Title: Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
1Infant Mortality, 1997Deaths In First Year Of
Life/1000 Live Births
Source OECD, 1999 NCHS
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4Life Expectancy For Women, 1997
Source OECD, 1999 NCHS
5Life Expectancy For Men, 1997
Source OECD, 1999 NCHS
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8Health Spending, 1990 1998U.S. Costs Rose
More Than Other Nations
Source Health Affairs 2000 19(3)150
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10U.S. Public Spending Per Capita for Healthis
Greater than Total Spending in Other Nations
Note Public includes benefit costs for govt.
employees tax subsidy for private
insuranceSource NEJM 1999 340109 Health Aff
2000 19(3)150
11Elderly as Percent of Total Population, 2000
Source Health Affairs 2000 19(3)192
12Americans Lead the World in Hours Worked
Source International Labor Organization, 1999
13Poverty Rates, 1997U.S. and Other Industrialized
Nations
Source Luxembourg Income Study Working
PapersNote U.S. figure for 1997, other nations
most recent available year
14On the one hand,
- Greater poverty makes our health care system work
harder
- But on the other hand
15Poverty-related illness is partly an effect of
our health care system
- Our system for health care financing exacerbates
the effect of poverty on health
- by making the opportunity cost high for the poor
to obtain health care
16Percent of Population withGovernment-Assured
Insurance, 1997
Note Germany does not require coverage for
high-income persons, but virtually all buy
coverageSource OECD, 1999
17Who Pays For Health Care? Regressivity Of U.S. He
alth Financing
Source Oxford Rev Econ Pol 19895(1)89
18Who Pays For Canada's NHP?Province Of Alberta
Source Premier's Common Future Of Health,
Excludes Out-of-Pocket Costs
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21Why are hospital administrative costs less in
Canada?
- Global budgets
- Operating budget
- Capital investment budget
- Negotiated with Province
- No bills.
- No need to track and bill for individual services
and goods
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23Why are physicians administrative costs lower in
Canada?
- Single payer
- One place to send bills
- One set of rules
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25Why are Canadas system administrative costs
lower?
- No need to determine who is eligible for what
- Canadas overall administrative close to
Medicare (before Medicare Choice), less than
Medicaid
- No marketing of insurance
- No billing or collecting insurance premiums
26Number of Insurance Products
27Private insurers High Overhead
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31Physician Visits Per Capita
Source OECD, 1999 - Data are for 1997 or most
recent available year
32Difficulties Getting Needed Care
Source Commonwealth Fund Survey, 1998
33Continuity of Care
Source Commonwealth Fund Survey, 1998
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36Minimum Standards For Canada's Provincial Programs
- Universal coverage that does not impede, either
directly or indirectly, whether by charges or
otherwise, reasonable access.
- Portability of benefits from province to
province
- Coverage for all medically necessary services
- Publicly administered, non-profit program
37 Of People With Serious Sx Seeing A Doctor
Before And After Passage Of NHP In Quebec
Source NEJM 1973 2891174
38Infant MortalityU.S. Canada, 1955-1996
FIRST PROVINCE IMPLEMENTS NHP
U.S.
CANADA
Source OECD 1999, Statistics Canada CDF
39Infant Deaths by Income, Canada 1996Even the
Poor Do Better than U.S. Average
40Homeless in TorontoDeath Rate Elevated, But
Lower than In U.S.
Source JAMA 2000 2832152
41Depression Management Better in Canada
Antidepressant prescribed 4 or more
visitsSource JGIM 1998 1377
42Physician Services For The Elderly Canadians
Get More of Most Kinds of Care
Source JAMA 1996 2751410
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48Few Canadian Physicians Emigrate
49Applicants per Medical School Place
Source JAMA 282892 Canadian Medical Education
Statistics, 1999150
50What's OK in Canada? Compared to the U.S.
- Life expectancy 2 years longer
- Infant deaths 25 lower
- Universal comprehensive coverage
- More MD visits, hospital care less bureaucracy
- Quality of care equivalent to insured Americans
- Free choice of doctor/hospital
- Health spending half U.S. level
51What's the Matter in Canada?
- The wealthy lobby for private funding and tax
cuts they resent subsidizing care for others
- Result government funding cuts (e.g. 30 of
hospital beds closed during 90s)
causingdissatisfaction
- U.S. and Canadian firms seek profit opportunities
in health care privatization
- Conrad Black, foe of public services, owns 2/3 of
Canadian newspapers
- Misleading waiting list surveys by right wing
group
52U.S. Coalition of Service Industries
- We believe we can make much progress in the
WTO negotiations to allow the opportunity for
U.S. businesses to expand into foreign healthcare
markets... public ownership of healthcare has
made it difficult for U.S. private-sector
healthcare providers to market in foreign
countries.