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US ushers in its new health care bill

In what has been called “a hard-fought victory for President Obama“, the Affordable Health Care for America Act (HR 3962), passed November 7, 2009 in the House of Representatives. The vote was 220:215, an extremely narrow victory (218 votes were needed to pass the bill). Among other things, the bill prohibits insurers from charging different rates or refusing treatment based on a patient’s medical history or gender, requires most employers to provide health insurance, increases Medicaid eligibility to cover more low-income people, a subsidy plan for low- to middle-income people to buy insurance, a central health insurance exchange where people can compare plans and rates, as well as a government-run insurance program.

In an earlier post, while the US was gearing up for its health care talks, I wrote extensively about some of the myths concerning public health care provision. Among these was the claim that public health care is much more expensive than private health care, which is simply not the case. In addition to the data I provided in that post, the Canadian Institute for Health Information’s annual report on health care spending was released today. According to their figures, Canada’s health care costs rose by 5% to $183.1 billion in 2009 compared to 2008. Canada’s per capita costs are highest at the early and late stages of life: $8,239 for an infant under one year old, and up to $17,469 for an adult over 80 years old. For those aged 1-64, the per capita cost is only $3,809 per person. There are also interesting regional differences, with Alberta and Newfoundland and Labrador having the highest per capita costs and BC and Quebec having the lowest. Our costs are in the top 20% worldwide: presumably the 20% with socialized health care systems, since our costs compare to France, the Netherlands, Germany, and Austria.

How do we compare to the US? The per capita cost in the US is $7,290 US, almost double Canada’s average of $3,895 and the highest of 26 countries surveyed by the Organisation for Economic Co-operation and Development (OECD). While Canada’s increased from 10.8% of the GDP in 2008 to an estimated 11.9% in 2009, the CIHI reported that the US was forecasting a similar increase in spending, up to 17.6% of its GDP. Interestingly, they also write that health care spending spikes during economic recessions.

The battle isn’t over yet in the US, which plans to take their health care bill to the Senate. Only one Republican in the House of Representatives voted for HR 3962, and 39 Democrats voted against it; the Democrats will need 60 of 100 votes in the Senate to end debate and bring the legislation to a vote. This was in part due to some controversial amendments at the last minute that added in some flexibility for states in dealing with abortion. Speaker of the House Nancy Pelosi compared the passage of the bill to the 1935 passage of Social Security, but it will be a rough run at the Senate if the abortion issue remains unsolved.


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