I agree, they all benefit from the spiilover of new developments that come from the US health care "system."
There's no doubt that the US health care "system" is very wasteful. There's also no doubt that the US system provides considerable tangible benefits to Canadians and many other countries. Once our system is more like theirs and the profit motive is reduced, I'd expect the pace of US medical innovation to closely parallel Canada's. And Mexico's.
I think you overestimate the developments coming from the US. Many countries have active research and development programs, both private and public, that provide breakthroughs in medicine, the US does not have a monopoly (for a
rough estimate look at the Nobel Medicine prize winners
All Nobel Prizes in Physiology or Medicine). Where the US fails miserably is in determining a cost:benefit for the research done. Here Big Pharma will spend billions to develop and market a new "flavour" of a drug to replace the old one that is going off patent. With an aggressive marketing campaign touting the (questionable) benefits of the new "flavour" they have a new blockbuster that makes them a fortune with little, if any, benefit to the health of the population. Meanwhile Canada and everyone else is perfectly content to spend pennies on the dollar to continue prescribing the old flavour. The money can then be better spent on something like say...vaccinating everyone against Whooping Cough"
California Has 4,017 Cases Of Whooping Cough (pertussis) And 9 Deaths,
Family Warns Whooping Cough Dangers After Infant Son's Death - NewsOn6.com - Tulsa, OK - News, Weather, Video and Sports - KOTV.com |.
Another example is procedures. A number of studies have demonstrated that for those with stable angina maximizing medical treatment (blood pressure, cholesterol) and lifestyle (smoking cessation and weight loss) provided similar outcomes (death, disability) as doing catheterization and angioplasty. The former is cheaper and has many other tangible and intangible benefits yet there has been no significant change in practice here in the US.
Here's an example that directly impacts my practice. I'm sure everyone has heard of the "stroke emergency" touting how if treated quickly with thrombolytics a stroke may be reversible. This is true but for every person exhibiting stroke like symptoms only a very small fraction are having a stroke, are treatable and only a portion of those have any benefit, the others don't recover or the thrombolytic made their stroke worse. In order to make this possible we now rush hundreds of patients to ER's putting the patients, their family, the ambulance crews and general public at risk. They bypass the patients usual hospital to come to a stroke center where we might treat a dozen patients a year out of a thousand or more brought in. No cost:benefit has been done, nor likely will be done. This is now the standard of care which we must all practice by. This is now the fastest increasing area of malpractice litigation in Emergency Medicine. We now get sued if we give TPA (and there is a bad outcome) and if we don't (because in our clinical judgment the risk exceeds the benefit).
And finally to equate Canada's R&D with Mexico is ludicrous. Canada has an equivalent to the NIH that funds basic science research as well as collaborates with industry
About National Research Council - NRC-CNRC.
There is much to admire and be proud of in US R&D (I was a participant until training as a physician) but it does not carry the rest of the world on its back.
DD
