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transplants. Most of these services are regionalized, so that a small number of centers each perform a large number of procedures. Such regionalization improves the quality of care since high volume centers are better able to maintain competence, and minimizes costs by avoiding unnecessary duplication of expensive facilities.
Fact: The average length of stay in hospital is 20 to 40 percent shorter in the U.S. than in most other developed nations. Same-day surgery, as mandated not by doctors but by insurance carriers, is a cast in point.
Comment: Cost containment by cruelty.
Fact: U.S. and Canadian health care costs, as a percent of GNP, were almost identical from 1960 until 1971 when Canada’s single-payer system was fully implemented, after which Canada’s costs were significantly lower.
Fact: A study by the Senate Aging Committee and the GAO, comparing prescription drug prices in five countries, showed that in the U.S., Holland and Germany (all multiple-payer countries), such prices were substantially higher than in the U.K. and Canada, (both singlepayer countries). TTie reason why Canadians pay only 62 percent as much as American for identical pharmaceuticals is that the larger and powerful buyer—the single payer— has considerable leverage in price negotiations with the drug industry.
Fact: Despite our enormous wealth, the U.S. infant mortality rate is among the highest of any developed nation. The reason is primarily due to lack of access to prenatal care. According to a 1987 UNICEF study, the U.S. had and infant mortality rate of almost 10 per 1,000 births. The rate for Singapore was 8+ per 1,000, for Canada 7+ and for Sweden 5 +.
Fact: in 1989, life expenctancy for men in the U.S. was almost two years less than in Canada and other developed nations. The life expectancy for women in 1989 was about two years less than in Canada and several other developed nations.
Comment: Our high poverty rates and poor access to health care are responsible for this poor record.
Fact: A Harris poll asked a random sample of Canadians the following question: “In the U.S. system the government pays most of the cost of health care for the elderly, the poor and the disabled. Most others either have health insurance paid by their employers or have to buy it from an insurance company. Some have no insurance. Under the U.S. system people can choose their own doctors and hospitals. On balance, would you prefer the U.S. system of the system we have here (in Canada)?” The answers to this question were as follows: three percent preferred the U.S. system; 95 percent preferred the Canadian system and two percent were unsure. \
Conclusion: A sensible, economical, and humane national health plan should, like Canada’s, include the following elements:
• Universal, comprehensive coverage. This would eliminate two
91.2%