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Your middle man is the government and they are taking their lb of flesh and more. And the % of uninsured is more like 16%. The people that love medicaid are dead beat welfare rats in most cases, so yea they love it.

The data do not show that rising health care costs are due to insurance companies. The majority of Americans get their private healthcare insurance through non-profit healthcare insurers. On average these insurers spend about 10% of premiums to run their companies and perform administrative functions and some are more efficient at about 7 percent. They have a low rate of fraud, roughly one to one and a half percent. If you add it all together that gives about 11 percent for overhead. That means about 89 percent of premiums go to actual care.

If we look at Medicare in the US, the cost of processing claims and membership (done by private insurers contracted by the government) is about three percent. Then you need to add the cost of running CMS (Center for Medicare and Medicaid Services). the cost of the IRS collecting the premiums and the cost of congressional and other government oversight. If you add all this up (the government won't actually supply this number) you get probably something over ten percent. However, Medicare fraud is 1000% higher than in the private sector so you have to add another 15% or so to the 10% admin costs. This gives a conservative total of over 20% administrative costs and fraud/waste. So for Medicare, less than 80% of premiums go to pay for actual care. And Medicare provides a single one size fits all product in contrast to private insurers who provide hundreds of different products.

Thus, Medicare is actually less efficient than non-profit private health insurance and a lower percentage of premiums (and tax dollars) are spent on actual care. I would note that for-profit insurers (Aetna, Cigna, Humana etc.) usually spend a lower percent of premiums on actual care because they spend a lot on advertising. My guess is that costs for Canadian health care are similar to Medicare though I don't have the figures to prove it. I don't doubt that the government will claim greater efficiency by not including all the costs (this is what government health care proponents do in the US, they only include claims and membership costs and don't include the other costs or the fraud) but if you add up ALL the costs it is likely not terribly efficient simply because government programs are rarely efficient.

The percent of premiums spent on actual care by private insurers has remained relatively constant over the last few decades while the cost of healthcare has increased dramatically. The reason is that the cost of care itself has increased. A major reason for this is that many things are possible now due to new technology that couldn't be done thirty years ago. Innovation in medicine costs lots of money and so all these new treatments and technology drive up the cost of health care. Defensive medicine and other factors also contribute but I don't think they are the primary drivers of health care inflation.

Finally, much (but not all) of innovation in medicine worldwide comes from the US. We in the US pay the bill for much of medical innovation that then gets used in other countries. This is a major reason why drugs cost less in Canada and other countries. Most new drugs come from the US and due to patent laws, this cost is mostly borne by US consumers who in effect subsidize other countries that charge less for the drugs.

It's all quite complicated but just saying that health care is expensive because of insurance companies is inaccurate.

Penicillin was disscovered in Scotland, insulin in Canada. A terrific American helped save thousands from polio. The first heart transplant was done in south Africa. Many wonderful drugs like asperine are based on traditional medine. Of course Bayer is German. From here itlooks like today American sience is focussed on hair loss and erectal dissfunction. Everyone has contributed much.
Just sayin.

The anecdotal evidence you cite is true and as I acknowledged, medical innovations do come from everywhere. Nevertheless, looking at aggregate numbers for new drugs, a lot are coming from the US.

http://www.dailyfinance.com/2010/11/30/where-do-new-drugs-come-from-u-s-biotechs-lead-the-way/

That was really a side comment anyway. My main point was about the role (or lack thereof) of insurance companies in health care inflation.

Yes, but the first baboon to human heart transplant was done in California.

But where was the first baboon to white house trsnsplant done?

Need a liberl application of spell check here. Whoa!
Makes for tough reading. Let me assist you.

We don't begrudge you your system. The biggest objection we have in the US against a 1 payer system is 1.) being forced into paying for somebody else and 2.) the inevitable rationing and loss of choice.

Our laws and our legal system is different from yours. You have caps on liability claims. Ottawa had sense enough to put forth tort limits on drugs and Health Care providers to contain costs. That will never happen here. You also don't have a flood of of poor and indigent immigrants from Latin America that are being taught how to suck off the system. We do.

I should also mention two other factors that are driving up the cost of Health Care in the US. First, is Medicare, which reimburses only about 60% of the cost of providing a procedure. That forces providers to shift fees over to non-Medicare procedures to make up for that every increasing 40% loss. Lastly, in the US, some 70% of all Health Care costs are channelled into the last 24 months of life. We will do extraordinary measures to extend life 1 day in many cases.

I am 66 years into a reasonably healthy life. I have absolutely no complaining to do about our health care, at least here in Saskatchewan. NO COMPLAINTS.

What I see as a problem is the Emergency waiting rooms in the cities (Regina is my only experience) being packed with people who don't seem to have an "emergency" health problem.

Sadly, too many lefties seem to resist the idea of allowing private health care to operate. A First Nation offered to put in an MRI service and operate it privately. My goodness, you would have thought they had offered to kill people for a fee! All the racists and socialists threw up such a clamour that the idea went by the wayside. I guess it is much better to fly out of province to receive a timely MRI.

Go figure. All in all, we have good care given to us, at least here in former left wing socialist Saskatchewan. Of course, the good NDP hacks push up to the front to take all the credit.

Rectal dysfunction can be a chitty issue.

More taxes are spent on health care in the USA than in Canada.
Health care is one of the most expensive items of both nations� budgets. In the United States, the various levels of government spend more per capita on health care than levels of government do in Canada. In 2004, Canada government-spending was $2,120 (in US dollars) per person on health care, while the United States government-spending $2,724.[68]

A 1999 report found that after exclusions, administration accounted for 31.0% of health care expenditures in the United States, as compared with 16.7% of health care expenditures in Canada. In looking at the insurance element, in Canada, the provincial single-payer insurance system operated with overheads of 1.3%, comparing favourably with private insurance overheads (13.2%), U.S. private insurance overheads (11.7%) and U.S. Medicare and Medicaid program overheads (3.6% and 6.8% respectively). The report concluded by observing that gap between U.S. and Canadian spending on health care administration had grown to $752 per capita and that a large sum might be saved in the United States if the U.S. implemented a Canadian-style health care system.[69]

However, U.S. government spending covers less than half of all health care costs. Private spending for health care is also far greater in the U.S. than in Canada. In Canada, an average of $917 was spent annually by individuals or private insurance companies for health care, including dental, eye care, and drugs. In the U.S., this sum is $3,372.[68] In 2006, health care consumed 15.3% of U.S. annual GDP. In Canada, only 10% of GDP was spent on health care.[5] This difference is a relatively recent development. In 1971 the nations were much closer, with Canada spending 7.1% of GDP on health while the U.S. spent 7.6%.[citation needed]

Some who advocate against greater government involvement in health care have asserted that the difference in health care costs between the two nations is partially explained by the differences in their demographics.[70] Illegal immigrants, more prevalent in the U.S. than in Canada,[citation needed] also add a burden to the health care system, as many of them do not carry health insurance and rely on emergency rooms � which are legally required to treat them under EMTALA � as a principal source of care.[71] In Colorado, for example, an estimated 80% of illegal immigrants do not have health insurance.[71]

The mixed system in the United States has become more similar to the Canadian system. In recent decades, managed care has become prevalent in the United States, with some 90% of privately insured Americans belonging to plans with some form of managed care.[72] In managed care, insurance companies control patients' health care to reduce costs, for instance by demanding a second opinion prior to some expensive treatments or by denying coverage for treatments not considered worth their cost.

Administrative costs for health care are also higher in the United States than in Canada.[7

After waiting 8 months for a hip replacement I spent a lot of money went to Thailand and got it done. I'd probably be still waiting and homeless living in a dumpster and eating garbage if I had waited on Canada's screwed up system to help me.

I get Canadians being proud of your system. However, with all due respect the quality isn't there.
However, with Obama care we are in a race to the bottom.

The lucky few.

The figures you are quoting are mostly baloney. The "report" you list is obviously by someone with an agenda using selective statistics. I can't imagine how they calculated a 31% admin overhead for healthcare in the US unless they are looking at the Veterans Administration which is run by the government. The US does spend more on healthcare than Canada because people have the freedom to get the care they want. This may not always be the most efficient but that is what people want. In Canada you get what the government thinks you need. If you look at people with serious medical problems (cancer, heart disease etc.) people live considerably longer on average with these conditions in the US than they do in Canada.

My earlier post debunks much of what you list. The overhead for government run healthcare is far higher than in the private sector but governments are good at obfuscating the real costs. You're citing incomplete government statistics designed to make the government look good.

Our system has failed my family and I badly. I personally pay much more into the system than most Americans would ever dream of. I live in southern Ontario which is the most densely populated area of Canada.

Our family Doctor retired 2 years ago and we have been on a waiting list since then to have a new one assigned(referred?) to us -no end in sight for that. That means basically the only way for us to access the system is through the emergency room, which involves a 7 to 9 hour wait to see a physician in our locale. Sometimes its faster but I would say that is a good honest average based on my experience.

This is the tip of the iceberg. In the last 2 years we have had:

a newborn daughter that was severerely damaged by the delivery doctor (or his intern-we don't know which)... no apology, no blame laid- just "don't let the door hit you on the ass on the way out"

My wife having to endure several extremely painful ruptured cysts in her ovary's without a referral to a Gyno to see what the problem is.

A 9 hour wait in emergency for me to get a prescription for a guardia infection I picked up on a grizzly hunt in BC.

My 2 year supply of blood pressure meds that our old Family doctor gave me prescriptions for is about to be finished- The pharmacist tells me I have to get a prescription before I can get more. I'm sure this will lead to another 7 to 9 hour wait for me- to get a prescription- I'm semi worried that whatever emergency room doc I end up with will probably only give me a 30 day scrip- that will necessitate me repeating the process all over again next month...

These are what come to the top of my head- I'm sure there's more if I sit and think about it for a while....

Our system is broken, badly.

Could anyone put up a time line on Canadian health care over the years?
How did it get to this point?

I don't think that would be worthwhile because things vary so much geographically. I haven't lived in Canada for a while but when I did I moved around a LOT and some areas had MUCH better medical care than others (including waiting times).

I suspect the amount of variation geographically may have stayed the same or even increased in recent years though. For example, in the past 2 years friends and relatives in Canada (Southern and Central Ontario; Manitoba (near Winnipeg) have needed:

1) one MRI had to wait a week but meeting the doctor and initial Xrays were the same day

2 another MRI had to wait 2 weeks but was for a knee problem so clearly not life-threatening

3) a complete knee replacement (just a 2 month wait after diagnosis -- I expected the wait to be much longer in Central Ontario but evidently a lot of medical practitioners wanted to get out of Toronto, but be within a morning's drive, so even small centres seemed to have no problem attracting doctors -- in contrast to, say, Temagami perhaps)

4) kidney stone shockwave lithotripsy (4 weeks but could have been done within 2 weeks if he had been willing to go to a different hospital which was a 2 hour drive away).

5) I also know of one elderly lady whose doctor retired, and she had to make use of the Emergency Room for 6 months until she got a regular doctor again (as noted above). During this time, she had to wait 6 hours to see a doctor just to get her blood pressure checked and prescription refilled.

6) dermatologist: 5 months wait for a fairly severe cosmetic problem on the face, but Winnipeg lacked dermatologists for some reason). This was a teenager, and this delay was the worst of these six in my opinion. Not life-threatening, but teenagers can be so cruel -- and I suspect they were.

John

I'm only 41 so I cant offer as complete a timeline as some of our more ahem "experienced" posters.

But as far as emergency room waits I can remember in high school going to the emergency room meant a four hour wait for sure...

There has been a bit of a stink going on in Ontario about wait times lately so the "health minister" has been publishing some figures lately:
- "90 per cent of patients who need to be admitted are checked into a bed in 27.9 hours or less".... their own published target is 12.2 hrs. Yay! Only 28 hrs to get admitted to a bed for acute care. AND don't overlook the fact that this is only 90%- one in ten poor bastard that is looking at some indeterminate amount of time to get that bed. 2 days-3 days? on a chair or the floor of the emergency room...?

-"In 2009, Canada had 1.7 acute-care beds for every 1,000 Canadians, putting it second last in a ranking of 34 OECD countries. The OECD average is 3.4 beds per 1,000."
Yay again! We are doing great there. I'm not exactly sure who we beat but china, india, indonisia, malaysia are all OECD countries- so all of them are kicking our ass but 1....

That's what my 5 minute google search turned up regarding emergency wait times anyways... which closely matches with my own first hand experience. I don't believe for a minute that real world wait times are anything close to what the .GOV publishes... You KNOW that those statistics are massaged very-very hard by about 5 levels of bureaucracy before they are released to the unwashed masses like me.

Pay very careful attention to this comment by 378canuck. It sums up our system very well

"After waiting 8 months for a hip replacement I spent a lot of money went to Thailand and got it done. I'd probably be still waiting and homeless living in a dumpster and eating garbage if I had waited on Canada's screwed up system to help me"

Phugging Thailand is a better option for healthcare than our system... it not like Thailand is known the world over for its cutting edge medical system and great standard of living- This saddens me soo much

This exactly mirrors my experience with OHIP. Ask him (or me) how much he has contributed into the health care system- the answer will shock any americans... I guaranteeeee it.