Could the United States afoord to NOT have medicare/medicaid?

[notyoueither]

That's because you're an idiot.

The dominant ethnic group (Europeans) in Canada is going to have lower demographic statistics?

x-posted

[Ben Kenobi]

The dominant ethnic group (Europeans) in Canada is going to have lower demographic statistics?

Given Gribbler's evidence this is possible.

[giblets]

A 2-year gap between hispanics and non-hispanics? That makes a 12-year gap between white Canadians and visible minorities plausible?

[Ben Kenobi]

A 2-year gap between hispanics and non-hispanics?

That would be the definition between 'lower' demographic stats, no?

[notyoueither]

Given Gribbler's evidence this is possible.

Beyond idiot.

http://www.milbank.org/quarterly/8301feat.html

Mortality of Canadians and White Americans

Figure 2 shows that the life expectancy of Canadians and white Americans diverged in the 1970s and that the difference has increased subsequently in each decade since then. Significantly, the differences between social insurance coverage in the two countries became apparent in the 1950s, when Canada instituted broader protection than the United States offered. By then, both countries had industrial accident, pension, and unemployment insurance, but in 1944 Canada also offered a system of family allowances. The gap in social insurance opened much wider after Canada implemented a universal health insurance program in 1972 (Kuderle and Marmor 1982, 83–5), in contrast to the far from universal programs, Medicare and Medicaid, created in the United States in 1965.

In addition, Canada’s social insurance programs are more redistributive than America’s, and the result has been much greater income equality in the former than the latter country. Although between 1974 and 1985, income inequality worsened in both Canada and the United States, the trend in Canada reversed in the following decade, whereas it continued in the United States. Between 1985 and 1997, Canadian patterns of income taxation and transfer payments were far more redistributive than those in the United States (Wolfson 2000; Wolfson and Murphy 2000).

After universal health insurance was implemented in Canada, several studies were made of the consequences for health care utilization. The results were mixed. Some showed that the inequalities among income groups in utilization and health status have persisted (Dunlop, Coyte, and McIsaac 2000; Dunn and Hayes 2000; Wilkins, Berthelot, and Ng 2002; Wood et al. 1999), but for the most part, utilization has increased, especially among the poor (McDonald et al. 1974; Munan, Vobecky, and Kelly 1974; Siemiatycki, Richardson, and Pless 1980). Although waiting times for elective and semiurgent procedures have lengthened since the 1970s, the degree to which the increase has reduced life expectancy, as contrasted with quality of life, is not significant (Naylor 1999). Moreover, (1) the differences among socioeconomic groups with respect to avoidable hospitalizations are far greater in American than in Canadian cities (Billings, Anderson, and Newman 1996); (2) the risk of inadequate prenatal care is greater for poor American women than for poor Canadian women (Katz, Armstrong, and LoGerfo 1994); (3) survival from some heavily technology-dependent conditions, for example, end-stage renal disease, is better in Canada than in the United States (Hornberger, Garver, and Jeffery 1997), perhaps the result of the high prevalence of for-profit dialysis centers in the United States; and (4) among hospitalized victims of myocardial infarction, Americans have more technologically intense interventions than Canadians but the same one-year survival (Anderson, Newhouse, and Roos 1989; Tu et al. 1997). In contrast, survival from hip fractures is worse in Manitoba than in New England (Roos et al. 1990), although comparisons with adjacent U.S. states might have been more appropriate. In general, however, most causes of death as well as mortality differences among income groups in Canada have declined since the 1970s (Wilkins, Berthelot, and Ng 2002). Furthermore, the use of U.S. services by Canadians is too small to have had a measurable impact on cause-specific mortality or life expectancy (Katz et al. 2002).

Several comparative studies (Gorey et al. 1997, 1998, 2000a, 2000b, 2003) of the association between income and survival rates from various cancers in American and Canadian cities revealed that

* There were few, if any, differences in the survival of different income groups in Canada but very substantial differences in the United States.
* People with cancer who came from poor populations in the United States had a worse chance of survival than did equally poor people in Canada. This was as true for poor whites as it was for poor African Americans.
* In general, when only middle- and upper-income groups were considered, the differences in survival between the two countries were not significant, either statistically or substantively. Survival among the wealthiest groups in Honolulu was better than in Toronto, however.

Cancer survival patterns in Honolulu were more nearly like the patterns in Toronto than were those of any other American city. Because Hawaii is the one American state that has attempted—though with only partial success—to implement universal medical insurance, the evidence suggests that the differences in cancer survival documented in these studies were primarily the result of differences in access to health services.

Similarly suggestive evidence of the importance of universal coverage comes from a comparison of changing Canadian and American mortality rates from 1980–84 to 1995–96, from causes of death amenable to intervention by the health care system. Douglas Manuel and Yang Mao (2002) showed the following:

* The death rates of breast cancer, Hodgkin’s disease, and peptic ulcer fell equally and were essentially indistinguishable in each country.
* The number of asthma deaths rose in the United States and dropped in Canada.
* The death rates of cervical cancer, hypertension/cerebrovascular disease, ischemic heart disease, tuberculosis, and appendectomy, cholecystectomy, and hernia fell in each country, but more rapidly and to lower levels in Canada than in the United States.

These observations suggest, too, that the Canadian system of comprehensive care, free of charge at the point of service, and with a greater emphasis than in the United States on primary care, may be generally more effective than the American system for the total population. In light of the great inequalities between whites and African Americans, however, the question is whether the differences between the two countries can be explained by the high rates of death among African Americans or whether these differences affect white Americans as well. Both the lower life expectancy of white Americans than Canadians since the 1970s and the results of the analyses of cancer survival suggest that there should be differences in most of the causes of death amenable to intervention by the health care system. This is important, because if the U.S.-Canadian differences can be explained only by the high rates of preventable deaths among African Americans, then equality between the United States and Canada could be addressed by equalizing the care received by African Americans and leaving the rest of the system untouched. But if the U.S.-Canadian differences are also attributable to differences between white Americans and Canadians, then equalization would require more than simply addressing the problems affecting African Americans, important though that is as an end in itself.

Figure 4 compares the age-adjusted death rates of Canadians (Statistics Canada 1980–99) and white Americans from the same causes as those described previously when African-American and white rates were compared. In virtually every case, Canadians have lower rates than white Americans. The exceptions are breast cancer, all respiratory diseases in children, and peptic ulcer, for which the rates are very similar or the same. Moreover, in those conditions for which the rates are falling, they tend to be falling more rapidly among Canadians. These conditions are hypertension and cerebrovascular disease, Hodgkin’s disease, appendectomy, cholecystectomy and hernia, cervical cancer, and chronic rheumatic heart disease. Ischemic heart disease has fallen at about the same rate in each population. HIV/AIDS mortality increased more rapidly and to higher levels among white Americans than Canadians, and in the 1990s it fell more rapidly. Nonetheless, the rates still are higher in the United States. Diabetes mortality is increasing in both populations as well, but far more rapidly among white Americans than among Canadians.

These comparisons strongly suggest that the Canadian health care system, though not without serious problems (Blumenthal et al. 2004), serves the interests of Canadians better than the U.S. health care system serves the interests of white Americans, not to mention African Americans. Even the use of American-made pharmaceuticals does not seem to have led to higher death rates in Canada, which should allay the fears of those concerned about reimporting drugs to the United States from Canada. Moreover, the lower death rates of Canadians have been achieved at about half the cost of what Americans pay for health care (Reinhardt, Hussey, and Anderson 2004). In 1999, in current U.S. dollars, the per capita health expenditures in Canada were $1,939, compared with $4,271 in the United States (World Bank 2003).

The bolded bit would be why Canadian stats seperate Aboriginals as they are the only (probably) group that differs significantly.

[Ben Kenobi]

There were few, if any, differences in the survival of different income groups in Canada

1, income groups!= race.

2. Let's see the hard numbers.

[notyoueither]

**** off.

[giblets]

Hey, aren't aboriginals ~4% of Canada's population and aren't they ~7 behind in life expectancy? So let's see...
white Canadians: according to Ben, 2 years behind in life expectancy. They are ~84% of the population.
aboriginals: 7 years behind. They are ~4% of the population.
visible minority, not aboriginal: ~12% of the population. According to these assumptions, they must be ~16 years ahead of the national average.

So if Ben was right about white Americans living longer than white Canadians, then there is a segment of the Canadian population that has a life expectancy of ~96 years. Amazing!

[Ben Kenobi]

Still no hard numbers. Why, if the system says that all are equal doesn't it keep track?

[rah]

WHO CARES

[korn469]

I guess the thing that bothers me so much about medicare/medicaid is that it is our government's largest investment and it is probably the one least likely to have a payoff in the future. I mean if you cut the medicare budget in half, and spent the rest on medical research, we'd probably develop a cure to many diseases in the next 20. Compare that to the status quo, where all of those trillions of dollars America will spend in the next 20 years probably won't lead to a single medical breakthrough.

[rah]

But it will prolong life for many. And as I get older, it's understandable why I might want to see that money prolong more peoples' lives now then later.