HealthLawProf Blog

Editor: Katharine Van Tassel
Concordia University School of Law

Monday, July 11, 2005

Canadian CABG's Half as Expensive as U.S. Version

From Modern Healthcare's Daily Dose:

Coronary artery bypass graft surgery costs about twice as much, on average, in a U.S. hospital than in a Canadian hospital, $20,673 vs. $10,373, with no difference in clinical outcomes, according to a study in [today's] Archives of Internal Medicine. Adjusting for clinical and demographic differences, the U.S. cost was 74.8% higher than the cost in Canada. The difference may largely reflect higher administrative overhead in the U.S. healthcare system, with its multiple payers, than in the single-payer Canadian system, said Mark Eisenberg, a physician at Jewish General Hospital in Montreal who helped lead the study. Defensive medicine and higher across-the-board costs in general also may be factors, Eisenberg said, adding that gauze pads cost twice as much in the U.S. as in Canada. The researchers compared outcomes and treatment costs for 4,698 bypass patients at five U.S. hospitals and 7,319 bypass patients at four Canadian hospitals.

The article is available for free only in abstract form.

On a not unrelated point, the Daily Dose ends with a link to and excerpt from yesterday's AP article by Matt Leingang, "Universal Health Care Push Being Revived."  The major points:

  • Advocates of a single-payer system — where the government would collect taxes and cover everyone, similar to programs in Canada and across Europe — have introduced bills in at least 18 state legislatures. Some are symbolic gestures, but heated debate is taking place in California and Vermont. Even in Oregon, where voters rejected a single-payer proposal as recently as 2002, voters are organizing another ballot measure for 2008.

  • In Ohio, doctors, union officials and religious leaders are gathering signatures to get a single-payer health system placed on a ballot next year.In Ohio, doctors, union officials and religious leaders are gathering signatures to get a single-payer health system placed on a ballot next year.

  • "The level of misery with private insurers is rising, and that's why we're seeing this increased activity," said Larry Levitt, vice president of the California-based Kaiser Family Foundation, which analyzes health care issues. "But whether one state can succeed, I don't know."

  • Claims that the system would cost less have merit, said John Sheils, vice president of the Lewin Group, a Virginia consulting firm that conducted a study last year of how a single-payer system would work in California. The study found that the state would save $343.6 billion in health care costs over 10 years.  But Sheils said a single-payer system isn't a panacea. States could be hard pressed to keep funding levels adequate during recessions, when tax revenues decline. "There are positives and negatives with all types of health systems," Sheils said. "The question that has to be asked is what are we getting out of our existing multipayer system that is worth all the money we are spending on it?"

  • In any event, voters are still leery. A Kaiser Foundation poll released earlier this year found that 55 percent of Americans opposed a single-payer health system. Thirty-seven percent favored it.

We haven't heard the last of this debate . . . . [tm]

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