I wasn’t as clear as I could have been in my previous post regarding Canadian emergency departments.
The intent of the posts was not to say that one system is “better” than the other. Comparing two completely different medical systems and declaring one “better” is similar to comparing a Hummer to a VW Bug and declaring one “better.” Different people will have different opinions depending on the needs of the user. Where a Hummer would be “better” for towing a boat, a VW Bug would be better for saving money in gas. Similarly, American and Canadian medical systems (as well as others around the world) each have their pros and cons.
When I said that we are kidding ourselves if we think care will be better, I was referring to the silliness of the concept that, once medical care is nationalized, the US will have less waits, more comprehensive care, and a lower price. Because wait times are hitting the headlines in the US right now, I illustrated that wait times are also bad in Canada where they have a national health system, but I didn’t really expand on my thought process. As several people noted in the comments, neither system is perfect.
An article just published in the New York Times illustrates the concept better.
Americans spend more than twice as much on healthcare as many countries in Europe, but we still have a huge void providing care to those who need it. To expand services, we must cut costs. There is no way around it. Cutting costs will necessarily cut services being provided.
Are we ready to give up our designer medications and immediate access to comprehensive testing so that more people have access to care? Are we ready to pay more for the treatment we receive?
As David Newman states in the NY Times article:
“You can make policy changes till you’re blue in the face, but if patients and doctors don’t change the way they think about medicine, we’ll never change medicine.”
We’ll find out soon whether the experiment works.
As an aside, Emergency Physicians Monthly is fortunate to have Dr. Newman as one of its new contributors. He is author of the book “Hippocrates’ Shadow” and is a talented writer. I’ll link to his articles in EPM when they’re published.
