Nakayama Don K, Langer Jacob C
Department of Surgery, Mercer University School of Medicine, Medical Center of Central Georgia, 777 Hemlock Street, Macon, GA 31201, USA.
Pediatr Surg Int. 2011 Mar;27(3):329-34. doi: 10.1007/s00383-010-2590-9. Epub 2010 Nov 18.
Some advocate single payer national health insurance, present in Canada, as a solution to problems in US health care.
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.
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.
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.
一些人主张采用加拿大现有的单一支付者国家医疗保险，作为解决美国医疗保健问题的方案。
通过电子邮件对美国和加拿大的儿科外科医生进行调查，了解他们在单一支付者体系下的态度（美国）和经历（加拿大），采用李克特量表（1 - 强烈反对至5 - 强烈赞同）评估单一支付者在质量、管理、组织和经济方面的特征。
总体回复率为22%（175/835），其中153名来自美国，22名来自加拿大。美国和加拿大的受访者预计，在单一支付者体系下，急诊（分别为66%和36%）和择期手术（分别为47%和9%）的医疗质量会更高。两组都认识到择期手术存在延迟情况。大多数加拿大人（81%）认为在单一支付者体系下能更好地获得手术治疗，但美国人中只有44%这样认为（p = 0.00012）。美国人（68%）认为单一支付者体系无法解决劳动力短缺问题，而加拿大人（68%）则持不同意见（p = 0.00001）。两组都认同个人收入会减少（p = 0.7）。
美国外科医生预见到的益处和问题，是有单一支付者体系直接经验的加拿大外科医生所没有经历过的。在美国医疗保健未来的持续辩论中，必须认识到这种差异。
