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Infant Mortality, 1997 Deaths In First Year Of Life/1000 Live Births
Infant Mortality, 1997 Deaths In First Year Of Life/1000 Live Births
Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
Life Expectancy For Women, 1997
Life Expectancy For Women, 1997
Life Expectancy For Men, 1997
Life Expectancy For Men, 1997
Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
Health Spending, 1990 & 1998: U.S. Costs Rose More Than Other Nations’
Health Spending, 1990 & 1998: U.S. Costs Rose More Than Other Nations’
Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
U.S. Public Spending Per Capita for Health is Greater than Total
U.S. Public Spending Per Capita for Health is Greater than Total
Elderly as Percent of Total Population, 2000
Elderly as Percent of Total Population, 2000
Americans Lead the World in Hours Worked
Americans Lead the World in Hours Worked
Poverty Rates, 1997 U.S. and Other Industrialized Nations
Poverty Rates, 1997 U.S. and Other Industrialized Nations
On the one hand,
On the one hand,
Poverty-related illness is partly an effect of our health care system
Poverty-related illness is partly an effect of our health care system
Percent of Population with Government-Assured Insurance, 1997
Percent of Population with Government-Assured Insurance, 1997
Who Pays For Health Care
Who Pays For Health Care
Who Pays For Canada's NHP
Who Pays For Canada's NHP
Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
Why are hospital administrative costs less in Canada
Why are hospital administrative costs less in Canada
Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
Why are physicians’ administrative costs lower in Canada
Why are physicians’ administrative costs lower in Canada
Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
Why are Canada’s system administrative costs lower
Why are Canada’s system administrative costs lower
Number of Insurance Products
Number of Insurance Products
Private insurers’ High Overhead
Private insurers’ High Overhead
Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
Physician Visits Per Capita
Physician Visits Per Capita
Difficulties Getting Needed Care
Difficulties Getting Needed Care
Continuity of Care
Continuity of Care
Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
Minimum Standards For Canada's Provincial Programs
Minimum Standards For Canada's Provincial Programs
% Of People With Serious Sx Seeing A Doctor Before And After Passage
% Of People With Serious Sx Seeing A Doctor Before And After Passage
Infant Mortality U.S. & Canada, 1955-1996
Infant Mortality U.S. & Canada, 1955-1996
Infant Deaths by Income, Canada 1996 Even the Poor Do Better than U.S
Infant Deaths by Income, Canada 1996 Even the Poor Do Better than U.S
Homeless in Toronto Death Rate Elevated, But Lower than In U.S
Homeless in Toronto Death Rate Elevated, But Lower than In U.S
Depression Management: Better in Canada
Depression Management: Better in Canada
Physician Services For The Elderly: Canadians Get More of Most Kinds
Physician Services For The Elderly: Canadians Get More of Most Kinds
Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
Few Canadian Physicians Emigrate
Few Canadian Physicians Emigrate
Applicants per Medical School Place
Applicants per Medical School Place
What's OK in Canada
What's OK in Canada
What's the Matter in Canada
What's the Matter in Canada
U.S. Coalition of Service Industries
U.S. Coalition of Service Industries

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Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births

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1 Infant Mortality, 1997 Deaths In First Year Of Life/1000 Live Births

Infant Mortality, 1997 Deaths In First Year Of Life/1000 Live Births

Source: OECD, 1999 & NCHS

2 Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
3 Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
4 Life Expectancy For Women, 1997

Life Expectancy For Women, 1997

Source: OECD, 1999 & NCHS

5 Life Expectancy For Men, 1997

Life Expectancy For Men, 1997

Source: OECD, 1999 & NCHS

6 Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
7 Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
8 Health Spending, 1990 & 1998: U.S. Costs Rose More Than Other Nations’

Health Spending, 1990 & 1998: U.S. Costs Rose More Than Other Nations’

Source: Health Affairs 2000; 19(3):150

9 Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
10 U.S. Public Spending Per Capita for Health is Greater than Total

U.S. Public Spending Per Capita for Health is Greater than Total

Spending in Other Nations

Note: Public includes benefit costs for govt. employees & tax subsidy for private insurance Source: NEJM 1999; 340:109; Health Aff 2000; 19(3):150

11 Elderly as Percent of Total Population, 2000

Elderly as Percent of Total Population, 2000

Source: Health Affairs 2000; 19(3):192

12 Americans Lead the World in Hours Worked

Americans Lead the World in Hours Worked

Source: International Labor Organization, 1999

13 Poverty Rates, 1997 U.S. and Other Industrialized Nations

Poverty Rates, 1997 U.S. and Other Industrialized Nations

Source: Luxembourg Income Study Working Papers Note: U.S. figure for 1997, other nations most recent available year

14 On the one hand,

On the one hand,

Greater poverty makes our health care system work harder But on the other hand …

15 Poverty-related illness is partly an effect of our health care system

Poverty-related illness is partly an effect of our health care system

Our system for health care financing exacerbates the effect of poverty on health by making the opportunity cost high for the poor to obtain health care

16 Percent of Population with Government-Assured Insurance, 1997

Percent of Population with Government-Assured Insurance, 1997

Note: Germany does not require coverage for high-income persons, but virtually all buy coverage Source: OECD, 1999

17 Who Pays For Health Care

Who Pays For Health Care

Regressivity Of U.S. Health Financing

Source: Oxford Rev Econ Pol 1989;5(1):89

18 Who Pays For Canada's NHP

Who Pays For Canada's NHP

Province Of Alberta

Source: Premier's Common Future Of Health, Excludes Out-of-Pocket Costs

19 Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
20 Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
21 Why are hospital administrative costs less in Canada

Why are hospital administrative costs less in Canada

Global budgets Operating budget Capital investment budget Negotiated with Province No bills. No need to track and bill for individual services and goods

22 Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
23 Why are physicians’ administrative costs lower in Canada

Why are physicians’ administrative costs lower in Canada

Single payer One place to send bills One set of rules

24 Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
25 Why are Canada’s system administrative costs lower

Why are Canada’s system administrative costs lower

No need to determine who is eligible for what Canada’s overall administrative % close to Medicare (before Medicare + Choice), less than Medicaid No marketing of insurance No billing or collecting insurance premiums

26 Number of Insurance Products

Number of Insurance Products

27 Private insurers’ High Overhead

Private insurers’ High Overhead

28 Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
29 Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
30 Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
31 Physician Visits Per Capita

Physician Visits Per Capita

Source: OECD, 1999 - Data are for 1997 or most recent available year

32 Difficulties Getting Needed Care

Difficulties Getting Needed Care

Source: Commonwealth Fund Survey, 1998

33 Continuity of Care

Continuity of Care

Source: Commonwealth Fund Survey, 1998

34 Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
35 Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
36 Minimum Standards For Canada's Provincial Programs

Minimum Standards For Canada's Provincial Programs

Universal coverage that does not impede, either directly or indirectly, whether by charges or otherwise, reasonable access. Portability of benefits from province to province Coverage for all medically necessary services Publicly administered, non-profit program

37 % Of People With Serious Sx Seeing A Doctor Before And After Passage

% Of People With Serious Sx Seeing A Doctor Before And After Passage

Of NHP In Quebec

Source: NEJM 1973; 289:1174

38 Infant Mortality U.S. & Canada, 1955-1996

Infant Mortality U.S. & Canada, 1955-1996

U.S.

CANADA

FIRST PROVINCE IMPLEMENTS NHP

Source: OECD 1999, Statistics Canada & CDF

39 Infant Deaths by Income, Canada 1996 Even the Poor Do Better than U.S

Infant Deaths by Income, Canada 1996 Even the Poor Do Better than U.S

Average

40 Homeless in Toronto Death Rate Elevated, But Lower than In U.S

Homeless in Toronto Death Rate Elevated, But Lower than In U.S

Source: JAMA 2000; 283:2152

41 Depression Management: Better in Canada

Depression Management: Better in Canada

* Antidepressant prescribed + 4 or more visits Source: JGIM 1998; 13:77

42 Physician Services For The Elderly: Canadians Get More of Most Kinds

Physician Services For The Elderly: Canadians Get More of Most Kinds

of Care

Source: JAMA 1996; 275:1410

43 Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
44 Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
45 Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
46 Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
47 Infant Mortality, 1997 Deaths In First Year Of Life1000 Live Births
48 Few Canadian Physicians Emigrate

Few Canadian Physicians Emigrate

49 Applicants per Medical School Place

Applicants per Medical School Place

Source: JAMA; 282:892; Canadian Medical Education Statistics, 1999:150

50 What's OK in Canada

What's OK in Canada

Compared to the U.S….

Life expectancy 2 years longer Infant deaths 25% lower Universal comprehensive coverage More MD visits, hospital care; less bureaucracy Quality of care equivalent to insured Americans’ Free choice of doctor/hospital Health spending half U.S. level

51 What's the Matter in Canada

What's the Matter in Canada

The wealthy lobby for private funding and tax cuts; they resent subsidizing care for others Result: government funding cuts (e.g. 30% of hospital beds closed during 90s) causing dissatisfaction U.S. and Canadian firms seek profit opportunities in health care privatization Conrad Black, foe of public services, owns 2/3 of Canadian newspapers Misleading waiting list surveys by right wing group

52 U.S. Coalition of Service Industries

U.S. Coalition of Service Industries

“We believe we can make much progress in the [WTO] negotiations to allow the opportunity for U.S. businesses to expand into foreign healthcare markets... public ownership of healthcare has made it difficult for U.S. private-sector healthcare providers to market in foreign countries.”

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