Monday, January 3, 2011

How many Canadians use the US for health care each year?

If any of you are regular Fox News viewers, or Neal Boortz listeners, you are well aware of the massive influx of Canadians who are crossing over the border because of wait times and rationing (which I'm certain will dramatically change if Republicans fail to repeal Romney...errr ObamaCare). 
In the wayback machine you might recall a gem of a quote from Rudy Giuliani during his Presidential bid“Think about it: If Hillary becomes president and we have HillaryCare, the Canadians will have absolutely no place to go to get health care.”  I'm sure he wouldn't mind creative license and you should feel free to insert Obama for up to date version... 
Well the Incidental Economist did some background a while back (that I caught recently via Brad Delong.)

As always, when we can we should turn to evidence and research, and on this topic it does exist.  The most comprehensive work I’ve seen on this topic was published in a manuscript in the peer-reviewed journal Health Affairs.  That study looked at how Canadians cross the border for care.  Most anecdotes involve Canadians, since it’s easy for those on the border to come here.  And, the authors used a number of different methods to try and answer the question*:

1) First, they surveyed United States border facilities in Michigan, New York, and Washington.  It makes sense that Canadians crossing the border for care would favor sites close by, right?  It turns out that about 80% of such facilities saw fewer than one Canadian per month.  About 40% saw none in the prior year.  And when looking at the reasons for visits, more than 80% were emergencies or urgent visits (ie tourists who had to go to the ER).  Only about 19% of those already few visits were for elective purposes.

2) Next, they surveyed “America’s Best Hospitals”, because if Canadians were going to travel for care, they would be more likely to go to the most well-known and highest quality facilities, right?  Only one of the surveyed hospitals saw more than 60 Canadians in one year.  And, again, that included both emergencies and elective care.

3) Finally, they examined data from the 18,000 Canadians who participated in the National Population Health Survey.  In the previous year, only 90 of those 18,000 Canadians had received care in the United States; only 20 of them had done so electively.

Just for kicks here are a few more charts from a recent Commonwealth Fund survey of 11 countries... (once again via Incidental Economist)

About one third of Americans report that they didn’t go to the doctor when sick, didn’t get recommended care when needed, did not fill a prescription, or skipped doses of medications in the last year because of cost.

Finally, about one in five Americans had serious problems paying or were unable to pay medical bills in the last year.  This is more than twice the percentage seen in any of the other countries.

It’s data like these that make me want to scream every time someone blithely says that we have the “best health care system in the world.”  This is more than just the uninsured; significant numbers of people in this country have trouble getting care because of cost.  And remember – we are spending WAY more than any other country already, and for all that money we’re getting middling to crappy results.

Why would anyone want to keep this going unchanged?


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