national center for policy analysis making ideas change the world myths about national health...

National Center for Policy AnalysisMaking Ideas Change the World

Myths About National Health Insurance


Myth No. 1

Health Insurance is a right.Health Insurance is a right.


Waiting

Britain:Britain: 1 million1 million

Canada:Canada: 876 thousand876 thousand

New Zealand:New Zealand: 90 thousand90 thousand


Patients Having To Wait More Than Four Months For Surgery

5%

23%26% 27%

36%

United States Australia New Zealand Canada Britain


Number of Weeks Patients Wait between Referral by GP and Treatment, by Specialty, 1993 and 2003

17.7

6.18.1

11.11314.1

32.2

20.1

10.3

30

15.3

28.6

0

5

10

15

20

25

30

35

Pla

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Su

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Gyn

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Op

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Gen

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Su

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Neu

rosu

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Oth

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Car

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(Ele

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Myth No. 2

NHI delivers high quality careNHI delivers high quality care


Patients Seen Annually(Average per physician)

3,143 3,176

2,222

Canada U.K. U.S.


Patients Spending More than 20 Minutes with Their Doctor

30%

20%

15%12%

5%

United States Canada New Zealand Australia Britain


Use of High-Tech Medical Procedures( per 100,000 people per year)

27 41 5145.765

80.886.5

203

388.1

Dialysis Patients Coronary Bypass CoronaryAngioplasty

U.K.CanadaU.S.


Access to Modern Medical Technology in the U.S., Britain and Canada (2000)

(Units per million people)

8.2

2.5

0.4

13.6

8.1

1.5

6.5

3.9

0.2

CT Scanners MRI Units Lithotripsy Units

CanadaU.S.U.K.


Myth No. 3

Care is determined by need, not Care is determined by need, not ability to pay.ability to pay.


Private Health Insurance

New ZealandNew Zealand 1/3 Population1/3 Population

AustraliaAustralia 1/3 Population1/3 Population

BritainBritain 7 Million7 Million


Myth No. 4

Although the U.S. spends more, it Although the U.S. spends more, it doesn’t get more.doesn’t get more.


United States Life Expectancy(Men)

68

7375

77

81

65

70

75

80

85

African-American

AmericanIndian

White (Non-Hispanic)

Hispanic Asian-American

Years


United States Life Expectancy(Women)

75

8082

84

87

65

70

75

80

85

90

AfricanAmerican White (Non-Hispanic)

American Indian Hispanic Asian-American

Years


Percent of the Population Age 15 and Older That is Obese

22.5%

19.3%17.3% 17.1%

12.5%

6.5%

United States(1997)

United Kingdom(1998)

Australia (1995) New Zealand(1997)

Canada (1996) France (1992)


Pregnancy, Childbearing and Abortions among Girls Ages 15-19

(per 1,000)

45.4

83.6

24.2

54.4

21.229.2

Canada U.S.

PregnancyBirth RateAbortion Rate


Breast Cancer Mortality Ratio(Percent of those with the disease who die from it)

46% 46%

31%28%

25%

35%

28%

New Zealand UnitedKingdom

Germany Canada United States France Australia


Prostrate Cancer Mortality Ratio(Percent of those with the disease who die from it)

35%

49%

19%25%

44%

30%

57%

New Zealand UnitedKingdom

Germany Canada United States France Australia


Percent of Americans Ages 45-64 Reporting Health as “Good”

81.8 84.974.2

58.2

71.775.6

71.1 71

85.4

Australia (1997) Canada (2001) Denmark (2000) Germany (1998) Netherlands(2000)

Norway (1998) Sweden (2000) U.K. (2000) U.S. (2000)


Percent of Americans 65+ Reporting Health as “Good”

70.8 70.2

59.7

47.4

56.862.3

55.5 56.5

72.6

Australia(1997)

Canada (2001) Denmark(2000)

Germany (1998) Netherlands(2000)

Norway (1998) Sweden (2000) U.K. (2000) U.S. (2000)


Percent of Adults Reporting Fair or Poor Health

30%

23%20%

31%

37%

10% 9%6%

10% 9%

0%

5%

10%

15%

20%

25%

30%

35%

40%

Australia Canada New Zealand United Kingdom United States

Below Average Income Above Average Income


Myth No. 5

Everyone is treated equally.Everyone is treated equally.


Per Capita Spending on Physician Services in British Columbia

$199.00

$410.00

$125.00$106.00

Specialists General Practitioners

Vancouver

Vancouver

Peace RiverPeace River


Inequalities in the Use of Physician Services Among Urban and Rural Patients in British Columbia

(Per capita spending 1993-4)

$6.50 $5.70

$13.50$11.50

$22.60

$7.10

$1.00

$5.70$4.70

$8.60

$2.80$2.40

Dermatology Neurology OB/GYN Pediatrics Psychiatry Thoracic Surgery

Urban Rural


Myth No. 6

Health care delivery is efficient.Health care delivery is efficient.


Average Length of Hospital Stay

Days6.4 Days

5.4

Days6.2

Days9.6

Days7.1 Days

6.2

OECDMedian

U.S. U.K. Germany Canada Australia


Acute Care Beds in Britain

15% Empty15% Empty

15%15% Non-Acute Patients Non-Acute Patients


Kaiser California vs. NHS Specialists per 100,000 People

12.3

8.3

2.4

4.94.1

0.8

Pediatricians OB/GYNs Cardiologists

KaiserNHS


Administrative Costs as a Percent of Medical Expenditures in the United States

27%

16%

0%

5%

10%

15%

20%

25%

30%

Medicare and Medicaid Private Insurance


Myth No. 7

No discrimination.No discrimination.


Minorities

Canada:Canada: Cree, InuitsCree, Inuits

New Zealand:New Zealand: MaorisMaoris

Australia:Australia: AboriginesAborigines


How the Elderly Evaluate Their Health Care

7%

14%

4% 4%

40%

23%

11% 10%

51%

23%

13% 14%

Experienced Long Wait forNonemergency Surgery

Difficulty Gaining Access toa Specialist

Long Wait for SeriousSurgery

Received InadequateOutpatient Services

U.S.CanadaU.K.


Myth No. 8

Costs are controlled.Costs are controlled.


Average Annual Real Growth in Per Capita Health Spending

1960-1998

2.6%2.3%

2.6%

3.5%

2.7%

0.8%

2.5%2.6%

0.00%

0.50%

1.00%

1.50%

2.00%

2.50%

3.00%

3.50%

4.00%

U.S. U.K. Canada Australia New Zealand Germany Netherlands Japan


Rate of Inflation

0%

10%

20%

30%

40%

50%

1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

Medical Services

All Goods

Cosmetic Surgery


Myth No. 9

Spending priorities are determined by Spending priorities are determined by medical need.medical need.


British National Health Service

Nonemergency ambulance ridesNonemergency ambulance rides 15,000,00015,000,000

Missed physician appointmentsMissed physician appointments 10,000,00010,000,000

Patients receiving nonmedical Patients receiving nonmedical

servicesservices 1,500,0001,500,000

AnnualAnnual


British National Health Service

Home alterationsHome alterations 375,000375,000

Occupational therapyOccupational therapy 456,000456,000

Day care servicesDay care services 260,000260,000

Homecare/Home helpHomecare/Home help

ServicesServices 578,000578,000

Annual


Myth No. 10

Problems can be reformed away.Problems can be reformed away.

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