Letter from America by Norm Calder

by Norm Calder

When I lived in the UK in the 90’s, in common with most Brits, I was mildly critical of the NHS. The usual suspects were the villains of the piece; the whole enterprise was too big, it was underfunded, consultants were difficult to get to and it seemed that doctors’ receptionists were sent to charm school to have any charm knocked out of them, before they were let loose to pursue their main purpose in life – putting obstacles in the way of patients trying to see doctors, ….but when the chips were down the care provided by the NHS was superb.

When I moved to Vancouver I was surprised to find that no private health care existed in Canada. Everything was run by a provincial service called the Medical Services Plan. There was enormously high public satisfaction with its performance and with the health outcomes. Canadians seemed extremely health conscious, with the emphasis of the service on prevention.

Canadians love their health service – so much so that, in a 2004 poll, they voted as the ‘Greatest Canadian’, the founder of their health service – Scots born, former Premier of Saskatchewan and leader of the Federal New Democratic Party, Tommy Douglas – ahead of world-renowned figures like Pierre Trudeau and Alexander Graham Bell. I remember at the time thinking it remarkable and speculating how many Brits could name the founder of the UK National Health Service, far less idolise him. (Some trivia: Tommy Douglas was also Donald Sutherland’s father-in-law and therefore Kiefer Sutherland’s grandfather)

Living in the US now, with very expensive health insurance cover, my experience of the healthcare system is mixed. Doctors, nurses and some receptionists are very customer focussed, but you still cannot get a routine appointment in less than five days. When I was detained overnight in hospital last year after being overly enthusiastic in the gym, the care I had was exceptional. I had every test known to man and was declared 100% fit before being released – but the bill, from five separate agencies, for a one night stay in the hospital was $32,000! After a paper blizzard of over 100 documents, my insurance company paid $16,000 and the rest disappeared into the ether.

It seems clear to me that one of the reasons Canadians hold their service in such high esteem, is that they have a constant benchmark just over the border here – and it is not a pretty picture.

Here are some US Healthcare statistics:

The spend is the highest in the world – 34% more than the second place country, Switzerland, and 134% more than the average for the countries of the OECD.

Healthcare costs represent 13.4% of GDP, double the UK’s 6.6%

Average cost of insurance per family is $13,150 per annum (Minimum wage is $15080 per annum)

Costs have risen by 110% in the last decade

Administrative costs are more than 20% of total – a large portion on doing what insurance companies do – denying/delaying claims.

Out of the world’s 12 most developed countries, the US

ranks 11th for men and 8th for women in life expectancy

has the highest infant mortality rates

has the highest level of premature deaths (before age 65)

47 million US residents (15% of total) do not have any health care cover, not counting the 12 million or so undocu

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