Congenital American Impatience Points to Obamacare’s Failure

Healthcare spending grew at the second-lowest rate on record in 2010, according to recent data from the Centers for Medicare and Medicaid Services(CMS). Still, the $2.6 trillion the United States spent represented a 3.9-percent increase over the previous year.

All told, health care consumed 17.9 percent of the U.S. Gross Domestic Product — a far larger portion of the economy than many other developed nations.

Critics of the U.S. healthcare system claim that we don’t get much more value than our peers for all those additional expenditures. On the other hand, those extra dollars do tend to pay for cutting-edge treatments and equipment the rest of the world can only dream of.

Why are Americans willing to spend so much more than those in other nations on health care? As a native Canadian and current American citizen, I’d posit that the answer boils down to cultural differences between the United States and the rest of the world.

Cross-cultural scholars point to historical events as instrumental in shaping the values and ideologies of Canada and the United States. Born out of armed revolution against an occupying foreign power, Americans have notoriously resisted government interference in their lives for centuries.

Canada, on the other hand, carefully legislated itself into independence and maintains strong political ties with the United Kingdom. Many of the Tories in the American Revolution — those who sided with the Crown — relocated to Canada after the fighting ended.

Even today, Canadian authorities worry about their country’s willingness to at least tolerate the status quo. In 2008, Canada’s Competition Policy Review Panel publicly fretted about the country’s “lack of sufficient entrepreneurial culture and ambition.”

What does all that history and culture have to do with health care? Quite a bit, actually. The entrepreneurial, independent American spirit tends to demand the best medicine has to offer — and right now. If it costs more, so be it.

According to the Organization for Economic Cooperation and Development (OECD), America spent an average of $7,960 per person on health care in 2009. The average per capita expenditure for OECD countries was just $3,233. Canada spent $4,363 per person — a little more than half as much as the United States.

Americans may be spending more — but they also believe that they’re getting a lot out of their health system. In the same survey, 90 percent of American adults reported being in good health. The OECD average was just 69.1 percent.

Americans’ desire for the best the world has to offer also translates to superior access to top-flight technologies and treatments. The same doesn’t hold true for the likes of Canada.

Consider the availability of medical technology in the two countries. The United States has 34.4 CT scanners per million Americans. In Canada, the number of scanners available is less than half that — just 13.9 per million residents.

The same trend holds for MRI units. In America, there are 25.9 per million; in Canada, just 8.0 per million. The lack of access to top-notch medical technology is a direct consequence of Canada’s government-funded single-payer healthcare system. It’s called Medicare, just like the U.S. government-funded health insurance program for seniors — but it covers all Canadians.

In order to keep costs down — and thus generate supposedly beneficial low per-capita health spending numbers — Canadian officials impose price controls on medical care. These controls result in shortages in the supply of care. If the budget runs out before a patient can receive the care she needs — or if she’s not deemed worthy of treatment — then she’ll just have to wait.

According to the Canadian Fraser Institute, wait times rose to new heights in 2011 — heights not considered clinically reasonable. Canadians waited an average of 19 weeks from a general practitioner’s referral to delivery of elective treatment by a specialist. That’s more than double the wait time of 18 years ago. Across the provinces, citizens waited for an estimated 941,321 procedures last year.

It’s no wonder that less than half of Canadians with chronic diseases feel the care they receive is excellent or very good, according to a survey from the Health Council of Canada.

My mother experienced these hard realities firsthand. She was deemed too old and weak by the Canadian government to receive timely treatment for her colon cancer when she initially sought care. By the time her number came up, the cancer had progressed, and there was nothing doctors could do. If she hadn’t been forced to wait, she could’ve been saved.

When I moved to the United States, my mother said, “I hope you won’t turn into an impatient, pushy American now.” The American’s refusal to wait might’ve saved her life — and can certainly save those of others.

The United States must find a way to address its health cost crisis. But the command-and-control approach that characterizes the Canadian healthcare system — and that Obamacare has set the groundwork for here — simply doesn’t square with America’s individualistic, perhaps impatient culture.

Even worse, as Canada shows, such an approach denies critical treatments to those who need them most.

Sally C. Pipes is President, CEO and Taube Fellow in Health Care Studies at the Pacific Research Institute. Her most recent book – The Pipes Plan: The Top Ten Ways to Dismantle and Replace Obamacare (Regnery) – was released in January 2012.


Nothing contained in this blog is to be construed as necessarily reflecting the views of the Pacific Research Institute or as an attempt to thwart or aid the passage of any legislation.

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