Wednesday, July 22, 2009

More health care thoughts

Would just like to make a couple of points. First, a lack of health care insurance doesn't necessarily mean a lack of health care. Consider the following:
...65% of uninsured American women age 40 to 69 had mammograms within the past five years, the same percentage as Canadian women. Thirty-one percent of uninsured American men ages 40 to 64 were screened for prostate cancer, compared with 16 percent of Canadians.
Second, and more importantly, while the health care debate seems to center around how to extend health insurance coverage to more people we should probably be more concerned with quality. After all, we have universal coverage in education through primary and secondary school, yet quality is often times abysmal. Success should be defined as something more than simply everyone enjoying access to at least a mediocre level of care (which is pretty much currently the case).

If increased quality is the goal then it seems strange to look to government as the answer, with increased government involvement rarely corresponding with such improvements. One proven means of promoting enhanced quality is competition, which current legislation does woefully little to encourage.

Update: In the comments section Ben points out that other sources suggest a higher percentage of Canadian men having prostate exams -- around a third. While digging into this issue some more I discovered that the provincial government in British Columbia forces men to pay for prostate exams themselves, a law that is currently under legal challenge:
The B.C. Human Rights Tribunal has been ordered to reconsider whether it's discriminatory to make men pay for prostate cancer screening tests while providing free pap exams and mammograms to women.

Victoria lawyer Laurie Armstrong launched a complaint four years ago, arguing it's discriminatory to charge for prostate specific antigen tests.

Currently, the province only pays for the tests if patients have symptoms of prostate cancer.
Deciding what procedures and testing the state will pay for is, of course, a form of rationing. It is simply impossible for everyone to get all the health care they want when they want it. Either you can decide via the marketplace or the state will decide for you via legislative fiat.

1 comment:

Ben said...

The Globe and Mail says the Prostate Exam statistic is more like 39% for blood tests and 33% for rectal examinations.