Wednesday, October 03, 2007

The 'flood' is a trickle.

Conservatives love to berate the Canadian health care system, ignoring such inconvenient but documented facts as the fact that Canadians live longer than we do. They claim that if Canadians are in good health, it is likely because of the flood of Canadians pouring across the border to get elective procedures in the United States that they can't get in Canada.

How much of a flood is this?

Well, I ran across an answer while perusing shrimplate's blog earlier today. In his post he cites Kate Steadman's health care blog in which she links to a study done in 2002 of how widely Canadians availed themselves of the opportunity to cross what is still an open border and have their health care needs taken care of here in the good ol' U.S. of A. The study concentrated on border areas of Quebec, but there is no reason to suppose that Canadians in Quebec love their health care any more than Canadians in other parts of the dominion.

The results are eye-popping-- for what they show isn't happening.

A 2002 Health Affairs paper examined hospitals near the border, as well as national surveys to tease out how many Canadians actually visit the U.S. to receive elective procedures.

In terms of hospitals along the border offering advanced treatments or special diagnostic technology (i.e. CT scans and MRIs), about 640 Canadians were seen, along with 270 for procedures like cataract surgery. They compare this to about 375,000 and 44,000 similar procedures in the region of Quebec alone during the same period. If you divide the total number of Canadians seeking those treatments in the US, divided by the number in Quebec alone that's about 0.09%. Not even a tenth of a percent.

Steadman goes on to cite data from 1996:

But the most striking stats come from the Canadian National Population Health Survey (NPHS). From the article:

Only 90 of 18,000 respondents to the 1996 Canadian NPHS indicated that they had received care in the United States during the previous twelve months, and only twenty had indicated that they had gone to the United States expressly for the purpose of getting that care.

Only 20 of 18,000 sought care in the United States.
(apparently less than those who were treated in the U.S. without seeking it, such as those involved in accidents or experiencing a medical emergency while visiting the U.S.)

Now, 1/10 of one percent is after all, one in a thousand. This is indeed a flood. I mean, I bet you could probably find one person in a thousand who given a choice would prefer driving a Yugo to a Cadillac. Or perhaps one person in a thousand who believes that the Apollo landings were all filmed on a stage in Hollywood, or maybe one person in a thousand who believes that Britney Spears is a good role model. Now, I don't mean to suggest that one person in a thousand is unimportant, but this hardly constitutes the 'flood' that the right would have you believe it is.

Steadman also gives us some context involving a poll of Americans who buy prescription drugs:

polling data from 2003 (approximately a year after the Health Affairs article) indicates that 8% answered YES to the following question:

"Have you ever bought prescription drugs from Canada or other countries outside the United States in order to pay a lower price?"

If 8% of the 18,000 Canadians polled in NPHS had expressly sought care in the United States, that would be 1,440. Not 20, as the survey showed.

In other words, we have 72 times the number of Canadians seeking care in the US going to Canada (or at least calling there) to get prescriptions.

Maybe that explains why pharmaceutical companies found it necessary to (successfully unfortunately) lobby Congress and the President to find ways to prevent Americans from buying the same drugs from the same factories from Canadian sources that they buy at twice the price in America. Note that the concerns of Canadians about not being able to come into the U.S. without a passport if/when we ever close the border because they will be inconvenienced in seeking American medical care haven't even come up in the debate. That is because it is such a vanishingly small number of Canadians who even come to the U.S. for elective procedures.


shrimplate said...

When I lived in upstate NY the local Plattsburg newspaper would occasionally have want-ads touting bus rides to Canada to buy prescription drugs.

Hence the Bush sop to the drug companies.

Paul said...

Eli and Shrimplate, great posts with solid info. I remember that business with Bush keeping Americans from buying Canadian drugs. As I recall it was supposed to be for our "safety."