NCPA - National Center for Policy Analysis


February 9, 2007

A theme among left-of-center polemicists, when writing on health care, seems to assume that the poor get better health care when they live in nations with government-run systems, says Amy Ridenour, president of the National Center for Public Policy Research.

But do the poor in other countries really receive good medical care?  It doesn't seem that way.  Consider remarks from the free-market Fraser Institute's annual report on waiting lists in Canada:

  • A profusion of research reveals that cardiovascular surgery queues are routinely jumped by the famous and politically-connected and suburban and rural residents confront barriers to access not encountered by their urban counterparts.
  • Low-income Canadians have less access to specialists, particularly cardiovascular ones, are less likely to utilize diagnostic imaging, and have lower cardiovascular and cancer survival rates than their higher-income neighbors.
  • A New England Journal of Medicine study cited in the report found that going from the lowest income neighborhood to the highest increased by 23 percent the use of cardiac angiography (a heart test) and decreased by 45 percent the waiting time to get one.

The causes of these socioeconomic disparities in access and outcome remain obscure, says Ridenour, but their persistence poses a clear challenge to the egalitarian principles of Canada's publicly funded health care system.

In conclusion, the health care inequities that occur in the United States also occur in other countries.  The experience of Canada suggests that the problem also replicates itself in universal health care systems.  Thus, any government system in a democracy is going to result in more resources going to affluent areas and less to poor ones-including health care systems.

Source: Amy Ridenour, "Is Health Care for the Poor Better Abroad?" National Center for Public Policy Research, February 1, 2007; and Nadeem Esmail, Michael A. Walker and Dominika Wrona, "Hospital Waiting Lists in Canada; Waiting Your Turn 16th Edition," Fraser Institute, October 2006.

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