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Single payer health insurance in pediatric surgery: US impressions and Canadian experience
Don K Nakayama1, Jacob C Langer
1Department of Surgery, Mercer University School of Medicine, Medical Center of Central Georgia, 777 Hemlock Street, Macon, GA 31201, USA. Nakayama.Don@mccg.org
Context:
Some advocate single payer national health insurance, present in Canada, as a solution to problems in US health care.
Method:
Pediatric surgeons in the US and Canada were surveyed regarding their attitudes (US) and experience (Canada) under a single payer by electronic mail regarding features of a single payer using a Likert scale (1-strongly disagree to 5-strongly agree) on quality, administration, organization, and economics.
Results:
Overall response rate of 22% (175/835), 153 US, 22 Canadian. US and Canadian respondents predicted a higher quality of care for both emergency (66 and 36%, respectively) and elective conditions (47 and 9%) under a single payer. Both groups recognized delays for elective surgery. Better access to surgical care under a single payer, seen by most Canadians (81%), was not predicted among Americans (44%, p = 0.00012). Americans (68%) did not believe a single payer would address workforce shortages, while Canadians (68%) disagreed (p = 0.00001). Both groups agree (p = 0.7) that personal income is decreased.
Conclusions:
US surgeons anticipate benefits and problems that Canadian surgeons with direct experience with a single payer do not experience. This discrepancy must be recognized during the ongoing debate over the future of US health care.
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