August 10, 2009
The health care debate-9: Oh, Canada!
(For previous posts on the issue of health care, see here.)
One has to feel sorry for Canada. There they are, this perfectly nice country to the north of us, just minding its own business. And yet, whenever there is talk of health care reform in the US, the most blatant lies are told about their health system, treating it as this awful, low-quality, bureaucratic nightmare, when by any objective measure they provide better service for all their people, with better outcomes, with little bureaucracy, and at lower cost.
There is almost reflexive lying about Canada's health system by apologists for the US's profit-seeking health system. We are told that Canadians are dissatisfied with their system, that they would love to have what the US has, and that they come over here in droves to seek high quality treatment. If you are a Canadian and want to become a political and media darling in the US, all you have to do is complain about the way you were treated in Canada, as was the case of a Canadian woman who got a lot of tearful mileage in the media here by exaggerating the seriousness of her condition and claiming that she would have died if she had not come to the US for treatment. And don't forget to mention that old standby, the supposedly long wait times for those hip replacements.
Recently US Republican senate leader Mitch McConnell gave a speech lambasting the Canadian system, in particular the hospital at Kingston, Ontario. His lies were promptly debunked by Kingston General Hospital chief of staff and also rebutted by Hugh Segal, one of the most conservative of Canadian politicians, as reported in an article by Gloria Galloway in the June 24, 2009 issue of Toronto's The Globe and Mail (unfortunately behind a firewall).
One thing should be made clear. The Canadian system is not perfect. No system is. In any single-payer system what you get depends on how much taxpayers are willing to spend on the system. If you have enough money and don't care if the insurance companies will cover you, then you can get high quality treatment in the US with little wait times. That is what a profit-based system health is biased towards. So it should be no surprise that well-to-do people from other countries can be found coming to the US for treatment that they would have to wait for back in their home countries. But the fact that money talks in the US is hardly an argument for the superiority of the system.
But what about not so well-to-do people from Canada also coming here for treatment? Rhonda Hackett, a Canadian clinical psychologist who has lived in the US for 17 years explains that phenomenon in the June 7, 2009 Denver Post:
Most patients who come from Canada to the U.S. for health care are those whose costs are covered by the Canadian governments. If a Canadian goes outside of the country to get services that are deemed medically necessary, not experimental, and are not available at home for whatever reason (e.g., shortage or absence of high tech medical equipment; a longer wait for service than is medically prudent; or lack of physician expertise), the provincial government where you live fully funds your care. Those patients who do come to the U.S. for care and pay out of pocket are those who perceive their care to be more urgent than it likely is.
Can you imagine any US private profit-seeking health insurance company agreeing to pay to send someone to another country for treatment? In her article Hackett systematically addresses seven other common myths about Canadian health care, refuting the lies that are spread.
- Myth: Taxes in Canada are extremely high, mostly because of national health care.
- Myth: Canada's health care system is a cumbersome bureaucracy.
- Myth: The Canadian system is significantly more expensive than that of the U.S.
- Myth: Canada's government decides who gets health care and when they get it.
- Myth: There are long waits for care, which compromise access to care.
- Myth: Canada is a socialized health care system in which the government runs hospitals and where doctors work for the government.
- Myth: There aren't enough doctors in Canada.
It is not a perfect system, but it has its merits. For people like my 55-year-old Aunt Betty, who has been waiting for 14 months for knee-replacement surgery due to a long history of arthritis, it is the superior system. Her $35,000-plus surgery is finally scheduled for next month. She has been in pain, and her quality of life has been compromised. However, there is a light at the end of the tunnel. Aunt Betty — who lives on a fixed income and could never afford private health insurance, much less the cost of the surgery and requisite follow-up care — will soon sport a new, high-tech knee. Waiting 14 months for the procedure is easy when the alternative is living in pain for the rest of your life.
Read her excellent article to get a better understanding of how the Canadian health system works.
Next: More on Canada's system
POST SCRIPT: How to deal with lies about Canada
Ohio congressman Dennis Kucinich, one of the strongest champions of a single-payer system for the US, slaps down an analyst who works for the conservative Manhattan Institute who tries to peddle the usual distortions about Canada's system. As Kucinich points out, almost 100% of the people in Canada have insurance (in fact, the number of uninsured in the US is greater than the entire population of Canada) and nobody goes bankrupt in Canada because of health care costs. In addition, he destroys the myth of wait times, and points out that no one in Canada goes without treatment due to the inability to pay, compared with 25% of the US population. The Manhattan Institute witness is unable to respond so, like a child, he sulks and refuses to answer. Pathetic.
The witness David Gratzer's analyses have been excoriated elsewhere but his position is not surprising since the Manhattan Institute is supported by all the usual suspects who oppose health insurance reform.