Interesting. Per capita health expenditures in Canada are almost as high as the United States, ~$5600/person/yr in the US, $4600 in Canada.Take a look at this graph: http://www.grahamazon.com/2006/11/the-most-important-us-health-policy-graph/Unfortunately, the author of that graph committed the 1st Grave Error of Graph Making, which is unlabeled or improperly labeled axes. The x-axis is a bit vague, so let me explain: it plots percentage of total health spending over the "percentage most sick people." Presumably the author came up with some metric to determine "level of sickness." What the graph reveals is that in the US the 1% "sickest" people account for 23.7% of all health spending, while the 5% sickest people account for half of all health spending.It is well known that as a disease advances, the cost of treating it grows exponentially, while the probability of a successful outcome decreases. The solution, from a health policy perspective, is to focus on health maintenance and prevention. There are two further problems, 1) devising a system where people have access to health care, 2) ensuring patient compliance (since noncompliance is also a source of much wasted health care spending, and noncompliance tends to be really high for maintenance/prevention measures).So the common wisdom is that health care spending is high in the United States in part because a large number of people (some 13-15% of the population) don't have regular access to health care, and don't seek treatment until their conditions have become so severe that medical treatment is unavoidable.But I'm perplexed as to why it's so high in Canada, where access to health care is more universal. Is it bureaucratic overhead or what?
Hi Martin,A couple of quick things come to mind. First, I think you're right about the bureaucracy. There are gross inefficiencies in the system that most Canadians are aware of -- and there have been repeated calls for reform (I believe a recent commission said as much). The system could be made much more efficient.But I also think that Canadians, unlike Americans, may be more inclined to opt into healthcare simply because the option is there to do it affordably. If you build a universal healthcare system, they will come. I have no statistics to back this claim, it's just a suspicion.Cheers,George
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