By G. Richard Dundas, M.D.
Bennington Banner, Letters, April 28, 2015
I recently attended a meeting at St. Peter’s Episcopal Church at which we discussed Green Mountain Care and the Affordable Care Act. Subsequently, a Banner reporter wrote an article in which he misidentified a member of the audience as Rep. Alice Miller. The participant had some negative things to say about the Canadian health care system and its costs. Miller was not at this meeting as she was busy doing her job in Montpelier. Furthermore, I know that Alice favors a health care system in the United States which, like the Canadian system, features universal health care.
It might be useful to restate the facts and compare the Canadian system to ours. Even better would be to compare the U.S. system to that of 11 other wealthy industrialized nations. Last year, the Commonwealth Fund did just that in their report “Mirror, Mirror on the Wall, 2014 Update.” They studied Australia, Canada, France, Germany, Netherlands, New Zealand, Norway, Sweden, Switzerland, the U.K., and the U.S. The U.S. ranks dead last. It turns out that the United Kingdom ranks first, Switzerland is second, and Canada next to the last. Other nations that were not included in this study (Singapore, Hong Kong, Italy, Japan, South Korea, etc) also have excellent health care systems.
Each of the other nations insures all residents (universal care). The U.S. does not. Before Obamacare there were 50 million people in our country who had no health insurance; currently there are about 37 million. Without insurance, people tend to put off needed health care. It is estimated that about 40,000 people died in 2013 because they had no insurance, couldn’t afford care, and didn’t go for care until it was too late.
The other nations in the study lead the U.S. in such important things as life expectancy and infant mortality. We ranked last in efficiency, equity (the rich get better care than the poor), and healthy lives. We ranked ninth in access to care and seventh in safety of care.
Even though we rank last among these nations, we rank first in a single area — the cost of care. The health care cost per capita in 2014 was $3,647 in the United Kingdom but was $8,895 in the U.S. The health care cost as a percentage of the GDP in 2014 was 9.4 percent in the United Kingdom but was 17.2 percent in the U.S. The extra 7.8 percent of our GDP amounts to about $1 trillion per year. Some of these dollars could reduce our national debt or pay for other things such as housing or infrastructure.
The U.S. provides relatively poor care at an excessive cost. The solution is to implement a better system.
A better system would include universal health care and a single payer. Universal care would help our problems with access and equity. Single payer would help our problems with efficiency and would lower costs.
The hurdle is that we must first wrest power away from the corporations (mainly insurance companies and pharmaceutical companies) who now control our health care and who have disproportionate influence on our federal government.
Dr. G. Richard Dundas resides in Bennington.