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Commentary

America's Failing Health
Paul Krugman, The New York Times, 8-27-04

Paul Krugman praises the health care programs of other advanced countries, without noting that they all face similar cost trends to the U.S., or, in some cases, even more ominous trends considering their more rapidly ageing populations. He also implies that the U.S. does worse than all its advanced peers on health indicators "by any measure of health care success you care to name" – which is a blatant falsehood.

The fact is that, among the OECD nations, each nation can point to some notable health care successes, and must admit to some failures. For instance Britain, which has a national health insurance system, has the worst cancer mortality rates among its advanced peers. Canada's system, which Krugman praises as all wine and roses, sends its middle class and upper class patients into the U.S. for services like heart bypass surgery, so they can skip the lengthy waiting lines for surgery that Canada’s system creates. Poor patients, of course, must make do with the "access" that Canada’s national health care system offers them.

Krugman should take a fresh look at European health care systems – where policymakers are moving market incentives back into national health care programs because of mounting concerns about cost, access to quality care, and patient frustration with limited choices. Contra Krugman, global trends are largely towards consumer-driven, market-based health care, not the Canadian cost containment first-and-last model.



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