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Claudia Sanmartin, Jean-Marie Berthelot, Edward Ng, Kellie Murphy, Debra L. Blackwell, Jane F. Gentleman, Michael E. Martinez, and Catherine M. Simile Comparing Health And Health Care Use In Canada And The United States Health Affairs, July/August 2006; 25(4): 1133-1142. [Abstract] [Full Text] [Figures Only] [PDF] [Reprints & Permissions]

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"Canadian-ize" The U.S. Health Care System For The Poor Only

Albert A. Okunade   ( 14 July 2006 )

"Canadian-ize" The U.S. Health Care System For The Poor Only 14 July 2006
Albert A. Okunade, Professor University of Memphis, Department of Economics and Center for Community Health Send comment to journal: Re: "Canadian-ize" The U.S. Health Care System For The Poor Only aokunade{at}memphis.edu Albert A. Okunade	Relevant literature concludes overwhelmingly that the United States spends disproportinately more on health care than Canada, and that the marginal dollar in the United States tends to buy "care" and not physiological outcome. The recent finding of Sanmartin and colleagues suggests that the ill health of the U.S. poor is linked to income disparities. Other than this, they found no major difference in the health status of the remaining U.S. and Canadian residents. One can suggest implications for these findings. Foremost, create for low-income U.S. citizens a national health care subsystem akin to the Canadian system in terms of scope, quality, and sustainability. Move the covered poor into the mainstream health subsystem when their incomes rise to exceed a defined critical level. Since income and education have high and positive correlation, an alternative policy would be to enact new (but preferably enforce or strengthen current) laws mandating a critical level of income-enhancing (that is, "income disparity" reducing) education for U.S. citizens. Since poor lifestyle choices (for example, unemployment and habitual sedentary tendencies) associated with ill health fall with a rise in incomes, individuals in the lowest income quintile will then improve health status as education (hence, income) rises. The above, practical policy implications are likely to take some time, but in the long haul they would tend to raise the productivity of the U.S. health care dollar for the poor and so overall. Several avenues through which this could occur also include a significant reduction in high-cost emergency care of the poor in the United States in addition to the reduction in fragmented health care, increased worker productivity, and reduction in government subsidy for health care for the poor and uninsured. There are additional intergenerational positive externalities of improved health status due to improved education and incomes.