Ross Duffin's blog

Health Care in the US & Canada

February 7, 2005

Over Thanksgiving in 2004, I attended a reunion for my wife's family in Texas. Although I certainly didn't go looking for an argument, I found myself in a shouting match at the dinner table with one of her relatives (by marriage) over the health care system in the US and how it compares to the system in Canada. I grew up in Canada and my sister is a health care professional there, so I think I know something about it. The level of ignorance about the Canadian system among Americans is appalling, however.

He cited stories of people going to the emergency room and waiting days to be seen.

Doesn't happen, I said.

He touted the quality of American care as the best in the world.

The best that money can buy, I corrected him. If you don't have the money to buy it, you don't get it.

The fact is, the medical care in Canadian hospitals is on a par with that in many of the top facilities in the US. They have the same medicines, the same equipment, the same highly trained doctors and nurses. Yes, I allowed, if you need an MRI, you might have to wait until the day after tomorrow instead of tomorrow. But when you have it done, it will be free. It's paid for by the government health insurance plan.

Ah! he said, his eyes gleaming as if to say, I've got you now! That's socialism! That's a failed system! We showed the triumph of our system with the fall of the Berlin wall.

You're an idiot, I screamed. Have some dessert, my wife said.

If this guy is any indication, Americans don't know the difference between socialism and communism. All of the countries in the West (the ones on our side, remember) except for the US have medical systems that include government-sponsored health insurance: Canada, Britain, France, Germany—you name it. Are we superior just because everything we have is based on a free market? Some countries with high taxes and a huge social safety net, like Sweden, are perennially ranked among the top countries for overall standard of living, and Canada, meanwhile, socialized medicine and all, is perennially ranked at the top in the world for health care. How can this be? How do you measure something like that?

Let's start with the percentage of the population with access to top-notch medical care. We all know that about 40 million Americans have no health insurance at all, so they don't have access to care, much less top-notch care. A lot more Americans have minimal coverage, so they don't have access to top-notch care either. I remember when our youngest child needed surgery as an infant, we were devastated when the insurance company called the night before the surgery to say that we'd have to have it done at a different hospital, because the one where it was scheduled was too expensive. We were paying insurance and the company was making medical decisions for us on the basis of cost! In Canada, everyone is covered for everything that doctors decide is necessary. Their health insurance comes out of their paychecks, and goes into a government-run system. They don't have to worry about catastrophic medical costs, because they won't have to pay any.

It seems to me that there are two other questions to ask in comparing health care between countries. The first is, who lives longer? It may surprise Americans to learn that Canadian women live, on average, two years longer than American women, and Canadian men live, on average, three years longer than American men. That's two or three years longer in retirement, two or three years longer with the grandchildren. This kind of result does not happen if the medical care is inferior or access to it is limited.

The second question is, who is happier with their medical care? Ask Canadians if they would like to trade their socialized system for the American system. No way. For whatever imperfections it may have, Canadians would still prefer the kind of universal access and coverage that they enjoy. There is one group of Canadians, I should say, that has shown that it prefers the American system, namely, physicians who are more interested in making money than in serving the public. American doctors make a whole lot more money than Canadian doctors, so any Canadian physician who has that as a top priority has already come down here. That's their right, of course, but it's one of the reasons that American medical care is so much more expensive than Canadian medical care—that and higher prescription drug prices, higher health insurance premiums, higher malpractice insurance claims and, consequently, malpractice premiums—the list goes on.

But don't talk to me about inferior medical care in Canada. It's low reputation here is based solely on scare-mongering, knee-jerk anti-socialism, and just plain ignorance. A lot of people make a heck of a lot of money in the health care industry in this country, and would hate to see the system change, no matter how much it would benefit Americans to change it. And they can afford to spend a lot of money on advertising and lobbying to keep things just they way they are, thank you very much.