Costs of Health Care

Regarding Health Care in the U.S. and Canada, Frances Sheppard states in her letter (Aug.2) that “for less than it costs us, the Canadians, the Japanese and the Germans . . . cover everyone.” Ms. Sheppard, however, is not telling us the whole truth.

She doesn’t mention that the figures coming out of Canada do not include the costs of long-term custodial care or capital costs as do ours, or the lack of modern technology in Canada. Add to that the enormous difference in drug use, HIV incidence, and personal violence between our country, as heterogenous as it is, and all the nations she mentions.

In my specialty, which is dermatology, Canadian doctors are often required to see up to 80 patients daily because of inadequate reimbursement. What kind of care do those patients get? The father of a friend of mine died in Toronto of a heart problem while on an 11-month waiting list for a pacemaker. What kind of coverage is that?

TERENCE F. MALOY, MD

President, Orange County Medical Assn.