California Dreaming: The Fantasy of a Canadian-Style Health Insurance Monopoly in the United States

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The purpose of this paper is to warn Americans about the dangerous ideas contained in the Universal Health Insurance bill (SB-840) that was recently passed by the Democratic Party majority in the California state legislature and Senate, but which was later vetoed by Governor Schwarzenegger. The bill has now been resurrected and submitted again to the State legislature for another vote. Proponents of the bill want to impose a government-run, health insurance monopoly in California similar to the one that Canada has. But, the Canadian experience shows that this is a seriously misguided proposal that will harm the quality and availability of medical care in the United States. Americans might be concerned about escalating costs and gaps in health insurance coverage at home but, for different reasons, the Canadian system is in many ways much worse.

Despite the fact that Canadians spend less of their national income on health care than Americans, the evidence is clear that the Canadian health insurance system is still among the most expensive in the world and does not return good value for money spent. Health care appears to cost less in Canada than in the United States largely because Canadian public health insurance does not cover many advanced medical treatments and technologies that are commonly available to Americans. Canadian patients do not get the same quality or quantity of care as American patients. On a comparable basis, Canadians have fewer doctors, less high-tech equipment, older hospitals, and get fewer advanced medicines than Americans. If Canadians had access to the same quality and quantity of health care resources that American patients enjoy, the Canadian health insurance monopoly would cost a lot more than it currently does.

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