Saturday, December 5, 2009

Medical Services Received: The Uninsured in U.S. = Canadian Universal Coverage

While researching on the origin of the oft quoted "47 million uninsured," I stumbled onto a wonderful article by June and Dave O'Neill, "Who are the Uninsured?" One of several aspects of the health-care coverage issue which they analyze is a comparison of the amount and type of services received between those with insurance in the U.S. and those without. As you would expect, those with insurance obtain more medical services, but there are some fascinating details about this.

First, when looking at who received a routine check-up, flu shot, mammogram, PAP smear, PSA test (screen for prostate cancer) and a blood pressure check with the past 2 years, the uninsured received 50-60% of the services that those with insurance received! Not bad. When measured as dollars per capita, the uninsured received only 40% of what the insured received, significantly less but still a substantial amount of health care.

But most interesting of all, the authors compared cancer screening rates of the U.S. uninsured to rates in Canada under universal health coverage. Forty-nine percent of uninsured U.S. women aged 40-69 had a mammogram within the last 2 years, whereas 65% of these women had one within the past 5 years--which is identical to the percent of Canadian women who received a mammogram over the same time period! This equivalence also holds for PAP smears, with 80% of both Canadian women and U.S. uninsured women receiving this cervical cancer screen within the past 5 years. The rate for insured U.S. women is higher at 92%.

Men fare even worse in Canada. In the past 5 years, 16% of Canadian men aged 40-64 received PSA testing, compared to 31% of U.S. uninsured and 52% of U.S. insured men.

(Click on image to enlarge)

Our system is not perfect. Too many individuals are currently priced out of health insurance and consequently forgo needed medical care. But as the above figures demonstrate, the answer is not more government involvement. The solution is to understand what has made the cost of health insurance premiums and of medical care rise faster than the the general rate of price inflation.

But that will have to wait until another post.


BMO life insurance said...

Hi. I think that the major problem of this desperate health care insurance situation in the US are the insurance companies. Health care shouldn't be a profitable business, it is about helping people. However, the figures show us otherwise. More than 15% of the American population is not covered at all because people can't afford to pay for it and I am afraid it will get worse.
All the best,

HaynesBE said...

I strongly disagree that health care should not be "a profitable business." I think it is the non-existence of profit-driven medicine which has led to rising costs and decreasing affordability. Yes, it is tragic that so many are priced out of medical care and health insurance--but the forces which have artificially driven up prices are government mandates and regulations, licensing restrictions which limit supply, while subsidies increase demand.

Medical care and health insurance are goods and services which, if allowed to, will function as all other goods and services--increasing in supply and quality as demand and profit margins are used to direct the flow of scarce resources to the most efficient users.

Just as a significant portion of unemployment is caused by minimum wage laws, a significant portion of the uninsured is caused by the artificially high prices of medical care mandated by government. Until we allow the free market to really work, we will never know how many truly are unable to find work or afford medical care.

Anonymous said...


This was fascinating data and a great response to everyone who thinks we should move to a Canadian-style health-care system. Hey - turns out that what we've got is already equal or better for the uninsured!

Great research and post!

- cfc

HaynesBE said...

Thanks Chris!
I just wish more people could understand this.