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Health care monopoly

By Ulli Diemer

To the Editor, Globe and Mail:
Re Monopoly isn't working -- Letters, October 21, 1998:

Patrick Hewlett of the Ontario Physicians' Alliance rightly observes that Ontario's crisis-provoking Harris government is mismanaging the province's health care system.

A pity, then, that Dr. Hewlett uncritically parrots the Tories' free-market fundamentalism with his claim that "government-run health-care monopoly is unable to provide efficient health care".

In fact, the evidence shows that the private sector is far more bureaucratic and much less efficient than the public sector when it comes to providing health care.

For example, when Germany shifted dental services from the public system to private insurance, administrative costs tripled from 5% to 15%.

The United States, which has the most privatized health care system of any OECD country, has been spending 14% of its GNP on health care, compared to 9% for Canada. Health care administrative costs are three-and-a-half times higher in the U.S. than in Canada, and administrative costs for health care insurance, specifically, are six times higher in the U.S. than in Canada's public system.

The efficiency of the Canada's public medicare system is reflected in the quality of care as well as on the balance sheet. Studies shows that on average, Canadians are more likely to receive needed care quickly than Americans. Canadians get more physician visits per capita than Americans, more immunizations, more hospital admissions, and more surgical procedures. A survey of 10 OECD countries showed that Canadians were the most satisfied with the care they received, while Americans were the least satisfied. In fact, Canadians are five times more likely to be satisfied with the health care they receive than Americans.

Infant mortality, maternal mortality, and life expectancy were worse in Canada than in the U.S. before the introduction of medicare. Canada's infant mortality rate is now only 70% of that in the U.S., while American women are almost twice as likely to die during childbirth as their Canadian counterparts. The average Canadian now lives two years longer than the average American. Not a bad track record for a system that is supposedly "unable to provide efficient health care".

Rather than advocating the destruction of Canada's public health care system, critics like Dr. Hewlett should be speaking out against the Harris government's strategy of running the system into the ground by mismanagement and underfunding.


Ulli Diemer
22 October 1998
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See also: Ten Health Care Myths