NCPA - National Center for Policy Analysis


March 24, 2008

Apparently, putting everyone in Medicare (i.e., creating a universal system like Canada's) leads to worse results than having only some people in Medicare (i.e., having a mixed public/private system), says John C. Goodman, president of the National Center for Policy Analysis.

For example, in a National Bureau of Economic Research study, David and June O'Neill draw on a large U.S./Canadian patient survey to show that:

  • The percent of middle-aged Canadian women who have never had a mammogram is double the U.S. rate.
  • The percent of Canadian women who have never had a pap smear is triple the U.S. rate.
  • More than 8 in 10 Canadian men have never had a PSA test, compared with less than half of U.S. men.
  • More than 9 in 10 Canadians have never had a colonoscopy, compared with 7 in 10 in the United States.

These differences in screening may explain why U.S. cancer patients do better than their Canadian counterparts, says Goodman.  For example:

  • The mortality rate for breast cancer is 25 percent higher in Canada.
  • The mortality rate for prostate cancer is 18 percent higher in Canada.
  • The mortality rate for colorectal cancer among Canadian men and women is about 13 percent higher than in the United States.

Amazingly, says Goodman, there are quite a few Canadians who are not being treated for conditions that clearly require a doctor's attention:

  • Among senior citizens, the fraction of Canadians with asthma, hypertension, and diabetes who are not getting care is twice the rate in the United States.
  • The fraction of Canadian seniors with coronary heart disease who are not being treated is nearly three times the U.S. rate.

Source: John Goodman, "Health Care Consumers Know Something Government Planners Don't," The Insider, Winter 2008.

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