The hidden costs of single payer health insurance

Canada's government monopoly, single-payer health care system is one of the worst ways to achieve universal health insurance coverage and Americans should avoid adopting a similar system, concludes a new study from the Fraser Institute.

Researchers found that health care in Canada appears to cost less because relative to the United States, Canadian public health insurance does not cover many advanced medical treatments and technologies, common medical resources are in short supply, and access to health care is often severely delayed.

Other major findings:

  • Government data shows an estimated 1.7 million Canadians (aged 12 and older) were unable to access a regular family physician in 2007.
  • The actual number of "effectively" uninsured Americans is less than half of the figure usually reported and that being uninsured is usually only a temporary condition.
  • Based on these figures, the study estimates that the percentage of the population that was "effectively" uninsured for non-emergency, necessary medical services at any given time during 2007 was not significantly different between the two countries: 7.9 per cent in the United States compared to 6 per cent in Canada.
  • On average, Americans spend more of their incomes on health care but they get better access to superior medical resources, and the United States outscored Canada on many key indicators of available health care resources, including the number of MRI units and exams, the number of CT scanners and exams and the number of inpatient surgical procedures.

    The study concludes that both Canada and the United States should look to countries such as Switzerland or the Netherlands, where the government is not in the business of providing health or drug insurance at all.

    Instead, individuals in those nations are required by law to purchase comprehensive health insurance in a regulated pluralistic private-sector market. Access to health insurance for low-income people is facilitated through a publicly-funded means-tested subsidy that varies according to the income and assets of the insured person, says Fraser.

    Source: Brett J. Skinner, Mark Rovere and Marisha Warrington, The Hidden Costs of Single Payer Health Insurance: A Comparison of the United States and Canada, Fraser Institute, September 30, 2008.

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    FMF Policy Bulletin/ 07 October 2008
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