Have you ever wondered why health care costs are so much higher in the US than in Canada? I was recently astounded upon finding out that a 60 day supply of a certain new anti-Parkinson’s drug being challenged by my insurer because it cost 800 US dollars, was being sold in Canada for a mere 128 dollars. Why would that be? In the interest of writing about it, I conducted some informal but solid research into the problem. Though many contributing factors can be named, like for instance, the fact that televised drug commercials directed at the public are discouraged by the Canadian government, I discovered another deeper and allegedly more malignant cause sitting at its roots.
The solution did not appear to me when I interviewed 2 pharmacists and a hospital administrator. Nor did I receive adequate answers when I queried several social news websites. Then I happened to meet for other reasons, an attorney friend who had served as a legislator. He boiled it down for me with one single word: “lobbyists.” Let me explain. Well-funded legislative third party negotiators aka. lobbyists, represent various collective self-interested groups of generally non-voter-represented competing interests, and with minimal central oversight.
Think of it this way. Let’s say you have a fixed number of healthcare dollars to spend on a cardiac coronary-artery bypass surgical procedure including professional fees, hospital stay, drugs and other charges. For example let’s imagine we’re in the US and Medicare will pay 30,000 dollars for total costs. That same 30,000 if used in Canada would be carefully distributed and negotiated principally by the central government within one organization, and then further aided by another oversight bureau in each province, keeping their eyes on the pie at all times, and perhaps even trying to get the total costs down to 20,000 dollars.
On the other hand, lobbying groups work the US system from the inside. For example, doctors represent one lobbying group. The hospitals represent another. Pharmaceuticals comprise a third big lobby (and we’ll throw in medical supplies and technical equipment there). Of course we cannot forget the lawyers’ lobby groups railing against any attempts at tort reform which might otherwise place limits on the malpractice liability system. And then there are the payer groups: private insurance and HMO’s.
Everyone is throwing money at legislators who deal on a very personal level with these lobbyists. Money gets dispensed through all kinds of “grey” channels. Then the lobbyists sit in the senate and house chambers keeping a close eye on how their purchased political interests vote on key issues. Meanwhile American adults, the average of whom cannot name the Vice President, eschew CSPAN for “JLo.” Instead of attending, observing or even following the House or Senate voting by their elected officials, millions express more concern over why star-candidate Pia Toscano was voted off of “American Idol.”
Nobody watches the legislative till in the US more than the lobbyists. The result? Using our cardiac surgery example, that original 30,000 US dollar allotment can quickly balloon to 40,000 as the well-heeled lobby-lubricated legislators aim to please all their special-interest lobbyists. For without those needed donations and other grayer perks, their slick TV campaign ads could barely compete with consumer-directed pharmaceutical ads and I daresay, American Idol itself.