America's healthcare is superior to Canada's

http://www.youtube.com... A. Access/Equity: In Canada everyone is universally covered country wide; while in the US 13.3 % under 65 have no healthcare coverage [1]. Even with insurance in the US, benefits are based on your ability to pay. There are no issues with insurance portability when changing jobs in Canada. If you have a preexisting condition and change employment in the US, you can be denied coverage under your new employers insurance. Job opportunities missed due to worry of not gaining medical coverage. B. Costs: Medical costs are 10.4% of Canada’s GDP, US 16% [2]. The US healthcare system is the most expensive in the world and under-performs in healthcare results compared to Canada [3]. Canada per capital medical expenditures is $4,522 compared to US $8,508. More than ½ of personal bankruptcies in the US are attributed out of pocket medical costs relating to a serious illness or injury. Most of filerswere average age of 41, with some college education having children within the middle income bracket; not the poor. Medical bankruptcies arenot possible under the Canadian system [4, 5]. Over the last decade there has been a shift to higher % paid by employees in employer based health plans [6]. Between 2010-15 health insurance costs had risen by 27%, out pacing inflation and wage growth burdening both employee and employer. Average cost of a family plan is $17,500 per year, not including co-pays or deductibles [7]. “In Canada, the health care system is funded by income, sales and corporate taxes that, combined, are much lower than what Americans pay in premiums.” [8] C. Mortality/Longevity Lower Infant mortality rates 4 per/1,000 in Canada, 6/1,000 US [9]. Longevity rates in Canada is 81.76 years vs. US which ranks 43 globally at 79.69 [10]. Canada has fewer deaths vs. the US for treatable conditions [11]. D. Open System/Administration Canadians have are no restraints on doctors or hospitals. If an emergency should arise when traveling there’s no bill to pay upon your return home. US insurance companies require in network doctors and hospitals; anything out of network is out of pocket. In Canada a person can choose whatever doctor they wish to see without a physician’s concern with a patient’s ability to pay. Canadian doctors are private and for fee based. Instead of dealing with hundreds of different insurers as in the US, they deal with only one insurer leaving more time for patient care over administrative tasks. Canadian admin. cost is 3% vs. US at 20-30% [37] The US has varying fee schedules, co–payments and eligibility requirements which beget higher costs [12]. The term “rationing” of healthcare services that is so demonized by US media is a fallacy. The rationing is based on need, where as in the US rationing is based on cost [13]. US insurance carriers routinely decide what tests and procedures are covered or not. E. Coordination and Continuity of Care: Canada has better medical IT systems for quicker access to information and care coordination. US doctors have difficulty receiving information in a timely manner and bogged down with administrative tasks [14]. Rebuttals: I. Wait times: Canada’s General Accounting Office of Congress, "patients with immediate or life-threatening needs rarely wait for services” [15]Wait times (WT) are weighted by priority of need. Those who seek ELECTIVE procedures wait the longest. [38]. Considering mortality rates for treatable medical conditions is lower in Canada it appears that WTs have little bearing on outcomes [16]. In the US 45,000 deaths annually are attributed to lack of insurance [17]. WTs are growing in the US; more expensive and elective treatments have the shortest WTs vs. chronic conditions; profit motivation [18]. Wait times under US Medicaid and Medicare are rising with times between 2 wks-2 mo. [19]. II. Medicaid & Medicare: Medicaid does assist those just above and below the poverty line (PL), 16.4% of the population, and Medicare for the retired [20]. To be eligible for Medicaid earning must be at or below “$29,700 for a family of four.” [21] With this income threshold 10.4 % of the population are still uninsured [22, 23]. Due to the maze of admin duties and low reimbursement rates, many physicians refuse to care for Medicaid/Medicare patients, lessening options for those who are ill. The US system is over bureaucratic and de-incentivizes physicians to care for this sector of the population [24, 25]. 15% under Medicare live below the PL and can’t afford supplemental health insurance to fill in the gaps of Medicare. Often seniors don’t fill prescriptions due to lack of prescription insurance coverage. This furthers exacerbates health conditions and contributes to higher costs to Medicare for otherwise treatable issues [26]. The fee schedule for Canada’s Medicare is far less complex and is negotiated by province; even with this physician’s earnings remain higher than the general public and are competitive with US [27, 28]. The majority of middle class Americans with employee sponsored plans pay 10% of their income goes toward insurance; individual plans 22% of income. Many are underinsured or fail to seek medical help due to expensive co-pays and high deductibles that weigh heavily of family budgets [29]. III. Specialization: (See video top of round). Less than 1% of Canadians seek care in the US [30]. More recent than your 1998/1999 study explains the causes of rising medical cost, 2016. Drugs and new technologies are the major causes of rising costs. New technologies do not always result in better outcomes. Administrative cost has risen to 20-30%. Nowhere in your citations studies does it state that Canadians are seeking specialized services in the US. PRO:“Now had it not been for the private system these advancements would not have been made and the life expectancy would not have thrived …”Life expectancy in Canada is higher than in the US. IV. Cheapest Prices/Competition: As stated earlier, the US spends more money on healthcare than any other country. It’s competition in pricing is within the framework of what the market will bear, especially with drug companies, [31] as well as the push for new trendy treatments that might not have a higher benefit over the old in an effort to be completive with other hospitals; new is not always better, but certainly more expensive; marketing of medical services over actual medical value [31]. V. Doctor Choice: In the US insurance policies dictate the selection of doctors within a network of providers. Seeking doctors out of network will result in uncovered total out of pocket expense. In Canada anyone can see any doctor without restriction, a doctor or hospital’s reputation on care is easily accessible for any Canadian’s to review [32, 33]. VI. Health care is not a right? An opinion. If you have a sick or injured child and cannot afford medical attention, as a parent aren’t you denying this innocent his right to health and well being? We are all a part of a society and must contribute to the welfare of its whole for stability, as we do with police, fire, and public works. Not caring for members of a society who fall ill increases burden upon others and lowers productivity of all involved. Society bears higher costs for an unhealthy population than a healthy one. A doctor takes the Hippocratic Oath to benefit the sick above all else including payment for services. To deny health services due to lack of ability to pay is inhumane. What will the result be? Are we to put down the poor ill like dogs when their burden of care becomes overwhelming [34]? Canada has done a fine job of eliminating the middleman of insurers to keep costs down; there is no profit incentive so costs are held low. See above for the GDP of Canada’s cost of health care over the US. It speaks for itself. VII. Drug Availability: As you stated the US has the FDA which has an intensive drug approval process to determine if drugs are safe prior to distribution [35, 36]. Canada has a similar process. I fail to see the point here. VIII. Refusal of Treatment: Yes, hospitals cannot turn away patients based on their ability to pay. Again, due to the numbers of uninsured this places a financial burden on these institutions that have to make up the loss in revenue on the backs of those who have insurance. This is not an issue in Canada. Also, many doctors are refusing Medicare/Medicare patients due to low reimbursements rates and bureaucracy lessening the availability of doctors of individuals in these systems. X. Paying for things you find morally wrong: This again as is in healthcare as a right, is a personal value judgment of morality which is subjective and metaphysical in nature, not one based on secular notions of what is best for a society as a whole. 1. http://tinyurl.com... 2. http://tinyurl.com... 3. http://tinyurl.com... 4. http://tinyurl.com... 5. http://tinyurl.com... 6. http://tinyurl.com... 7. http://tinyurl.com... 8. http://tinyurl.com... 9. http://tinyurl.com... 10. http://tinyurl.com... 11. http://tinyurl.com... 12. http://tinyurl.com... 13. http://tinyurl.com... 14. http://tinyurl.com... 15. http://tinyurl.com... 16. http://tinyurl.com... 17. http://tinyurl.com... 18. http://tinyurl.com... 19. http://tinyurl.com... 20. http://tinyurl.com... 21. http://tinyurl.com... 22. http://tinyurl.com... 23. http://tinyurl.com... 24. http://tinyurl.com... 25. http://tinyurl.com... 26. http://tinyurl.com... 27. http://tinyurl.com... 28. http://tinyurl.com... 29. http://tinyurl.com... 30. http://tinyurl.com... 31. http://tinyurl.com... 32. http://tinyurl.com... 33. http://tinyurl.com... 34. http://tinyurl.com... 35. http://tinyurl.com.... 36. http://tinyurl.com... 37. http://tinyurl.com... 38. http://tinyurl.com...