Tuesday, October 09, 2007

A look at Canadian Health Care (Reposted)

[This post from last year (October 1, 2006) popped up from a search. It still reads okay and recent discussions of universal health care make it relevant.]

Sarah Robinson, writing at David Neiwert's blog, lists and corrects the usual negative points used by uninformed people arguing against national health care systems.

...As a health-care-card-carrying Canadian resident and uninsured American citizen who regularly sees doctors on both sides of the border, I'm in a unique position to address the pros and cons of both systems first-hand.

1. Canada's health care system is "socialized medicine."
False. In socialized medical systems, the doctors work directly for the state. In Canada (and many other countries with universal care), doctors run their own private practices, just like they do in the US. The only difference is that there's one insurer: the provincial government.
...the doctors I see here tend to be more focused, more relaxed, more generous with their time, more up-to-date in their specialties, and overall much less distracted from the real work of doctoring. You don't really realize how much stress the American doctor-insurer fights put on the day-to-day quality of care until you see doctors who don't operate under that stress...

2. Government-run health care is inherently less efficient -- because governments themselves are inherently less efficient.
False. There is no logical way that a private system can be more efficient and pay eight-figure CEO compensation packages and still make a profit for shareholders.

3. Wait times in Canada are horrendous.
True and False -- depending on which province you live in, and what's wrong with you. Canada's health care structure runs on federal guidelines that ensure uniform standards of care -- but are administrated as separate systems by the various provinces. Some provinces don't plan their facilities as well; in those, you can have waits. Some do better. As a general rule, the farther north you live, the harder it is to get to care, simply because the doctors and hospitals are concentrated in the south. But that's just as true in any rural county in the U.S.
...for the country's newspapers, it's a prime watchdogging opportunity. Any little thing goes sideways at the local hospital, and it's on the front pages the next day. The American system might benefit from this kind of constant scrutiny: it's one of the things that keeps the quality high. But it also makes people think it's worse than it is.

4. Canada's care plan only covers the basics. You're still on your own for any extras, including prescription drugs. And you still have to pay for it.
True -- but not as big an issue as you might think. The province does charge a small monthly premium -- ours is $108/month for the whole family -- for the basic coverage. The premium is waived for people on public assistance or disability.

"The basics" covered by this plan include 100% of all doctor's fees, ambulance fares, tests, and hospitalization charges -- in other words, the really big-ticket items that routinely drive American families into bankruptcy.

5. You have to wait forever to get a family doctor.
Sheesh. Somebody, somewhere, is getting paid a lot of money to make this stuff up. There are any number of first-rate GPs in our neighborhood who are taking new patients. And if you don't have a working relationship with one, but need to see a doctor now, there are 24-hour urgent care clinics in most neighborhoods that will usually get you in and out on the minor stuff in under an hour.

6. Single-payer health care will make America less competitive.
False. I can't believe people still have the gall to argue this point, but apparently, they do. It's wrong for at least five good reasons.

*...a more attractive business environment for large manufacturers
*Being relieved of insurance worries also makes individual citizens more competitive...
*....very tangible sense of civic pride and shared effort my Canadian neighbors have in the fact that they're taking the best possible care of their own...
*Decades of deferred medical care are starting to catch up with Americans. We're seeing it on many fronts: infant mortality, lifespan, cancer rates, heart disease rates, and increased diabetes...
*...people go see the doctor if they're sick for more than a day or two. It was this easy access to early treatment, along with the much tighter public health matrix that enables doctors to share information quickly, that allowed the country's health care system to detect the 2003 SARS epidemics in Toronto and Vancouver while they were still very localized, act within hours to stop them before the disease spread any further, and track down and treat exposed people before they got too sick to be helped. In both cases, the system worked flawlessly...

7. This all sounds great -- but the taxes to cover it are just unaffordable.

False. On one hand, our annual Canadian tax bite runs about 10% higher than our U.S. taxes did. On the other, we're not paying out the equivalent of two new car payments every month to keep the family insured here. When you balance out the difference, we're actually money ahead.

At the end we get to Sarah's real rant...

And, frankly, it feels a whole lot better to know my taxes are taking care of my fellow Canadians than it does to have it buying bombs to drop on Iraqi towns, a fully-equipped CIA gulag, and Baghdad pizza deliveries via Halliburton. It's hard to become a worldwide empire when you're putting half your tax revenue into hospitals and doctors, as Canada does. Likewise, it's hard to insure your citizens when half your tax revenue is going to feed your war machine. In a very real sense, America has chosen to secure its oil supply at the cost of its own citizens' health. The more we spend on the former, the less we have for the latter. And our own relative health -- both physical and economic -- is starting to show the consequences of that choice. Ultimately, all these things are connected: by making ourselves energy independent, we might not only make ourselves more secure, we'll also finally be able to invest in the kind of health care that will make us truly competitive in the world community.

These are just excerpts. Her remarks are much longer. I have already discussed my own views elsewhere so there is no need to repeat them here.

It has become clear to me in the last five years that the American public can be led by the nose in any direction, whether or not it rational, reasonable, ethical or affordable. I am reminded of the cynical words of G.B. Shaw who said "Englishmen never will be slaves: they are free to do whatever the Government and public opinion allow them to do."

I wish I were more optimistic about the feasibility of an Americal National Health Care, but some argue flatly that "health care is not a right." With the death of habeas corpus and the practice begun in my lifetime of political prisoners being held by America I am starting to wonder if anything is a right.

No comments: