Canadian Health Care: Myths vs. Facts
Corporate lobbyists in Washington D.C. and the politicians in their pockets are bashing and misrepresenting our excellent Canadian health care system. As a Canadian who has worked in hospitals on both sides of the border I would like to set the record straight regarding our single-payer "Universal Health Care" system, and respond to some of these sickening attacks.
In a previous post I explained the basics of Canadian health care , and I pointed out that the highest rate is only $108 for a family of three or more. Those with limited income get their insurance virtually free, just like American members of Congress do. Yes, those same elected nimrods who bash Universal Health Care are receiving essentially the same thing.
Senators and Congressmen get to participate in the Federal Employees Health Benefits Program(FEHB). This is low cost (but good) insurance and taxpayers pay two thirds of the premiums. FEHB insurance does not deny claims because of pre-existing conditions, just like Canada's Health Care system.
Former President Bill Clinton has been a very vocal supporter of Canada's system. He knows America's system as well as any American, and he knows a lot about the Canadian system. Clinton notes that in the U.S. today, there are "incentives to keep people misinformed and full of fear."
The main tactic used by lobbyists is to take isolated incidents of poor health care delivery and misrepresent these rare incidents as if they were standard operating procedure in Canada. Sure, examples of medical malpractice and improper diagnosis can be found on both sides of the border, but malpractice is not the norm in Canada or the USA.
The Canadian System provides for universal coverage for medically necessary health care services provided on the basis of need, rather than the ability to pay. In practical terms "universal coverage" means you get the services and care you need, but doctors bills and hospital bills are unheard of in Canada. I visit my family doctor every three months for medication refills, and to discuss any health concerns. These visits are free just like major surgeries and specialist appointments are free. "Ability to pay" is never a concern in Canada.
Any time (24/7/365) I have a health related concern I can dial 8-1-1 and speak with an experienced nurse or a pharmacist. The nurse will decide if I can treat the problem myself, or if I should see my family doctor or go to the emergency room.
The only time I used that service was when I had a swelling spider bite on my foot. I was driving home and the nurse told me it was potentially serious. "Go to the Emergency Room and have it looked at right away." As always the emergency room visit cost me nothing, and the prompt treatment probably saved me from getting a skin graft.
THE "WAITING LIST" STRAW MAN ARGUMENT
Yes, Canada does have waiting lists for some procedures, but...
...1. Nobody ever goes on a waiting list for emergency care. Heart surgeries, Cancer treatments, etc all take place immediately.
Are Canadians really being "forced" to get treatment in the USA?
No. Sometimes the specialists and surgeons are backed up, or staffing shortages occur. In a small number of cases Canadian patients get sent south of our border when it is best for the patient. Complicated pregnancies requiring a certain hospital to do the delivery, and rare diseases where the best expert is in the USA are two examples, However - when this happens - it is all at the Canadian Governments expense. Travel(Ambulance or Air Ambulance) and treatment are all paid for 100% by the Government, not the patient.
How many Americans get to travel to Canada when the top specialist is in our country, and have it paid for by the American Government? Sending patients to the USA for teatment, when appropriate, is a good thing not a bad thing.
Overall President Clinton is on the right track, and he surely has President Obama in his corner. Both men know that America's system is immoral and embarrassing when compared to all established Western democracies.
Universal Health Care, regardless of ability to pay, is the only way to go. I look forward to the day when my American friends can enjoy the Universal Health Care I take for granted.
In a previous post I explained the basics of Canadian health care , and I pointed out that the highest rate is only $108 for a family of three or more. Those with limited income get their insurance virtually free, just like American members of Congress do. Yes, those same elected nimrods who bash Universal Health Care are receiving essentially the same thing.
Senators and Congressmen get to participate in the Federal Employees Health Benefits Program(FEHB). This is low cost (but good) insurance and taxpayers pay two thirds of the premiums. FEHB insurance does not deny claims because of pre-existing conditions, just like Canada's Health Care system.
Former President Bill Clinton has been a very vocal supporter of Canada's system. He knows America's system as well as any American, and he knows a lot about the Canadian system. Clinton notes that in the U.S. today, there are "incentives to keep people misinformed and full of fear."
The main tactic used by lobbyists is to take isolated incidents of poor health care delivery and misrepresent these rare incidents as if they were standard operating procedure in Canada. Sure, examples of medical malpractice and improper diagnosis can be found on both sides of the border, but malpractice is not the norm in Canada or the USA.
The Canadian System provides for universal coverage for medically necessary health care services provided on the basis of need, rather than the ability to pay. In practical terms "universal coverage" means you get the services and care you need, but doctors bills and hospital bills are unheard of in Canada. I visit my family doctor every three months for medication refills, and to discuss any health concerns. These visits are free just like major surgeries and specialist appointments are free. "Ability to pay" is never a concern in Canada.
Any time (24/7/365) I have a health related concern I can dial 8-1-1 and speak with an experienced nurse or a pharmacist. The nurse will decide if I can treat the problem myself, or if I should see my family doctor or go to the emergency room.
The only time I used that service was when I had a swelling spider bite on my foot. I was driving home and the nurse told me it was potentially serious. "Go to the Emergency Room and have it looked at right away." As always the emergency room visit cost me nothing, and the prompt treatment probably saved me from getting a skin graft.
THE "WAITING LIST" STRAW MAN ARGUMENT
Yes, Canada does have waiting lists for some procedures, but...
...1. Nobody ever goes on a waiting list for emergency care. Heart surgeries, Cancer treatments, etc all take place immediately.
2. We have some waiting lists for some non-emergency procedures such as knee replacements, MRI scans, etc but wait times are not ridiculous and they are well prioritized. The big difference between Canada and the USA is Canadians will always get the procedure. ALWAYS. So what if they have to wait. It's not a perfect world.
3. In America I saw people die of Cancer with no treatment, because
they were poor. I also knew several people who walked around on painful
knees and hips because they could not afford the arthroscopy or joint
replacement. I am certain they would have been delighted to get on a
waiting list for a free joint replacement.
4. Rich Canadians can "jump the queue" and pay for non-emergency MRI's or surgeries if they wish. Personally, I would prefer to use a cane for a few months (just like Dr. House) and get my knee replaced for free.
Are Canadians really being "forced" to get treatment in the USA?
No. Sometimes the specialists and surgeons are backed up, or staffing shortages occur. In a small number of cases Canadian patients get sent south of our border when it is best for the patient. Complicated pregnancies requiring a certain hospital to do the delivery, and rare diseases where the best expert is in the USA are two examples, However - when this happens - it is all at the Canadian Governments expense. Travel(Ambulance or Air Ambulance) and treatment are all paid for 100% by the Government, not the patient.
How many Americans get to travel to Canada when the top specialist is in our country, and have it paid for by the American Government? Sending patients to the USA for teatment, when appropriate, is a good thing not a bad thing.
Overall President Clinton is on the right track, and he surely has President Obama in his corner. Both men know that America's system is immoral and embarrassing when compared to all established Western democracies.
Universal Health Care, regardless of ability to pay, is the only way to go. I look forward to the day when my American friends can enjoy the Universal Health Care I take for granted.
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Too bad former President Clinton wouldn't consider a Canadian-like system back in 1993. Like Obama, all ideas were on the table except that one.
September 12, 2009 1:21 PM | Reply | Permalink
Yeah, it's all free. Except that you pay extremely high taxes. And you have a society that is largely composed of people who work, whereas the US has a huge welfare class. And you have the US to be there as a backup system. And those wait times you dismiss are far more onerous than you admit. And people do die waiting, or because of waiting (a year for an MRI?, 4 months for angioplasty? These are actual wait times, google it if you care to)
September 12, 2009 6:50 PM | Reply | Permalink
Dr. Goldstein - Thanks for an informative (and accurate) perspective on Canadian healthcare. The Canadian healthcare system surpasses ours in the most critical areas - it covers all, at not much more than half the cost, and it achieves better health outcomes as measured by the standard criteria of life expectancy and infant mortaliy. However, it is not only Canada that surpasses us - all the other major industrialized democracies (more than a dozen) do better than we do by the same criteria; we're at the bottom. Individual incidents of poor service occur everywhere, including Canada of course, but they are more common here - certainly far more individuals die here from inadequate care than in any other of the industrialized democracies.
The one area where I might differ slightly in the implication of your post is in the notion that a single payer system like Canada's is the only way to achieve the healthcare coverage and outcomes of these other nations. Many of other nations utilize a combination of various public and private mechanisms, somewhat similar to proposals here for a public option. In many of those nations, basic health benefits are covered by the government, but supplemental benefits are often purchased through private insurers. France is often cited as a model example. The critical feature is not single payer per se, but a very strong public presence, either as insurer or regulator of insurance practices.
Finally, I don't need to tell you, but it might be worthwhile reminding some readers that you are not claiming that Canadian healthcare is free. It is indeed paid mainly through taxes, but the amount of those taxes is much less than the amount we spend here per capita via insurance premiums or out of pocket charges. Canadian healthcare utilizes primarily a fee for service model as we do here, and with freedom to choose physicians, but I believe all societies in the future will be forced to move away from this model in order to forestall rapidly rising healthcare costs. Freedom to choose will remain, but more likely what will be chosen are an integrated network of providers rather than individual providers who practice in a fashion uncoordinated with each other. It may or may not remain fee for service, but it will be restructured to eliminate waste and duplications that plague us here and to some extent in other nations.
September 12, 2009 7:23 PM | Reply | Permalink