Comparing Ohio and Ontario by the Numbers

The Beacon Journal points to better health stats in Canada

A Laurel to the Akron Beacon Journal and reporter David Knox for a well-done piece showing that, healthwise, the Buckeye State compares disfavorably to its neighbors 60 miles across Lake Erie. It’s the kind of story that contradicts the sort of rhetoric we heard in the primaries, when Republican presidential candidates went around saying that the U.S. had the best health care in the world. We at CJR had been urging the press to consider data that showed otherwise. The Beacon Journal took an interesting approach in doing so.

The paper looked across the lake to the province of Ontario, an area similar to Ohio in population, median age, average household and family size, and education. (Ontario has a larger minority population—23 percent compared to 17 percent in Ohio.) Their economies are also similar, with almost the same percentage of residents employed in manufacturing, wholesale, and retail trades. Wages and salaries are comparable, too. The main thing that is not comparable is the health care system. In Ontario, the Ontario Health Insurance Plan, or OHIP, pays the bills for all basic hospital and doctor care. In Ohio, private insurance pays the bills; that is, if people have it. If not, they go without care, hope they can find some charity to help, or use the state’s overburdened safety net.

Starting with some macro statistics, theBeacon Journal quoted from a congressional study showing that, among the thirty countries that make up the Organization for Economic Cooperation and Development (OECD), the U.S. ranks third to last in infant mortality rates, ahead of only Mexico and Turkey, the two other OECD countries that don’t have some form of universal coverage. Americans also have shorter-than-average life spans. Since these gross numbers don’t say much about the cost and quality of care in Ohio, the Beacon Journal looked at its own state and how it stacked up against Ontario. Citing statistic after statistic, the paper clearly and fairly showed that Ontarians fared better than Ohioans on many measures.

Sixty-five-year-olds in Ontario can expect to live three years longer than their counterparts in Ohio. The life expectancy of a newborn in Ontario is 80.7 years; in Ohio, 76.4 years; 5.5 newborns per 1,000 die each year compared to eight per 1,000 in Ohio. Ontarians also have lower death rates from heart disease, cancer, stroke, diabetes, and emphysema.

Lest you think health care is perfect in Canada, the Beacon Journal showed that it is not. Sometimes there are long waiting lists for non-life-threatening illnesses and high-tech procedures. So, yes, someone with a sports injury might have to wait for an MRI. People with a suspected brain tumor, however, don’t wait. And it’s wise to remember that increasingly long waits are developing for services here—visits to primary care doctors and for mammograms, to take a couple of examples. The article showed that, per capita, Canada spends less on health care than does the U.S. —$3,768 per person (10 percent of GDP) in Canada, compared with $7,026 per person in the U.S. (nearly 16 percent of GDP).

New statistics from The Commonwealth Fund, a New York City philanthropic organization, reinforce the points made by the Beacon Journal. Earlier this month, The Fund released its latest study comparing U.S. health care with other countries’ care. Finding that the nation’s performance deteriorated over the past two years, it concluded that the U.S. health system “continues to perform far below what is achievable.” An example: the U.S. ranks last out of nineteen countries in preventable deaths, slipping from fifteenth place two years ago. France scored the best.

Even though the U.S. made some improvements to its system, other countries did better—they simply worked harder, and their centralized systems make it easier. In the United Kingdom, that bastion of socialized medicine, hospitals that had been the least successful at treating heart disease got better.

If British hospitals have improved their cardiac care, what are U.S. hospitals doing? The Fund’s survey did find that the public reporting of hospital data was one of the few bright spots for the U.S. Hospitals account for one-third of the more than $2 trillion health care bill. Much of that money has been spent competing with other hospitals and erecting new buildings to house more and bigger technology.

People are beginning to realize that the U.S. spends the most money in the world on health care while getting far less than other nations. But the media haven’t yet connected all the dots. Reporters should take to the trail laid by the Beacon Journal and The Commonwealth Fund. CJR will be watching to throw out some Laurels for stories that do.

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Trudy Lieberman is a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR's healthcare desk, which is part of our United States Project on the coverage of politics and policy. She also blogs for Health News Review. Follow her on Twitter @Trudy_Lieberman.