Single-payer traits worth emulating


While the healthcare system in Canada is more efficient than the U.S. system, former Cigna executive Wendell Potter highlights two facets of Medicare our neighbor to the north should embrace.

Canada should make its universal health insurance system even more public, embracing Medicare's federal arrangement and prescription drug benefit, according to Potter's article for the Center for Public Integrity. The single-payer program for the elderly and disabled consistently scores higher on customer satisfaction surveys than private payers.

The Canadian Medicare program does not cover medications. But by offering prescription drug insurance for seniors, the program could reduce the use of and spending on nonpharmacy medical services. Along with an 8 percent drop in hospital visits, prescription drug insurance was linked to a 7 percent decrease in Medicare payments per person for inpatient services, according to an April study from the University of Illinois and Johns Hopkins University in Baltimore. It was also linked to a 12 percent decrease in inpatient charges per person.

Private insurers in the United States also would be wise to emulate Medicare's Part D program. Insurers can attract and retain members by including prescription benefits in their exchange plan offerings, given more than half of Americans take at least one prescription a year and prescriptions account for more than 10 percent of medical spending, FierceHealthPayer previously reported.

Potter also highlighted the fact that under Medicare's federal arrangement, benefits and services remain consistent from state to state. However, the Canadian Medicare program has broad latitude in administering benefits and services, which results in different consumer experiences across provinces.

Experts from Canada, Denmark and other countries have maintained that a U.S. Medicare-for-all system would alleviate high administrative cost. In Canada, administrative costs average 1.3 percent, well below the average 31 percent for the U.S. healthcare system, Danielle Martin, M.D., vice president of medical affairs and health system solutions at Women's College Hospital in Toronto, Canada, told the Subcommittee on Primary Health and Aging last month. Martin also addressed U.S. concerns about socialized medicine, explaining that in Canada, insurance is public and hospitals and providers are private entities.

To learn more:
- read the Center for Public Integrity article

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