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Single payer health insurance in pediatric surgery: US impressions and Canadian experience

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Abstract

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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References

  1. The Physicians’ Working Group for Single-Payer National Health Insurance (2003) Proposal of the physicians’ working group for single-payer national health insurance. J Amer Med Assoc 290:798–805

    Article  Google Scholar 

  2. DeGrazia D (2008) Single payer meets managed competition: the case for public funding and private delivery. Hastings Cent Rep 38:23–33

    Article  PubMed  Google Scholar 

  3. Himmelstein DU, Wollhandler W (2009) US health care: single payer or market reform. Urol Clin N Am 36:57–62

    Article  Google Scholar 

  4. Deber RB (2003) Health care reform: lessons from Canada. Am J Public Health 93:20–24

    Article  PubMed  Google Scholar 

  5. Sarpel U, Vladek BC, Divino CM, Klotman PE (2008) Fact and fiction: debunking myths in the US healthcare system. Ann Surg 247:563–569

    Article  PubMed  Google Scholar 

  6. Ames JT (2003) Letter to the editor. J Amer Med Assoc 290:2798

    Article  CAS  Google Scholar 

  7. Jevani I (2003) Letter to the editor. J Amer Med Assoc 290:2798

    Article  Google Scholar 

  8. Velanovich V (2003) Letter to the editor. J Amer Med Assoc 290:2798

    Article  CAS  Google Scholar 

  9. McCormick D, Woolhandler S, Bose-Kolanu A et al (2009) US physicians’ views on financing options to expand health insurance coverage: a national survey. J Gen Intern Med 24:526–531

    Article  PubMed  Google Scholar 

  10. Fronstin P, Helman R (2009) The 2009 health confidence survey: Public opinion on health reform varies; strong support for insurance market reform and public plan option, mixed response to tax cap. EBRI Issue Brief, no. 331, July 2009

  11. Nakayama DK, Newman D (2008) Pediatric surgery workforce: population and economic issues. J Pediatr Surg 43:1426–1431

    Article  PubMed  Google Scholar 

  12. Accreditation Council of Graduate Medical Education (2009) ACGME program requirements for graduate medical education in pediatric surgery. http://www.acgme.org/acWebsite/downloads/RRC_progReq/445_pediatric_surgery_07012007_u08102008.pdf. Accessed 13 Aug 2009

  13. National Resident Matching Program (2009) About pediatric surgery. http://www.nrmp.org/fellow/match_name/ped_surgery/about.html. Accessed 13 Aug 2009

  14. Skarsgard ED (2006) Networks in Canadian paediatric surgery: time to get connected. Paediatr Child Health 11:15–18

    PubMed  Google Scholar 

  15. The Congenital Diaphragmatic Hernia Study Group (2006) Treatment evolution in high-risk congenital diaphragmatic hernia: ten years’ experience with diaphragmatic agenesis. Ann Surg 244:505–513

    Google Scholar 

  16. Health Canada (2009) About Health Canada. http://hc-sc.gc.ca/ahc-asc/activit/about-apropos/index-eng.php. Accessed 18 Aug 2009

  17. Troppmann KM, Palis BE, Goodnight JE et al (2009) Career and lifestyle satisfaction among surgeons: what really matters? The National Lifestyles in Surgery Today Survey. J Am Coll Surg 209:160–169

    Article  PubMed  Google Scholar 

  18. Kibbe MR, Troppman C, Barnett CC Jr et al (2009) Effect of educational debt on career and quality of life among academic surgeons. Ann Surg 249:342–348

    Article  PubMed  Google Scholar 

  19. National Physician Survey 2007 (2009) Results for surgical subspecialists. http://www.nationalphysiciansurvey.ca/nps/2007_Survey/Results/ENG/Specialty/pdf/Surgical/Surgical.Demographics.ENG.pdf. Accessed 13 Aug 2009

  20. Asch DA, Jedrziewsski MK, Christakis NA (1997) Response rates to mail surveys published in medical journals. J Clin Epidemiol 50:1129–1136

    Article  CAS  PubMed  Google Scholar 

  21. McFarlane E, Olmsted MG, Murphy J et al (2007) Nonresponse bias in a mail survey of physicians. Eval Health Prof 30:170–185

    Article  PubMed  Google Scholar 

  22. Statistics Canada (2009) http://www.statcan.gc.ca/start-debut-eng.html. Accessed 12 Aug 2009

  23. US Census Bureau (2009) http://www.census.gov/. Accessed 12 Aug 2009

  24. American Pediatric Surgical Association (2009) Pediatric Surgical Training Programs. http://www.eapsa.org/Training1.htm. Accessed 12 Aug 2009

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Authors and Affiliations

  1. Department of Surgery, Mercer University School of Medicine, Medical Center of Central Georgia, 777 Hemlock St., MSC 140, Macon, GA, 31201, USA

    Don K. Nakayama

  2. University of Toronto, Hospital for Sick Children, Toronto, ON, Canada

    Jacob C. Langer

Authors
  1. Don K. Nakayama
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  2. Jacob C. Langer
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Correspondence to Don K. Nakayama.

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Nakayama, D.K., Langer, J.C. Single payer health insurance in pediatric surgery: US impressions and Canadian experience. Pediatr Surg Int 27, 329–334 (2011). https://doi.org/10.1007/s00383-010-2590-9

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  • DOI: https://doi.org/10.1007/s00383-010-2590-9

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