Wednesday, July 08, 2009

No free lunch

One of my pet peeves about health care is when people refer to Canada's system as "free." Of course it isn't free. Few things are. The Canadians simply pay for it in a different way -- typically through taxes. But it isn't always enough, which is why some Canadians also have to pay at least a nominal fee out of their own pockets:
During the 1990s, several provincial governments attempted to reign in health care spending. One result that can be at least partially attributed to those cuts is that Canada has 12.7 C.T. scanners for every million people compared with 34.3 in the United States. There is also a gap when it comes to physicians. In 2007, Canada had 2.18 practicing doctors for every thousand people, according to the O.E.C.D., compared with 2.43 in the United States.

By the turn of the millennium, the public backlash provoked by a widespread sense of poorer health service prompted governments to stop cutting and to start looking at ways of running the system more efficiently while finding new sources of revenues.

Ontario now has a health care premium paid by individuals, based on income, and health tax paid by employers. Individuals’ annual payments range from nothing, for people with taxable incomes of less than 20,000 Canadian dollars, to a maximum of 900 Canadian dollars for people with taxable incomes over 200,600 Canadian dollars.
If you want more you have to pay more. Meanwhile I also noticed this yesterday in the Economix blog series on Canadian care:
Most dental work, prescription drugs for people not at retirement age, and eyeglasses are among the many costs not covered. The Canadian Institute for Health Information estimates that governments covered about 70 percent of the 171.9 billion Canadian dollars (roughly $148 billion) spent on health care last year.
The government does not have an endless amount of money. You face resource constraints in any health care system imaginable -- the only question is how you most efficiently allocate them.

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