Alternative health care models

2007-05-04

in Canada, Politics

On their website, Scientific American has a story comparing the Canadian and American health-care systems. The story suggests that Canadians get better value for money, and may well have a better health system overall, despite spending about half as much per person as Americans do. The article explains that Canadians live longer in general, as well as being less likely to die during the course of treatment.

There is good reason to believe that there could be greater efficiency in a system like those of Canada and Britain, where the federal government is the main purchaser of health products. Unlike individuals – who have limited knowledge about health care and few opportunities to exploit economies of scale – governments can buy intelligently and in big batches. They can make deals with pharmaceutical producers and other suppliers of health products. The importance of scale in the purchase of health products is demonstrated by efforts by groups like the Bill and Melinda Gates Foundation to acquire effective and affordable treatments for the major illnesses of the developing world through the use of large-scale acquisitions. More controversially, central-payer health care systems may be better placed to prioritize who should be treated and to what extent. Spending large amounts of money extending the lives of very sick people contributes less to overall societal health than spending the money on early treatment or preventative medicine, though the relative desirability of the two depends on your philosophical beliefs about how spending should be prioritized. Arguably, the Canadian system also produces fewer conflicts of interest than the American political system, in which health corporations are major campaign donors.

In comparing the two, there is one other major phenomenon that bears considering. Because Americans are the main market for new drugs, forms of surgery, and other types of medical care, it is possible that they are subsidizing research and development which can then be accessed at a lower cost by those outside the United States. One does ocassionally hear accusations that Canadians are ‘free-riding’ on the American system in this way. This is obviously connected to one of the hottest topics of political and legal debate at the moment: intellectual property law. In particular, the ethical questions about who bears the costs and benefits of innovating still only have partial and contingent answers.

It will be interesting to see what the Canadian and British systems look like in twenty-five or thirty years. Managing the ongoing demographic transition will be a challenge – just as it will be with pensions – but it seems as though it will ultimately be beneficial to have a lower birthrate and population. Only once that is true of the world as a whole can we really expect to create a society that is sustainable overall.

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{ 2 comments… read them below or add one }

. May 5, 2007 at 2:16 pm
. August 29, 2008 at 5:20 pm

Healthcare Is Not A Right

Posted by Chris Berry on March 25, 2008 in Divisive Issues, Rights & Wrongs

With every new presidential election cycle, the debate over healthcare returns to the front burner of American politics. There is no question that we have major problems with the delivery of healthcare services to the uninsured and underinsured among us. A host of complex factors contribute to the problem, not the least of which are the changing nature of the relationship between employers and employees, and the increasing unwillingness of Americans to accept any degree of personal responsibility for the risks we face in life.

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