Among the pillars of Canada’s health care system is the contention that it improves the health of the poor. By doing away with financial impediments to medical services, Canada’s socialized regime is supposed to enable the poor to live as healthily as the more well-to-do.
It turns out that is not true. Though the poor do go and see the doctor more often than would otherwise be the case, it doesn’t enhance their health outcomes. Evidently, all the doctor’s visits can’t overcome the persistence of unhealthy living habits. All this is according to a study, based on the Canadian experience, by David Alter, Therese Stukel, Alice Chong & David Henry in the February 2011 issue of Health Affairs.
As indicated in the abstract provided below, the authors call for early intervention programs to ensure people learn healthy behaviours. But wouldn’t this message already have been communicated by doctors? And if this hasn’t worked, why would sending the message earlier?
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Lesson From Canada’s Universal Care: Socially Disadvantaged Patients Use More Health Services, Still Have Poorer Health
David Alter, Therese Stukel, Alice Chong & David Henry
Health Affairs, February 2011, Pages 274-283
Abstract:
Lower socioeconomic status is commonly related to worse health. If poor access to health care were the only explanation, universal access to care should eliminate the association. We studied 14,800 patients with access to Canada’s universal health care system who were initially free of cardiac disease, tracking them for at least ten years and seven months. We found that socially disadvantaged patients used health care services more than did their counterparts with higher incomes and education. We also found that service use by people with lower incomes and less education had little impact on their poorer health outcomes, particularly mortality. Countries contemplating national health insurance cannot rely on universal health care to eliminate historical disparities in outcomes suffered by disadvantaged groups. Universal access can only reduce these disparities. Our findings suggest the need to introduce large-scale preventive strategies early in patients’ lives to help change unhealthy behavior.
