Alternative health care models

On their website, Scientific American has a story comparing the Canadian and American health-care systems. The story suggests that Canadians get better value for money, and may well have a better health system overall, despite spending about half as much per person as Americans do. The article explains that Canadians live longer in general, as well as being less likely to die during the course of treatment.

There is good reason to believe that there could be greater efficiency in a system like those of Canada and Britain, where the federal government is the main purchaser of health products. Unlike individuals – who have limited knowledge about health care and few opportunities to exploit economies of scale – governments can buy intelligently and in big batches. They can make deals with pharmaceutical producers and other suppliers of health products. The importance of scale in the purchase of health products is demonstrated by efforts by groups like the Bill and Melinda Gates Foundation to acquire effective and affordable treatments for the major illnesses of the developing world through the use of large-scale acquisitions. More controversially, central-payer health care systems may be better placed to prioritize who should be treated and to what extent. Spending large amounts of money extending the lives of very sick people contributes less to overall societal health than spending the money on early treatment or preventative medicine, though the relative desirability of the two depends on your philosophical beliefs about how spending should be prioritized. Arguably, the Canadian system also produces fewer conflicts of interest than the American political system, in which health corporations are major campaign donors.

In comparing the two, there is one other major phenomenon that bears considering. Because Americans are the main market for new drugs, forms of surgery, and other types of medical care, it is possible that they are subsidizing research and development which can then be accessed at a lower cost by those outside the United States. One does ocassionally hear accusations that Canadians are ‘free-riding’ on the American system in this way. This is obviously connected to one of the hottest topics of political and legal debate at the moment: intellectual property law. In particular, the ethical questions about who bears the costs and benefits of innovating still only have partial and contingent answers.

It will be interesting to see what the Canadian and British systems look like in twenty-five or thirty years. Managing the ongoing demographic transition will be a challenge – just as it will be with pensions – but it seems as though it will ultimately be beneficial to have a lower birthrate and population. Only once that is true of the world as a whole can we really expect to create a society that is sustainable overall.

Author: Milan

In the spring of 2005, I graduated from the University of British Columbia with a degree in International Relations and a general focus in the area of environmental politics. In the fall of 2005, I began reading for an M.Phil in IR at Wadham College, Oxford. Outside school, I am very interested in photography, writing, and the outdoors. I am writing this blog to keep in touch with friends and family around the world, provide a more personal view of graduate student life in Oxford, and pass on some lessons I've learned here. View all posts by Milan