Canada: land of the happy health care consumer

I’m in Montreal today and enjoying the opportunity to catch up on Canadian news. Today’s Montreal Gazette has a story that’s tailor made for a visiting American health care blogger: Most Canadians satisfied with health-care system; But only 1-in-4 Quebecers happy.

According to the [telephonic]…  survey of 1,750 adults, 44 per cent rate the state of health care in Canada as good or excellent – an increase of seven percentage points since 2007 and 20 points higher than in 2004.

About the same number rate the state of health care as fair. Just one in nine say it’s poor or very poor, half as many as in 2004. As well, eight in 10 Canadians who have used the health-care system in the past year say they were satisfied with the care they received.

Ontarians are most satisfied, it found, with 57 per cent rating the health-care system as good or excellent. But that could soon change; the new Ontario budget limits funding increases to hospitals to 1.5 per cent next year. Quebecers are the least content. Just one in four say the state of health care is good or excellent.

The results echo what I usually tell people about the Canadian health care system: people are reasonably happy with the system, but results vary significantly by province. The province-by-province differences are not surprising, because health care is mainly administered and financed at the provincial level.

I’ve heard a fair amount of grousing from Canadians about health care: from doctors unhappy that their pay is constrained and from patients and families (at least in Quebec) worried about the impact cost control attempts have on their own access to care. What I don’t hear is fear about losing coverage, rising premiums and co-pays, or battles with insurance companies.

I also haven’t heard anyone pining for conversion to a US-style system.

There’s no way the US will convert to a Canadian-style system. And if somehow it happened you wouldn’t find Americans expressing as much satisfaction about such a system as Canadians do. Part of that may be national temperament: Americans the rugged individualists, Canadians more in the soft Western European mold.

And yet a lot of the opinion comes down to concerns about change. People are deeply uncomfortable with change, but once it occurs they get used to the new way of doing things and wouldn’t want to go back to what was there before. It’s one reason some Republicans are so eager to reverse the newly passed health care bill right away. They realize if they don’t get it done soon there will be growing grass roots opposition to changing things back along with the institutional inertia that builds up with the creation of new programs.

Don’t be surprised if within a few years –and maybe sooner– Republicans will be defending ObamaCare (though without using that term) just the way they attempt to defend Medicare today.

March 29, 2010

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