American Seniors Deserve Better than Canadian Health Care
By Sally C. Pipes
Seven in ten Democrats want to establish a Canada-style single-payer system. Progressive lawmakers are even more gung-ho.
Sen. Bernie Sanders, I-Vt., has introduced a "Medicare for All" bill modeled on Canada's system. Sixteen of his Democratic colleagues have co-sponsored it. Meanwhile, over 60 percent of Democrats in the House are behind a similar bill.
Before Americans rush to implement Canadian-style health care, they should ask their northern neighbors about life under single-payer. Their answers would surely curb American enthusiasm for the concept.
According to a new study from the Commonwealth Fund, one in three Canadian seniors isn't satisfied with the care she receives -- a far larger share than in any similar country, including the United States.
One of the reasons they're unhappy? They have to wait months for care. In Nova Scotia, elderly patients must queue up for more than 600 days for a hip replacement and more than 700 days for a knee replacement. Patients in Manitoba seeking cataract removal, meanwhile, typically wait more than 12 weeks for an appointment with an ophthalmologist and another 41 weeks for surgery.
Even Canada's medical establishment agrees the country's government-run system is ill-equipped to care for seniors. As the Canadian Medical Association put it, "Canada's healthcare system was not built to meet the challenges of our aging population."
Across the entire country, the median wait for care from a specialist following referral from a general practitioner was a record 21.2 weeks last year, according to the Fraser Institute, a Canadian think tank. That's more than double the 9.3-week wait that Canadian patients faced a quarter-century ago.
More than three-quarters of Canadians believe that patients who have been on waiting lists longer than recommended for their condition should be able to pay for private treatment. Canadian law effectively prohibits them from doing so.
Wait times will worsen as the share of seniors -- who utilize above-average amounts of care -- grows. By 2024, more than one in five Canadians will be 65 or older. By 2036, seniors will account for a quarter of the population.
The United States is experiencing a similar demographic shift. Seniors will comprise more than 20 percent of the population by 2030. Yet our admittedly flawed healthcare system is doing a far better job of caring for older citizens than Canada's.
According to the Commonwealth Fund survey, three in four of Americans 65 or older are satisfied with the care they receive. That's a larger share than Australia, France, and Canada.
It's especially telling that American seniors are most satisfied with healthcare programs that are based on private competition. Medicare Advantage, for instance, offers seniors a choice of private plans that contract with Medicare to provide benefits. In one survey, 88 percent of Medicare Advantage participants were satisfied with their coverage. Medicare Part D, which enables seniors to purchase subsidized prescription drug coverage from a range of private providers, enjoys similarly high approval ratings.
There are many things the United States can do to improve care for older patients. Mimicking Canada isn't one of them.
Sally C. Pipes is President, CEO, and Thomas W. Smith Fellow in Health Care Policy at the Pacific Research Institute. Her latest book is The False Promise of Single-Payer Health Care (Encounter). Follow her on Twitter @sallypipes.
