Debt Free

Everyone seems to complain about how much of their annual budget is spent on health care these days. Many long for either nationalized or single payer systems like most other industrialized nations seem to enjoy. The list is long and distinguished; Canada, England, Sweden, Australia, etc. Citizens of those nations simply have better health care available to them and they haven't a worry about paying for it. That would be great for us too, free health care. We should all enjoy something like this. After all, everyone has a right to health, and we should take care of seeing to it that everyone enjoys their right to health care.

The problem is that the whole “free health care for everyone” thing is an egalitarian fantasy. One only needs ask any of the thousands of Canadians who flock to U.S. doctors and hospitals every year seeking to circumvent the long wait times encountered in the Canadian national health care system. It's not that Canadians don't spend money on health care, either. On the contrary. They actually spend an astounding 9.3% of their GDP on it every year. BC and Newfoundland are projected to spend a full 50% of their provincial budgets on health care this year and Alberta will reach that dubious milestone in the next 4 years. The Canadian Taxpayer's Federation, admittedly an organization with an agenda, reports that in some provinces, the percentage of a Canadian's tax burden derived from health care is as high as 40%.

According to a recent study by the World Health Organization (WHO), Canada ranks 30^th out of 191 countries studied with respect to the quality of national health care systems. The WHO even went so far as to state “Canada does not have the best health care system in the world”. For example, Canada ranks among the lowest among industrialized nations in the number of Physicians per 1,000 citizens, at 2.14. As a means of comparison, the U.S. has 2.56. This is still far below some of the leaders in this regard, such as Switzerland (3.61), Russia (4.25), Italy (4.20), or Belgium (4.49). Some of this can be attributed to the compensation afforded to Canadian physicians according to the Canadian health care system.

More troubling is the average wait time experienced by those under such systems as found in Canada and England for basic life saving procedures, such as an EKG. If you have a heart condition, this is basic diagnostic tool that should be available to your physician immediately. According to a recent study published in the New England Journal of Medicine, the average wait time experienced by Canadians seems rather long to those raised with the the U.S. health care system. For example the average wait time in Canada to see various specialists, after seeing one's GP are as follows:

• Internal Medicine - 4.5 weeks

• Medical Oncology – 3 weeks

• Urology - 7.5 weeks

• Neurosurgery – 11 weeks

• Opthalmology – 14.3 weeks

• Orthopedic Surgery – 14.7 weeks
  

That seems like a fairly long wait, but should the specialist determine that additional treatment is indeed required, be prepared to wait even longer. For example some of the average wait times reported in the NJM include:

• Internal Medicine - 6.3 weeks

• Medical Oncology - 2.6 weeks

• Urology – 5.3 weeks

• Neurosurgery – 7.8 weeks

• Opthalmology – 13.1 weeks

• Orthopedic Surgery – 25.3 weeks

Imagine upon being told by your physician that you indeed have a brain tumor (after waiting 11 weeks to see the neurologist in the first place), that they'd be happy to fit you in at the earliest opportunity; 2 months from now! Or that that, after already waiting over 3 months to get a specialist to look at your failing vision, they would be able to start corrective surgery for the problem in only 3 more short months!

It's not that Canadians spend an erroneous amount of money on their health care compared to those in the U.S., either. Actually, Canadians spend about $3,300 per capita on health care, whereas Americans spend over $5,600 (2003 figures, according to the Organization for Economic Co-operation and Development's 2005 study). It's that they aren't getting a good value for their dollar. It matters not that they spend comparatively little compared to the U.S., it's that their health care dollars are not buying them ready access to services.

Despite what some would have you believe, American's do spend a large portion of their money on publicly funded health care. Over 44% of American health care in 2003 was financed with public money. In Canada, the figure was just shy of 70%. The biggest problem in the U.S. is that many people simply do not have health insurance, about 46.6 million (15.9% of the U.S. population – both figures according to the 2005 U.S. census report) at last count. Some of the uninsured were so by choice. Many workers, especially those young, single, and feeling invincible decline to accept employer sponsored health insurance, preferring to take their chances. In fact, a 2005 study by George Washington University's National Health Policy Forum found that 35% of workers at small companies (3 to 199 employees) declined health benefits, although employee monthly costs averaged only between $43 (single coverage) and $282 (family coverage). At all size firms firms the average cost rose to $308 and $829 respectively.

The cost of health insurance is steadily rising, prompting employers to look at new and unique solutions to the problem. On of these is to join with other small businesses to form insurance buying co-ops. This allows the businesses to be eligible to participate in a larger group plan than they'd otherwise be eligible for.

One thing is for sure, we need to look at new and unique solutions for the health care problem. One thing that many Americans seem to not want to do is to view the whole thing as a personal responsibility issue, preferring instead to view it as a government problem. It's been ingrained into the minds of many that access to health care is an inalienable right, like free speech, the right to bear arms, or the freedom to assemble. While that would be fantastic, the fact is that health care costs money, and plenty of it. Everybody needs to make the determination of how much money they feel it should cost, and where those funds should come from. Remember, medical schools is expensive, time consuming and ill suited to many. Remember too, that all those shiny, computerized medical miracles strewn about modern hospitals are extremely expensive to develop and procure.

Paying for health care, weather at the governmental level or individually won't get any cheaper. If the government pays for it, you are still paying for it. Those who pay no taxes relish in this idea. Those of us who do, may want to look into the whole issue a bit deeper. If we get $829 worth of health insurance every month, but our taxes increase by $1,100, is that a good value, or just the price we'll have to pay?