Why can't Americans buy Health Care in Canada? Proposing a 10-mile experiment...
I propose that the Canadians open up their health care system to any American who lives within 10 miles of the border.
The Americans would be charged whatever it is that Canadians spend per capita on health care (as a total percentage of their taxes, not the premiums which are tiny) plus some sort of monthly service charge for the privilege. Then, they'd have the same access to the system (including access to prescription medications) that Americans do, except for ambulance rides, because ambulances might have trouble at the border.
It would be interesting to see what would happen. My guess is that Americans might purchase this coverage for basic medical care, but maintain an extremely high-deductible policy in the event that they come down with some totally rare disease and need access to the world's smartest doctor.
Another guess: Americans would find that if they lived near a big Canadian city, their wait times for procedures or appointments wouldn't be as long as they thought. If they lived near a little town, basic care would be pretty easy to get but wait times for fancy stuff would be longer. (I've long maintained that part of the "wait time" story has more to do with living in the boonies than with the system itself.)
I know that Canada's current Prime Minister, Stephen Harper, would be unlikely to support this idea because a "run for the border" would embarrass his conservative political buddies down south. But maybe it could be tried in the more liberal provinces?
Very curious to know what the health care economists in the crowd would think of this idea as a single-payer trial balloon.
Since our congress outlawed even being able to purchase drugs from Canadian pharmacies, I kinda doubt that they would float this particular "trial balloon", although I like the idea.
August 27, 2009 8:02 PM | Reply | Permalink
I know--what I'm hoping is that having made such a fuss about choice, congress might find itself with no alternative but to offer this choice.
I also think that maybe "buying drugs from Canada" should be revisited. It's a healthcare issue that people can relate to, and there was quite a ruckus in the northern states when congress yanked this "buy in bulk and save" opportunity out of peoples' hands.
August 27, 2009 9:21 PM | Reply | Permalink
Just saw this which looks like a step in the right direction.
August 28, 2009 8:12 PM | Reply | Permalink
Wouldn't work. The only way to make a system like this workable would be to get enough healthy people in on it to fund the sick people. Almost certainly the healthy people would not want to pay the extra money, leaving only the sick people, meaning that Canada would, on net, lose money from this.
August 27, 2009 9:25 PM | Reply | Permalink
Which is not to say that I have any objection to the U.S. allowing it, if Canada is willing.
August 27, 2009 9:29 PM | Reply | Permalink
Wouldn't work. The only way to make a system like this workable would be to get enough healthy people in on it to fund the sick people. Almost certainly the healthy people would not want to pay the extra money, leaving only the sick people, meaning that Canada would, on net, lose money from this.
August 27, 2009 9:28 PM | Reply | Permalink
Do we know for sure that it would be "extra money?" Canadian Health Care doesn't have costs for advertising, for making their facilities look really fancy, for exceptional amounts of paperwork, nor do they have to provide profits to their investors in the form of dividends. It's my understanding that would knock about 20% off the premiums people would pay in the US, even before (or possibly in the absence of) looking at whether the people signing up would be sick or well.
Basically what I'm wondering is whether, dollar for dollar, Canadian Health Care would be "competetive" with the care provided by buying US health care/insurance.
August 27, 2009 11:05 PM | Reply | Permalink
Do we know for sure that it would be "extra money?"
It is possible that buying into the Canadian system would save some people money if they dropped their private insurance. However, people who could afford private insurance but who do not have it, or healthy young people with only catastrophic insurance would likely pay more if they bought into the Canadian system. These are the people who would help to fund the system the most, but are also the people who would benefit the least from it.
The people who would benefit the most from buying into the Canadian system would be the poorest and sickest. These would also be the people who would take the most out of the system.
The point is, such a policy would almost certainly select for the net recipients, not the net contributors, thus bankrupting the Canadian system.
There would be no way to make a plan like this work without forcing people who are net payers into the system in order to pay for the people who are net recipients.
August 28, 2009 2:46 PM | Reply | Permalink