A Way Out of the Healthcare Cost Explosion? Look North
According to a study by the University of Toronto in Health Affairs, US health care spending could be cut by billions a year if doctors spent the same amount of time and money dealing with insurance plans as their Canadian counterparts. Because Canada has a single-payer system — essentially Medicare for all — and because of our patchwork quilt of financing healthcare here, US doctors spend nearly $83,000 per physician per year dealing with insurance companies, compared to around $22,000 for doctors in Ontario, the study found. Staff in US doctors’ offices also spend around 10 times longer per physician per week dealing with health plans than their Canadian counterparts.
The findings are similar to those found by a US Government Accountability Office study commissioned by my old boss, US Rep. John Conyers, back in 1991:
“If the universal coverage and single-payer features of the Canadian system were applied in the United States, the savings in administrative costs alone would be more than enough to finance insurance coverage for the millions of Americans who are currently uninsured.”
I acknowledge the political impossibility of enacting a single-payer system here in the US. But in our tough economic times, the financial death spiral we are in on healthcare costs, and watching the ongoing sumo match around the ACA, I do wish President Obama had stepped in front of the cameras a couple years ago and said “It’s time all Americans had Medicare, with a choice of high-quality health plans.”
This is also a family issue for me: my younger brother, one of the most brilliant physicians I have ever seen, actually fled to Canada 12 years ago in a fit of pique about the administrative burdens of medicine in the US, our litigious culture and the epidemic of drug-seeking patients. Today as an intensivist running the biggest ICU in Quebec, he’s never been happier. Sure, there are plenty of affluent Canadians coming across the border for elective procedures they were stuck in a queue for back home, but at the end of the day, Canada kicks our ass in coverage, most major health indicators, and notably, physician satisfaction.
It’s getting harder for the US to continue its jingoistic tune that we have the best healthcare in the world. We do — but only if you can pay for it, and can find doctors who will see you.