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Framing the issue of ageing and health care spending in Canada, the United Kingdom and the United States

  • Michael K. Gusmano (a1) and Sara Allin (a2)

Abstract

Political debates about the affordability of health care programmes in high-income countries often point to population ageing as a threat to sustainability. Debates in the United States, in particular, highlight concerns about intergenerational equity, whereby spending on older people is perceived as a threat to spending on the young. This paper compares how the problem of health spending is defined in Canada, the United Kingdom and the United States by presenting the results of a content analysis of print media during the period 2005–2010. We found that population ageing was cited as an important source of health care cost increases in all three countries but was cited less frequently in Canadian newspapers than in the UK or US papers. Direct claims about intergenerational equity are infrequent among the articles we coded, but newspaper articles in the United States were more likely than those in Canada and the United Kingdom to claim that of high health care spending on older people takes resources away from younger people. In Canada a much larger percentage of articles in our sample either claimed that high health care spending is crowding out other types of government expenditure. Finally, we found that almost no articles in the United States challenged the view that population ageing causes health care spending, whereas in both Canada and the United Kingdom a small, but steady stream of articles challenged the idea that population ageing is to blame for health care spending increases.

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Corresponding author

*Correspondence to: Michael K. Gusmano, Hastings Centre, 21 Malcolm Gordon Road, Garrison, NY, 10524 USA, Email: mkg2104@columbia.edu

References

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Abelson, J. and Collins, P. A. (2009), ‘Media hyping and the “Herceptin access story”: an analysis of Canadian and U.K. newspaper coverage’, Healthcare Policy, 4(3): e113e128.
Allen, K. (2007), ‘Financial: Bernanke warns U.S. about burden of ageing population’, The Guardian, 19 January, p. 28.
Anderson, G. F. and Hussey, P. S. (1999), Health and Population Aging: A Multinational Comparison, New York: The Commonwealth Fund, http://globalag.igc.org/health/world/hpa.pdf [5 January 2013].
Angrisano, C., Farrell, D., Kocher, B., Laboissiere, M. and Parker, S. (2007), Accounting for the Cost of Health Care in the United States, San Francisco, CA: McKinsey Global Institute, http://www.mckinsey.com/mgi/rp/healthcare/accounting_cost_healthcare.asp [accessed 7 December 2012].
Boothe, P. and Carson, M. (2003), What Happened to Health-Care Reform? Toronto: CD Howe Institute.
Brown, L. D. (1998), ‘Exceptionalism as the rule? U.S. health policy innovation and cross-national learning’, Journal of Health Politics, Policy and Law, 23(1): 3551.
Canadian Institute for Health Information (2012), Health Care Spending to Reach $192 Billion this Year, Ottawa: Canadian Institute for Health Information, http://www.cihi.ca/CIHI-ext-portal/internet/en/Document/spending+and+health+workforce/spending/RELEASE_28OCT10 [5 January 2013].
Centers for Medicare and Medicaid Services, Office of the Actuary (2012), National Health Expenditure Projections, 2012–2022. Washington, DC: CMS.
Cook, F. L., Marshall, V. W., Marshall, J. G. and Kaufman, J. E. (1994), ‘The Salience of Intergenerational Equity in Canada and the United States’, in T. Marmor, T. Smeeding and V. Greene (eds), Economic Security and Intergenerational Justice: A Look at North America, Washington, DC: Urban Institute Press, 91129.
Day, C. L. (2011), ‘Partisan-Ideological Conflict and Aging Policy: Seeking Common Ground to Avoid Leaping into the Abyss’, Presented at the 2011 Annual Meeting of the American Political Science Association, Seattle, WA, 1–4 September.
Daw, J. R. and Morgan, S. G. (2012), ‘Stitching the gaps in the Canadian public drug coverage patchwork? A review of provincial pharmacare policy changes from 2000 to 2010’, Health Policy, 104(1): 1926.
Entman, R. M. (1993), ‘Framing: toward clarification of a fractured paradigm’, Journal of Communication, 43(4): 5158.
Evans, R. G., McGrail, K., Morgan, S. G., Barer, M. L. and Hertzman, C. (2001), Apocalypse No: Population aging and the future of health care systems, SEDAP research paper 59, http://socserv.mcmaster.ca/sedap/p/sedap59.pdf [20 January 2014].
Foote, D. K. and Venne, R. A. (2005), ‘Awakening to the intergenerational equity debate in Canada’, Journal of Canadian Studies, 39(1): 521.
Gamson, W. A. (1992), Talking Politics, New York: Cambridge University Press.
Gusmano, M. K. and Okma, K. (2010), ‘The Bright Side of Aging: Reframing the Debate’, Presented at the American Political Science Association Meeting, Washington, DC, 2 September.
Huang, B. and Priebe, S. (2003), ‘Media coverage of mental health care in the U.K., U.S.A and Australia’, Psychiatric Bulletin, 27: 331333.
Hunter, J. (2010a), ‘Liberals not the first to attempt taming the beast that is health-care spending’, The Globe and Mail, 5 March, p. 3.
Hunter, J. (2010b), ‘Health Minister defends modest spending hikes; need to rein in annual increases in health care spending or “system will implode”’, The Globe and Mail, 4 March, p. 1.
Iyengar, S. (1990), ‘Framing responsibility for political issues: the case of poverty’, Political Behavior, 12(1): 1940.
Kaiser Family Foundation (2010), Medicare Chartbook, http://facts.kff.org/chart.aspx?cb=58&sctn=169&p=2 [17 September 2012].
Klein, R. and Marmor, T. R. (2006 [1997]), ‘Reflections on Policy Analysis: Putting it Together Again’, in M. Moran, M. Rein and R. E. Goodin (eds), The Oxford Handbook of Public Policy, Oxford: Oxford University Press; Schneider and Ingram, 892909.
Kotlikoff, L. J. and B., Scott (2004), The Coming Generational Storm: What You Need to Know About America’s Economic Future, Cambridge, MA: The MIT Press.
MacKinnon, J. C. (2004), ‘The arithmetic of health care’, Canadian Medical Association Journal, 171(6): 603604.
Marmor, T. R. and Mashaw, J. L. (2006), ‘Understanding Social Insurance: Fairness, Affordability, and the ‘Modernization’ of Social Security and Medicare’, Health Affairs, 25(3): w114w134.
Maxwell, J. (2008), ‘Out of the ER: finding the “right’ setting for elderly patients’, The Globe and Mail, 24 March, p. 2.
Mickleburgh, R. (2007), ‘Mojo no match for crisis in health’, The Globe and Mail, 16 February, p. 1.
Morone, J. (2005), Hellfire Nation, New Haven: Yale University Press.
New York Times (2010), ‘Health care and the deficit’, New York Times, 12 December, p. 7.
Oberlander, J. and White, J. (2009), ‘Public attitudes toward health care spending aren’t the problem; prices are’, Health Affairs, 28(5): 12851293.
Payne, G., Laporte, A., Deber, R. and Coyte, P. C. (2007), ‘Counting backward to health care’s future: using time-to-death modeling to identify changes in end-of-life morbidity and the impact of aging on health care expenditures’, The Milbank Quarterly, 85(2): 213257.
Peterson, P. G. (2000), Gray Dawn: How the Coming Age Wave Will Transform America and the World, New York: Crown Publishing Group.
Reinhardt, U. E. (2008), ‘Why does U.S. health care cost so much? (part III: an aging population isn’t the reason)’, New York Times, Economix: Explaining the Science of Every Day Life, http://economix.blogs.nytimes.com/2008/12/05/why-does-us-health-care-cost-so-much-part-iii-an-aging-population-isnt-the-reason/ [8 December 2012].
Roehrig, C. S. and Rousseau, D. M. (2011), ‘The growth in cost per case explains far more of U.S. health spending increases than rising disease prevalence’, Health Affairs, 30(9): 16571663.
Rowland, D. (1992), ‘A five-nation perspective on the elderly’, Health Affairs, 11(3): 205215.
Rudiger, A. (2008), ‘From market competition to solidarity? Assessing the prospects of U.S. health care reform plans from a human rights perspective’, Health and Human Rights: An International Journal, http://www.hhrjournal.org/index.php/hhr/article/viewArticle/23/80 [30 December 2012], 10(1): 113.
Sabin, J. E. (2012), ‘Individualism, solidarity, and U.S. health care’, Virtual Mentor, 14(5): 415418.
Sarafini, M. W. and Galewitz, P. (2012), ‘Aging population, costs worsen Medicare’s long-term prognosis’, The Rundown: A Blog of News and Insight, PBS Newshour, http://www.pbs.org/newshour/rundown/2012/04/aging-population-costs-worsen-medicares-long-term-prognosis.html [7 December 2012].
Shelton, A. M. (2010), The Impact of Medicare Premiums on Social Security Beneficiaries, CRS Report for Congress, Washington, DC: Congressional Research Services.
Skinner, J. (2011), ‘Understanding prices and quantities in the U.S. health care system’, Journal of Health Politics, Policy and Law, 36(4): 791801.
Soroka, S. N. (2011), Public Perceptions and Media Coverage of the Canadian Healthcare System: A Synthesis, Ottawa: Canadian Health Services Research Foundation.
Toronto Star (2008), ‘The health-care “elephant” grows’, Toronto Star, 30 March, p. 14.
Tuohy, C. H. (2002), ‘The costs of constraint and prospects for health care reform in Canada’, Health Affairs, 21(3): 3246.
Truffer, C. J., Keehan, S., Smith, S., Cylus, J., Polsal, J. A., Lizonitz, J. and Clemens, M. K. (2010), ‘Health spending projections through 2019: the recession’s impact continues’, Health Affairs, 29(3): 522529.
van Elk, R., Mot, E. and Franses, P. H. (2010), ‘Modeling healthcare expenditures: overview of the literature and evidence from a panel time-series model’, Expert Review of Pharmacoeconomics & Outcomes Research, 10(1): 2535.
Vilella-Vila, M. and Costa-Font, J. (2008), ‘Press media reporting effects on risk perceptions and attitudes towards genetically modified (GM) food’, Journal of Socio-Economics, 37(5): 20952106.
Walkom, T. (2007), ‘No easy cure for health tax’, Toronto Star, 9 September, p. 6.
White, J. (2011), ‘Prices, volume, and the perverse effects of the variations crusade: point-counter point’, Journal of Health Politics, Policy and Law, 36(4): 775790.

Framing the issue of ageing and health care spending in Canada, the United Kingdom and the United States

  • Michael K. Gusmano (a1) and Sara Allin (a2)

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