Health-Care Myths Debunked
by Brett Skinner
President, The Fraser Institute.
- First Posted: Aug 06 2009 14:57 PM
- Updated: 10 months
Proponents of government-run health insurance have a nasty habit of ignoring the facts, as well as the interests of patients.
The saddest thing about the health-care reform debate in both Canada and the United States is that those who advocate for government-run health insurance have no regard for the facts, and no apparent concern for the interests of patients. Bob Rae’s misinformed commentary about the case of Shona Holmes is an example of this.
Ms. Holmes is an Ontario woman who traveled to the United States to receive medical treatment that she could not get at home without enduring a long and risky wait. Her experience is featured as a case study in the failure of government-run health insurance and is at the centre of the current debate about health reform in the U.S.
Mr. Rae did not accurately present the facts of the Holmes case, characterizing her condition as a “benign tumour.” For those interested, the website of the Mayo Clinic where Holmes was treated has posted the details of her story.
“Benign” is in the eye of the beholder because Mayo Clinic doctors diagnosed Holmes as having a Rathke's cleft cyst (RCC). The clinic’s website describes this as a rare condition in which a fluid-filled sac grows near the base of the brain and eventually can cause hormone and vision problems. According to the Mayo Clinic’s version of events, by the time she first saw an American neurosurgeon, “Holmes had lost half the vision in her right eye and 25 per cent in her left eye.”
Mr. Rae says Holmes was “insured by OHIP,” Ontario’s provincial public health insurance program. Yet even after an MRI confirmed that she had a brain tumour, Holmes was put on a waiting list that was five to six months long before she could see a Canadian specialist. What practical good is Ontario’s so-called universal public health insurance if the system couldn’t provide timely access to the medical treatment Holmes needed? Access to a waiting list is not the same thing as access to health care.
Indeed, all kinds of myths about health care in Canada and the U.S. are commonly cited by advocates of government-run health insurance.
Take for instance the claim that 47 million Americans have no health insurance. Dr. Devon Herrick of the National Center for Policy Analysis annually updates a detailed analysis of U.S. Census figures that are used to make this claim. According to his research, 85 per cent of U.S. residents in 2007 were privately insured or enrolled in a government health program. Of the uninsured, 18 million had household incomes above $50,000 and could afford health insurance; and 14 million qualified for government programs but had not enrolled.
Herrick concludes that 32 million people, or 70 per cent of the uninsured, could easily obtain coverage but have chosen to forgo insurance. That means 95 per cent of U.S. residents either have health coverage or access to it.
Meanwhile, Statistics Canada reports that about 3 per cent of the Canadian population surveyed in 2007 (excluding northern Territories and aboriginal reserves) were without access to a regular primary care physician except through ER admission at a hospital, or other non-regular means during the previous year. An additional 3 per cent had no access at all to a primary care physician – by any means. Without access to primary care, patients cannot get diagnosis, referrals for specialist treatment, or prescription drugs. In other words, they are in practical terms no better off than uninsured Americans.
There are plenty of other myths – like Mr. Rae’s argument that large numbers of Americans file for bankruptcy due to uninsured medical expenses. In 2006, Dranove and Millenson published a critique of this argument in the journal Health Affairs showing that uninsured medical expenses were cited in only 17 per cent of bankruptcy filings. Further, they found that medical expenses were only one of several reasons for bankruptcy cited in these cases. In fact, medical expenses accounted for only 12 to 13 per cent of unsecured debts among the small percentage of bankruptcy filers who cited medical expenses as one of several other reasons for their bankruptcy claim.
The implication of the medical bankruptcy myth in the U.S. is that it would not occur under a government-run health insurance system. But research commissioned by the Office of the Superintendent of Bankruptcy in 2006 showed that 15 per cent of bankrupt seniors in Canada cited medical reasons, including uninsured medical expenses, as the primary cause of bankruptcy. Furthermore, recent research published by the Fraser Institute shows that in 2006 and 2007, the only two comparable years on record, personal bankruptcy rates were actually higher in Canada than in the U.S.
Comments
Re:Marks
“ I find this entire article riddle with half-truths carefully cherry picked to support a predetermined worldview and unworthy of the aim of this column to provide "Insightful Commentary and Analysis." Just to cite a couple of examples: The author's assertion that 18 million households had income over $50,000 and could afford insurance. That presupposes that it was available, which it clearly is not in the case of someone with a pre-existing condition. He also fails, by omission, to address some of the more pernicious activities of the health insurers in the U.S., such as denying and clawing back benefits from sick people and limiting coverage. Furthermore, his bio clearly states that he's a paid shill for the insurance industry. I'm sorry, by anyone who's "worked as a research consultant to the Insurance Bureau of Canada" can't be relied upon to do anything but parrot his master's talking points, however eloquently. My message to the editorial department at The Mark: What were you thinking? If you want to be taken as a credible news source, it's your job to expose this sort of astroturf nonsense, not lend it credibility.
Gord Gilmour
“ What planet are you on sir? Americans should not be commenting on a system (canadian healthcare) which they know nothing about and you sir should do the same when it comes to the US healthcare. How about 60% of bankruptcies in our country are due to medical bills. http://www.reuters.com/article/newsOne/idUSTRE5530Y020090604 How about $1500- a month for an individual health insurance plan for a couple over 50 in my state of NJ. So 18 million of us chose to not have health insurance. Well how far does your $50,0000 a year go after you pay $18000 annually for a health insurance policy, $16800 a year for a mortgage, $6000 a year for one vehicle and insurance, $10,000 a year for food, $3000 a year for gas, $2400 a year for electric, $720 a year for water, $1000 a year for a phone and if your lucky maybe a $1000 a year for shoes and clothes. What are we up to, what ? $58920 and this is only the necessities? Now what about that little 30% income tax? $15000 on an income of $50000 which leaves you with actually $35000 a year to pay for the above and if you are real lucky you may get a refund from your government at the end of the tax year if you have deductions. Give me a break! Come try it down here for a while buddy. If we could sell our home right now we would move up to your neck of the woods because we know what your healthcare system is like . My husband is a Canadian citizen and has lived through both and he will take his homelands system over this sorry excuse for healthcare in the US anytime!
sara flooo
“ I'd like to respond to this load of drivel point by point. --- (1) It is absurd and insulting to suggest that those who support a public health care system "have no regard for the facts, and no apparent concern for the interests of patients." Judging from the infantile scribblings you've left here, you have little right to call out others for playing fast and loose with facts. --- (2) You refer to the "myth" that 47 million Americans are uninsured. It is a myth, sort of. Though this number was correct in 2005, it fell to 45.7 million as of the 2007 U.S. census. This was because more and more states expanded their public insurance coverage programs. --- (3) To clarify, Dr. Devon Herrick is not a Medical Doctor. He holds a Ph.D. in political economy from the University of Texas at Dallas. --- (4) Your assertion (borrowed from Herrick) that 32 million people could "easily access" health care is unfounded. If you bothered to read the U.S. census's study on health coverage, you'd know that the bulk of uninsured people either lost the plans they had with their employer because they were recently laid off, or because they simply can't afford to pay for either government or private insurance. --- (5) I find it odd that you equate the percentage of Americans without insurance with the percentage of Canadians who do not have a family doctor, as if, because the U.S. has private health care, there is no doctor shortage in that country. Pick up any U.S. newspaper, and you'll find that Americans, in both urban and rural areas, face the same doctor shortages we do. on top of their problems with private health coverage. --- (6) So because the proportion of seniors in Canada who declare bankruptcy due to medical expenses and the proportion of the U.S. general population who do the same are roughly equivalent, we're both as bad off? That's a pretty big leap. I'm sorry, but without numbers on how many American SENIORS are declaring bankruptcy due to medical expenses, your argument here is useless. --- There were a few assertions made by Mr. Rae that you left unanswered. I'd like to know why you haven't: --- (a) defended Shona Holmes for trying to get the Ontario government to pay her private medical expenses --- (b) defended U.S. private insurers against Mr. Rae's assertion that these insurers often refuse to cover their clients' catastrophic medical expenses --- If you'd like to read some real facts, I invite you to read over the U.S. census bureau's report on health insurance, income, and poverty at http://www.census.gov/prod/2008pubs/p60-235.pdf --- If you'd like to read the junk analysis Mr. Skinner used for his piece, you can read good ol' Dr. Derrick here, but be warned - there are far too many flaws in his analysis for me to point out here: http://www.ncpa.org/pub/ba595
Alanna Chu
“ She lied about it's fatality. There are enough references to support this if you took the time to look.... I don't know where you get your facts, but my research shows how the U. S. system prioritizes on socio-economic class & not urgency. Look up somebody named Robin Beaton, a retired nurse who started a small business & had her Blue Cross rescinded...because of ACNE (something 90% of teen-agers get) & a fast heart rate (which could happen to healthiest of people). http://www.pbs.org/moyers/journal/07102009/profile.html. I have plenty more references to refute that article of your's in case you're interested. Here's another: http://www.latimes.com/news/nationworld/nation/la-na-congress-benefits2-2009aug02,0,7524121.story?page=2. Check the bottom, Rep. Steve Kagan's (Democrat of Wisconsin) eldest daughter, a nurse in Miami can't even afford health insurance. Explain that one. However, Mr. Skinner, if you are advocating a private system; keep gov't out of health care, then you should agree that based on this premise alone, Shona Holmes' lawsuit against OHIP & Ontario falls flat. Government should stay out of health care then the Government certainly shouldn't reimburse her & most certainly, not with tax-payers' dollars.
CK Twight
“ Mr. Skinner has written "“Benign” is in the eye of the beholder because Mayo Clinic doctors diagnosed Holmes as having a Rathke's cleft cyst (RCC)." I believe he means to imply that whether something is serious depends on one's perspective. This may be true, but "benign" is not in the eye of the beholder. It is a technical medical term that is used to class tumors as cancerous (malignant) or noncancerous (benign) according to various characteristics of the tumor. There are objective, rather than subjective, criteria for classing a tumor as benign or malignant. You can find a definition of benign vs malignant tumors at MedLine http://bit.ly/qXnS8 it is misleading to characterize the term as though it was a matter of perspective. Rathke's cleft cyst http://bit.ly/yzWyg are benign. A tumor is classed as benign if it is a growth that is noncancerous and will not spread to other areas of the body. Usually they are not medically urgent matters, though if they grow too large they may cause problems. Either Mr. Skinner is unaware that "benign" is a technical term, in which case his knowledge of medicine seems suspect, or he is purposely equivocating between the technical sense of "benign as it is used to class tumors and the non-technical sense of "benign as non-harmful, in which case his argument and honesty are suspect.
Meredith Schwartz