title: Single payer health insurance in pediatric surgery: US impressions and Canadian experience.
abstract: BACKGROUND
  Some advocate single payer national health insurance, present in Canada, as a solution to problems in US health care.
  
  
  METHODS
  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.
authors.affiliation: Department of Surgery, Mercer University School of Medicine, Medical Center of Central Georgia, 777 Hemlock Street, Macon, GA 31201, USA. Nakayama.Don@mccg.org
authors.forename: Don K
authors.initials: DK
authors.lastname: Nakayama
authors.forename: Jacob C
authors.initials: JC
authors.lastname: Langer
mesh_terms: D001291:Attitude of Health Personnel; D002170:Canada; D016009:Chi-Square Distribution; D002648:Child; D006801:Humans; D007348:Insurance, Health / Q000191:economics*; D010372:Pediatrics / Q000191:economics*; D011787:Quality of Health Care; D018855:Single-Payer System / Q000191:economics*; D013514:Surgical Procedures, Operative / Q000191:economics*; D014481:United States