Krugman misjudges the Canadian Health Care system

I actually heard this on the radio last week, but the Club For Growth gives a good summary:

In a debate sponsored by Intelligence Squared US, liberal economist Paul Krugman tried to defend universal healthcare, but in the process, got humiliated by the audience. Check out this wonderful excerpt from the transcript (PDF):

PAUL KRUGMAN
And private insurance? That’s the thing, I— Actually, can I just —I wanted to ask a question. And—

JOHN DONVAN [MODERATOR]
Please—please do—

PAUL KRUGMAN
—and I wanted to ask, actually two questions, to the audience. First, how many Canadians, would Canadians in the room please raise your hands. [ONE PERSON APPLAUDS, LAUGHTER]

JOHN DONVAN
We have about seven hands going up—

PAUL KRUGMAN
Okay, not as many as I thought. Okay, of those of you who are not on the panel who are Canadians,, how many of you think you have a terrible health care system. [PAUSE] One, two—

JOHN DONVAN
We see—almost all of the same hands going up. [LAUGHTER]

PAUL KRUGMAN
Bad move on my part. [APPLAUSE]

This is funny because Krugman completely misjudged his audience, and because I don’t like him because I think he’s a tremendous blowhard.

I’m not going to try to argue that the response of the 7 Canadians in question prove that the Canadian healthcare system is inadequate or inferior to the US system.  Obviously it’s too small a sample size and the nature of the debate probably skewed the ideology of Canadians participating.

What I am going to argue is this:  the Canadian healthcare system is not overwhelmingly better or preferential to the US system, as evidenced by the sheer number of Canadians that emigrate to the United States on a consistent basis.

The yearly flow of US citizens to Canada each year has been up and down over the past 15 years, with no clear trend, but seems to hover around 5,000 (plus or minus 1,000) [chart].

The yearly flow of Canadian citizens to the USA also has no clear trend, but appears to be about 15,000/year, with a range between 10,000 and 20,000. [chart]

I believe people vote with their wallets, and they vote with their feet; and at least 3 to 1, people choose to stream into the US and live with the terrible healthcare system* we have than stay in Canada where they get free health care*.  If you consider the migration patterns in proportion to their populations, it looks even worse for Canada:  1 in 2200 Canadians run south of the border, and 1 in 60,600 Americans take off to the Great White North.

It seems that Canadians are far more likely to become Americans than to die in a traffic accident, although they’d probably consider the latter more tragic.

* HEATHLY DOSE OF SARCASM, IF YOU DIDN’T GET IT

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7 Comments

Filed under damn lies, politics

7 responses to “Krugman misjudges the Canadian Health Care system

  1. Nathanael

    Um, Canadians who come to the US but do *NOT RENOUNCE THEIR CANADIAN CITIZENSHIP* keep Canadian healthcare.

    So your numbers are utterly, utterly meaningless. Sure, maybe getting free Canadian healthcare *and* being in the US is better than getting free Canadian healthcare and being in Canada. So what?

    Thanks for playing!

  2. Jake

    Hadn’t thought of that. It’s true, most of my Canadian friends who have emigrated to the U.S. have kept their Canadian citizenship. The healthcare must be the reason. I can’t think of any other reason.

  3. Lincoln

    Your numbers argument is ridiculous. Not only because we keep our healthcare but because we’re going to the USA *despite* your terrible healthcare system*, not because of it. There’s a reason that Canadians who travel to the USA, even for very short periods of time, buy health insurance: we know that your system is a nightmare!

    I’m a 41 year old man. I’ve had the usual maladies and mishaps that a person my age has had (pneumonia, broken bones, sprained muscles, various aches and pains…. whatever); meaning I’ve not had serious issues like cancer attack me. That said, I have the same fears that most people do: that something will strike me out of the blue. For instance, a friend was diagnosed with cancer not too long ago and she is the same age as me and it really hits home.

    But those illnesses are scary enough on their own. I can’t imagine the added burden that must come to someone with such a condition who also has to worry about how they’re going to pay for their care. It’s ludicrous, really. Someone diagnosed with such a sickness is the last person that should be worrying about their finances. But Americans, well the not-so-well-off-financially ones anyway, must have that as a constant worry. “What if I get sick? I’ll go bankrupt. My family will be homeless,” etc. As we’ve learned from the various horror stories that have come out even having insurance ensures nothing. Your insurance company can just make up some nonsense about how it’s not covered or you had a preexisting condition or whatever.

    It’s baffling to me that anyone would want that system.

    I used to read the web site ask.metafilter.com a lot. And every time a health related question would be asked, I would just think, “Why don’t you just go to the doctor?” People would post there: “I woke up with an intense pain in my lower abdomen and it won’t go away. What do you think it is?” or “I’m having trouble breathing. What should I do?” and my mind would be reeling…. “Go the doctor!” But then I realized, “Oh, they’re American. Maybe they don’t have any money or insurance,” and it strikes me that never in my life have I ever had to consider such a thing. If I’m sick, I don’t post a query on a web site and hope some anonymous stranger has been stricken with the same symptoms. I go to a doctor.

    *No sarcasm intended.

  4. wow, I missed a flurry of activity here.

    Nathanael: as I understand it, the provincial healthcare systems require you to be a permanent resident of the province and I thought you had to be working (or on the dole). you can’t just live in the US as long as you want and go back up there for healthcare: http://www.health.gov.on.ca/english/public/pub/ohip/eligibility.html

    other provinces may vary, I suppose.

    Jake (and Nathanael) — I suppose some people would keep their Canadian citizenship in order to keep the healthcare for catastrophic events, but it doesn’t seem practical for day-to-day health maintenance. are you going to run north of the border when you have aches and pains? maybe if you’re on a border-town, but it’s not like I’m going to fly from DC to Toronto to visit my primary care provider. and given that there are residency restrictions, I wouldn’t run the risk of living in the US for 8 months hoping that OHIP will take me back if I develop cancer.

    I know it’s only Wikipedia, but their section on cross-border healthcare is interesting: http://en.wikipedia.org/wiki/Canadian_health_care#Cross-border_health_care; Canadians go to the US for critical care, Americans go to Canada for marijuana. 🙂

    and Lincoln: right, you go to a doctor (if you can get on their schedule) and then you wait 8-12 weeks for an MRI. we get an MRI within a week. No sarcasm intended.

    • Lincoln

      Re: the “if you can get on the schedule” statement. This is *not* an issue. I often call my doctor the same day and have no problem getting an appt. If there is a problem, I usually just go the next day. Of course, if I tell them it’s something particularly troubling, they’ll get me in more promptly. And I live in the province that your media constantly offers up as an example of poor wait times. I, nor anyone I’ve ever spoken to about it, has complaints about the wait times.

      re: the MRI: you’re able to get an MRI promptly if it’s needed promptly. Do Americans truly believe that we’ve got people who are dying because of the wait times here? I mean, if it were the case, right wingers would have trotted them out already. The one they have trotted (Shona) turned out to be lying. She didn’t have a tumor, she had a cyst, and it was not life threatening and would have been dealt with properly if she weren’t a paranoid crackpot.

      The thing I don’t understand is that it seems like Americans are saying, “Millions of Americans can’t afford healthcare… but if they could, they wouldn’t have to wait for it!” You all seem more concerned about the people who can afford an MRI not having to wait than making an MRI accessible to everyone who needs one. A friend of mine recently had an MRI. She’s works retail making about $10 an hour, mostly living hand to mouth. If she were in America, the MRI would not have been possible for her and the wait times irrelevant.

      I’ve never had an MRI but I’ve had X-Rays; I’ve had surgery; I’ve had ultrasounds; my step-dad has Parkinsons; my mother has a pacemaker; none of our conditions marinated into something else while waiting for healthcare. My boss gets dialyses three times a week and has for years. No way in hell he could afford that south of the border. He’d be dead by now.

      Also, you need to be neither working or on the dole to get health care. The link you yourself provided doesn’t say anything about working/EI being mandatory. As for place of residence, you can’t live outside the province for more than 6 months in a row. If you do, it expires… until you return and are back in the province for 153 days. But again, this is a red herring. Most of the people who are packing up and heading to FL or CA or AZ or wherever are people who can afford to do so. They don’t always care if their OHIP continues. They’re wealthy enough that they can afford American healthcare. But your current healthcare issues are not about the people that can afford it.

      Also, the press seems to keep saying, “We have the best healthcare in the world!” Well, that’s not the issue. Yes you have great doctors and innovation. Making healthcare available to everyone doesn’t change that. It just means more people can benefit from it.

      As for keeping your citizenship… most would do it because there’s no benefit to relinquishing it.

      • The residency requirements were a response to Nathanael and Jake, who proposed people emigrate to the US and retain rights to Canadian healthcare. I think anyone who tries to play that game is just destined to make themselves a victim of one system or the other.

        Great doctors and innovation will be compromised when the government implements limits on what will be paid for services. That is part-and-parcel of this whole reform — it’s not like Obama is planning to buy/pay for a “Cadillac”-plan for every uninsured American…

        And as for citizenship in general — you’re right, and that’s why I’ve done nothing formal to relinquish my Canadian citizenship. I’m not 100% sure of my status, but I think they’ll take me back if I show up at the border with my birth certificate, a two-four of Molson [I don’t know what the kids up there drink anymore], and my Team Canada jersey.

      • oh, and I’ll go a step further and admit that I may be misled by horror stories from north of the border (wait times, MRIs) — but only if you admit the possibly that you too are subject to the same type of misinformation.

        we each have the positions we want to believe, we both find the facts, statistics, and anecdotes that support our position, and we both can’t possibly believe that we’re on the wrong side of the debate.

        that’s really what my original post was about — Krugman being so sure he’s right and being called out on it in a very public forum. something we should all be wary of.

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