Now granted one might expect this poll is skewed a bit by patriotism and the natural inkling to prefer the safe and familiar to that other horrid system over the border. For contrast, Harvard asked Americans some similar questions in spring 2008, and got this:
March 20 (Bloomberg) -- The majority of Americans say U.S. private health care may not be better than national systems in Canada, France and the U.K., according to a poll by the Harvard School of Public Health.
The survey, co-sponsored with Harris Interactive Inc., a Rochester, New York, research and polling company, found that 45 percent of Americans thought the U.S. medical system generally was the best. The remaining 54 percent either didn't know or thought other countries' systems were better.
Now I freely admit Canadians spend too much time comparing ourselves to Americans, and are probably a bit prouder of our health care system than it really deserves given its mediocre placement when compared on objective criteria to some other UHC systems, but no one has ever accused Americans of lacking in patriotism either. As an observer of your politicians, seeing them assert America's this or that is the best in the world without any factual basis cited is pretty common, and never fails to get applause so I take this poll as a pretty tepid endorsement of the US health care system.
Adding in ideology and party affiliation reinforces the significance of the Canadian result. Harris-Decima provides breakdowns by party, where only 12% of Conservatives preferred the American system and 76% preferred Canada's. Even among our right wing (who as a rule tend to be very pro-American), you don't find a lot of support for the American model.
More surprising to me is this from Harris-Decima:
Considering both cost and patient care factors, a majority of Canadians (55%) think that the health system should be more public, and only 12% think that more of the health system should be private. One in four (27%) believe that the current system strikes the right balance between publicly funded and pay-per-use care.
Canadians have been consistently worried about our health care system as an electoral issue for over a decade, and things like wait times, cost of drugs, and availability of family doctors (apparently not that big a problem) are regular political footballs. Amazingly, to the extent Canadians want our government run, bureaucrat ridden, inefficient, crumbling and totalitarian system to change, the majority want it to be even more "socialized."
The actual question asked here:
While emergency care, necessary treatments and trips to a family doctor are covered under the Canada Health Act, other services such as private hospital rooms, and certain medical procedures such as dentists, chiropractors and massage therapists are subject to user fees. Considering both cost and patient care factors, do you think that the current approach strikes that right balance between publicly funded and pay-per-use care, should there be more elements included in private health care, or should there be more elements included in public health care?
Again, even among Conservative party supporters, 55% want Canada's system more public, and only 12% want it more private. Canadians have had decades to see our system at work, probably most people have lived their whole lives under it, and seeing that, they would like to see their dentists and massage therapists moved under the socialist umbrella and out of the private insurance market (For dentistry I particularly agree. Basic dental care is not a cosmetic luxury). That is more than an idle endorsement in the abstract, doing any of this would probably involve an increased tax burden so we are putting our money where our mouths are.
Perhaps a bit stale, but in 2003, Gallup did a comparative poll of Canadians, Americans and Brits on health care, and here's what they found:
In all three countries, there is great variation of opinion within the population on both the quality of medical care and the availability of affordable healthcare. It is a testament to national health systems that people in Canada and Great Britain are significantly more satisfied with availability of affordable healthcare than their American counterparts are.
If you click through, the NHS seems to suffer in quality of care, but Canada stacks up fine and smashes the US on availability/affordability.
All of these do suffer from the flaw that presumably few of the respondents will have actual experience with the other systems in question. Not ideal, but we have this interesting poll of Americans living in Canada, which, despite the headline ("Americans in Canada prefer U.S. health care") and its statistically unscientific basis (opt-in, top heavy with 6-figure earners and masters degree holders), is an interesting look at what the best off Americans could expect to find under a single payer model:
Overall, the Americans said they preferred the U.S. system for emergency, specialist, hospital and diagnostic services, and said they preferred the timeliness and quality of the American system.
However, they also rated Canada's system high for access to drug therapy and ranked the services of family physicians almost equally in both countries. They also rated the equity and cost efficiency of Canada's system highly.
The participants were upper middle-class, mostly the kind of people likely to be well-insured in the U.S., said Lewis.
"They had high expectations of health care in Canada," he said. "I was surprised by they solidarity they showed for the Canadian system. Even their praise of the American system was qualified. They said, 'Yes, it is good. But it is expensive, and not everyone has access.' "
See the dirty secret here is that Canada has historically been notably less wealthy than the US (Nationmaster lists the US at $6K higher in GDP per capita for 2006) and there was always an element of apples to oranges in comparing our systems. We have fewer MRIs? Well, duh. Of course America should have had the better system, and at the upper end of the income spectrum, they probably do. The fact that we're ahead at all is itself an indication of how broken the US model is. Even so, the people at the top of the income pyramid in the US could expect to see their health care level decrease a bit under a single payer system, but not disastrously so. On the upside for them, people of conscience should like knowing the 47M uninsured had coverage too, and not for nothing either is this:
Meanwhile, 32 per cent also noted that while they lived in the U.S., health insurance concerns affected their decisions about where to look for a job, and 29 per cent said it influenced decisions about whether to remain at a workplace.
Even the upper middle class worries about their health care when it comes to choosing a job or a place to live. It's tempting to ignore these sorts of rich-people problems since what they could lose under a single payer system is mostly related to the hidden quota system of American health care, where the top 3/4 get much faster health care by virtue of excluding the bottom 1/4 from nearly any care. It's tremendously unjust but so broadly systemic that to the individuals benefiting from this mechanism, it is no surprise they don't really see the problem and are nervous about losing it. If you have good insurance, you just go in and get the procedures you need. It's not like you walk into the operating room and order the doctor to stop operating on someone poorer than yourself so he can treat you. The unfairness is obscured and so no one feels personally responsible for it.
So it's worth considering the benefits they'll get to blunt their opposition. It's unlikely the upper middle will ever be thrilled about UHC in America, but keeping them from vehemently opposing it is plainly important.
Overall, the picture in scientific polling is a much stronger endorsement of the Canadian model, and a stronger rebuke of the US model than found in the McClatchy survey. It really strikes me odd that right wingers fixate on attacking the Canadian model, since we do stack up so well. So be it, they're falliable and if they foolishly want to use us as their bogeyman, break out the flashlights and let's get spooky. This is one horror movie that won't qualify for a "based on a true story" tagline. |
