Tuesday, October 11, 2011

Comparing costs of health Care

From today's Globe and Mail:

Montanans will spend almost $8-billion (U.S.) for health care this year, while Saskatchewanians will spend $4.5-billion. That is a whopping difference. But spending is just part of the story.
In Montana, more than 280,000 people under the age of 65 had no health insurance last year, according to Families USA. Another 55,000 insured residents still faced “catastrophic” out-of-pocket health expenses – meaning more than $14,000. Private health insurance does not come cheap: The average premium for a family was $13,770 a year, double what it was five years earlier, according to the Kaiser Foundation.

 The state of Montana is the same size (population) with the same ethnic mix and industry as Saskatchewan.  A population of 1 million in both places, the G&M found that the total health care expenditure for Montana was nearly twice that of Saskatchewan, but more importantly, a quarter of the population is not covered (by choice or because the cost of insurance is prohibitive -- also some people with "pre-existing conditions" cannot obtain health care coverage).

As a microcosm of the problems faced by many Americans, Montana is a good example of what is wrong.  Of course, for some people in Montana the cost of health care (or access) is not a problem, but it remains that for a quarter of Montana's population health care is a huge problem (BTW those young people who maintain they don't need "no stinking healthcare" use expensive emergency room treatment when something happens!).  

Montana is now looking at adopting the Saskatchewan model (don't know if its possible) as a way of controlling health care costs (oft forgotten is that the states cover the bulk of health care costs -- hence the states' dislike for "Obamacare" -- they foot the bill of the expanded program).  Americans often thing that the Canadian health care system is monolithic, when in fact Canada has 11 health care system (each province is different), the Federal government used to have a great deal of say on the medical system used in each province, but this has whittled away as the old 50/50 funding model has been replaced with a 85/15 model today --  money speaks here!  Saskatchewan's system is very different to that of Quebec and Ontario, so the departure is not as radical as it may first appear.  It will be interesting to see the rank of those with vested interests (HMOs and big Pharma) -- doctors increasingly work in large practices and may actually prefer the Canadian health care system!

Anyway, an interesting analysis from the Globe and Mail, and a massive problem for the GOP/Republicans!  If an American state decides to implement a "Canadian" health care system it will cause massive problems for the Washington talking machine.

Note:  Last night I learned that there are more MRI machines in Montana than in all of Canada.  It begs the question, does Canada have too few MRI or does Montana have too many?  This morning, I checked with a doctor friend, asked him how long it I would have to wait to get an knee MRI -- he told me: two weeks for elective, and if I tore something he could get me in before the weekend!!! So my guess is that Montana has too many MRI... maybe this explains why there healthcare costs are so much higher?


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