rm007's Journal: Why are Canadians healthier than Americans?

The Boston Globe has an article today asking why Canadians are healthier than Americans despite spending less on healthcare.

From the article:

An impressive array of comparative data shows that Canadians live longer and healthier lives than we do. What's more, they pay roughly half as much per capita as we do -- $2,163 versus $4,887 in 2001 -- for the privilege.

Exactly why Canadians fare better is the subject of considerable academic debate. Some policy wonks say it's Canada's single-payer, universal health coverage system. Others point to Canadians' different ethnic mix. Some think it's because they use fewer illegal drugs and shoot each other less with guns, though they do smoke and drink with gusto.

Still others think Canadians are healthier because their medical system is tilted more toward primary-care doctors and less toward specialists. And some believe it's something more fundamental -- a smaller gap between rich and poor.

Perhaps it's all of the above. But there is no arguing the basics.

By all measures, Canadians' health is better," said Dr. Barbara Starfield, a university distinguished professor at Johns Hopkins Medical Institutions. Canadians do better on a whole variety of health outcomes, she said, including life expectancy at various ages -- 1, 15, 20, 45, 65, 80, you name it.

Seatbelts, drugs...

[Cyberdyne]

As the article suggests, lower seatbelt wearing and higher drug usage will be a factor, but one which apparently becomes glaringly obvious when you look at the right figures wasn't mentioned: cities. When you compare murder rates per capita between cities of the same size, Canada is roughly equal - but because Canadians live in much smaller towns and cities (how many cities of over 10 million people are there in Canada?), this skews the murder figures dramatically. I suspect there may be a broader correlati

Re:Seatbelts, drugs...

[rm007]

One of the annoying things about the article (and indeed about most articles that cite statistics) is that the factors that you mention and other non-policy variables that are referred to in the article itself are, for the most part, known. They should be able to account for these in the statistics.

Nevertheless, you should be careful about putting too much emphasis on the size of large cites. While there are no metropolitan areas of 10 million + in Canada, there are only 2 in the US (although Chicago

Re:Seatbelts, drugs...

[Cyberdyne]

IIRC once you lower the threshold a little (5 million, say) it's easier to compare - and the figures look very different from a raw comparison of the two countries, certainly for homicide.

GDP only accounts for a little over 20% of the difference. I suspect malpractice insurance will be another significant factor, as will ER [ab]use thanks to a rather weird unfunded federal mandate. Throw in the much higher drug costs as well, you're probably pretty close to parity on spending - and none of the extra US sp

Re:Seatbelts, drugs...

[rm007]

Interesting that you should mention the UK, Until last year I was living there and experienced first hand the vagarities of the NHS . Talk about bloat. Paying high taxes for healthcare and then paying for private insurance was painful. The public system there provides and excellent example of what not to do. They seem to have done their best to eliminate whatever scale efficiencies that might otherwise be possible by replicating the adminstrative burden that American healthcare operators face because of

Economic impact

[Here I Stand]

2 points/questions

1. both of you imply that high US health care costs do not necessarily = value for money for the patient . is this likely to ever translate into a drag on the US economy?

2. how does the mix of higher canadian taxes vs lower health costs pan out? does it constitute a government subsidy for canadian businesses?

Re:Economic impact

[rm007]

1. It might, healthcare spending accounts for about 15% of US GDP, if the same or more *health utility* could be achieved by spending half as much (a huge and unproven assumption) that would equate to 7.5% of GDP, so perhaps. Still, the fact still remains that American workers are the most productive in the world. The American econonmy might indeed be even more powerful if healthcare costs could be reigned in but I'm not sure that drag exists now.

2.If it were, I am sure that someone would have taken the