are treated within six months. In Canada, less than half of patients are treated in the same time with many waiting over a year. Britain is not a place to break a hip — only 15 percent of patients are treated within six months. Many die during the wait.

Many of the advances in 21st century medicine come from MRI scans. Most Americans wait less than a week for an MRI; most Canadians wait over a year. In America, doctors use 27 MRI scans per million. In Canada and Britain, it is less than a fifth of that at just five MRI scans per million.

Care for children also varies. Newborns most at risk need the close care of a neonatal specialist. In the U.S., we have over six neonatologists per 10,000 live births. In Canada, they have fewer than four; and in Britain fewer than three. In this country, we have over three neonatal intensive care beds per 10,000 births, with just 2.6 in Canada and less than one in Britain. No wonder babies in Britain have a 17 percent higher than average chance of dying compared to 13 percent a decade ago. Overall, the life expectancy of a Briton below the poverty line is falling, especially for women.

The starkest difference in care appears when you are sickest. In Britain, government hospitals maintain nine intensive care unit beds per 100,000 people. In America, we have three times that number at 31 per 100,000. In sum, Britain has less than two doctors per 1,000 people, ranking it next to Mexico, South Korea and Turkey. Even dentists are in short supply. The average American dentist sees 12 patients a day, while the average British dentist must see more than 30.

Stories of poor care under a government-only system are common in Britain. Last February, the Daily Mail reported on Mrs. Dorothy Simpson, 61, who had an irregular heartbeat. Officials at the National Health Service denied her care and told her she was “too old.” The Guardian reported in June that one in eight NHS hospital patients wait more than a year for treatment.