Thursday, 17 September 2009

Talking to Americans About Health Care

A Message From The Fifth Column To Our American Friends And Neighbours

As a Canadian, who like the vast majority of Canadians, would never give up my public health care system, I find the debate in the United States over health care to be quite perplexing. In fact in Canada whenever the prospect of a parallel private system is brought up the public quickly makes it known that a two tier system is unacceptable and any increased private role in the system is undesirable.

Indeed when I observe what is happening in the United States it sometimes appears that the best that can be hoped for is a compromise, a compromise that in all probability will not have the efficiencies of a universal single payer public system and a compromise that may end up being simply a government subsidy to the insurance industry.

But no matter what happens, the bottom line is that I do hope that our American neighbours at least end up with a system that does not see the middle class continuing to face losing their homes and having to declare bankruptcy due to health care costs and the poor continuing to die prematurely due to lack of health care.

What, of course, upsets us most in Canada are the misrepresentations and lies about the Canadian health care system (and public health care systems in general) that have become part of the debate in the United States.

It seems, and I do not want to get sidetracked into a different debate here, that some of the opposition to health care reform is driven by other agendas, and shall we say an inability of certain groups to accept the results of the recent United States election.

But I do want to raise one philosophical difference between Canadians and the Americans that health care opponents are trying to take advantage of.

This is the fact that Americans see themselves as more individualistic than Canadians and see government in a much less positive light than Canadians. Canadians on the other hand think in much more social and collective terms and see government as a means for the people to do things collectively.

At least that is the stereotype that the opponents seem to be using in decrying any government role in health care as being socialism and thus evil. Socialism is not a dirty word in Canada, and neither is liberalism. We like our single payer public health care system – call it socialized medicine if you like.

Interestingly enough, one of the differences in our political history, and one that relates directly to the establishment of Medicare (as we call our public health care system) in Canada has been the role of religion in politics. As a Canadian I find the role of the so-called Christian right in American politics to be perplexing, indeed absurd at times. While there are right wing Christian influences within our Conservative Party, the most significant religious influences in Canadian politics have come from the left, from the Social Gospel, led by preachers like J.S. Woodsworth, Stanley Knowles and Tommy Douglas from the CCF and NDP, who first proposed such things as public welfare, public pensions and Medicare, all of which have become part of the Canadian social fabric.

Indeed,Tommy Douglas, who, as Premier of Saskatchewan, first established Medicare in Canada, over the objections of the health care and insurance industries, even battling a doctors strike, was chosen by Canadians as The Greatest Canadian.

So how does Canadian Medicare work.

The Canada Health Act sets out the basic principles of Canadian Medicare.

Administration: - All administration of provincial health insurance must be carried out by a public authority on a non-profit basis. This authority must be accountable to the province or territory, and their records and accounts are subject to audits.

Comprehensiveness: - All necessary health services, including hospitals, physicians and surgical dentists, must be insured.

Universality: - All insured residents are entitled to the same level of health care.

Portability: - A resident that moves to a different province or territory is still entitled to coverage from their home province during a minimum waiting period. This also applies to residents which leave the country.

Accessibility: - All insured persons have reasonable access to health care facilities. In addition, all physicians, hospitals, etc, must be provided reasonable compensation for the services they provide.
What that means is that you go to your doctor and you get taken care of. You go to the hospital and you get taken care of. You are not asked for payment and you receive no bills. Yes you pay through your taxes and sometimes through premiums, depending on the province's funding system.

You choose your own doctors and you and your doctors decide what is the best treatment option. There is no one from the insurance industry approving your treatment. There is no one from the insurance industry denying you treatment because you've been sick before. There are no "co-pays" or payment caps. The minimum wage earner or welfare recipient receives the same quality of care as the corporate executive. No one can pay extra to jump to the front of the line. And the quality of care is excellent.

My last visit to the hospital involved a migraine that would not go away, and though I had a doctors appointment booked later that week I decided to go to the emergency department because I was getting fed up with the pain. I did have to wait awhile to see the doctor, then I got put on an IV pain reliever and waited some more, while the pain decreased. The doctor then saw me and referred me for a CAT scan and said it might be a few hours before they could take me, but actually it was about 15 minutes. The CAT scan was clear so no worries about brain tumours. We talked about putting me on beta blockers, which I was already discussing with my family doctor, but just waiting for test results to confirm I did not have asthma (from another hospital visit where I arrived early for my appointment and was able to have the test done right away). After seeing my family doctor I was put on beta blockers and have hardly had a migraine since.

I could relate all sorts of stories of the excellent care received by myself, my family and friends from our public health care system.

The most important benefit of public health care, especially for the poor is regular preventative care. When you have to decide between providing the necessities of life for your family or paying for a routine check-up, more often than not the routine health care is ignored, in some cases until it is too late. People die because of that. This is particularly important for healthy baby check-ups. When you have to decide between buying food for your baby or taking him to the doctor for a routine check-up what do you think the decision will be.

Yes there are problems. Wait times for elective and non-urgent procedures can be longer than they should be and we currently have a shortage of family doctors. These are not problems caused by the nature of the public health care system. Indeed adding a private option would only divert resources from those that need it most to those that can pay to jump to the head of the line. These are problems that to some degree require more funding and to some degree require the training of more doctors and specialized technicians.

There is one problem that I do consider systemic and that is the lack of coverage for prescription drugs outside of hospitals as part of the national system. That being said, private insurance coverage for prescription drugs is a fairly common employment benefit at a reasonable cost and the provinces do have programs to pay the drug costs of low income earners or residents with high drug costs in relation to their household income. But a national Pharmacare program is necessary to complete Canada's Medicare System

The other argument that is made in favour of the American completely private health care system is that only private for profit health care provides research and innovation. Have these people never heard of the Centers for Disease Control and Prevention (or for that matter NASA). Indeed more research is probably done in government facilities than in private ones. When it comes to hospital research, it is not whether it is a for profit hospital that determines whether research is done, but whether it is a teaching hospital. Indeed Canada, and other countries with public health care systems all have internationally respected teaching hospitals that are doing leading edge medical research.

Public health care is at the top the list when Canadians are asked what it means to be a Canadian, Indeed the idea of for profit health care or anyone getting better or faster health care because of their wealth or income is something Canadians consider to be unethical and immoral. Universal single payer public health care is a basic Canadian value.

And just so that I am completely clear, despite the lies that Americans have been told, there are no government bureaucrats involved in Canadians personal health care decisions and no death panels. There are no insurance companies denying care due to pre-existing conditions, There are no "co-pays" and there are no payment ceilings.

Final Words

I would hope that Americans do not let the misrepresentations about the Canadian health care system prevent the implementation of health care reform in their country. Indeed, I fear that the opportunity to implement single payer universal public health care for the United States has already been lost. And the public option is threatened by the massive lobbying campaign that is dominating the media. Health care reform is something that may not be attainable if left to the politicians. If the American people want health care reform they must stand up and demand it. Now is the time for the silent majority to be heard.


I have not included any statistics or links with these comments as I wanted to keep it to my own words but for those that are interested in further information I am providing the following:

Canadian Medicare and the Canada Health Act

Canada's Health Care System (Medicare)

Canada Health Act - Health Canada Information

Canada Health Act (text from Justice Department)

Canadian Health Coalition

Canadians (and Americans Living in Canada) on Canadian Health Care


Former Conservative Prime Minister Mulroney supports Obama's health-care fight

Defending Canada's Health Care: Truths and Lies - Jack Layton

Keep Canada Out of the U.S. Health-Care Debate - Bob Rae

Canadians Defend Their Health Care System

Universal Health Care Message to Americans From Canadian Doctors & Health Care Experts

Debunking Canadian health care myths

A puzzled Canadian ponders surreal U.S. health-care debate

Americans Who Can't Go Home

What they don’t want you to know about Canadian health care

My brain and the Ontario health-care system

The Truth About Canadian Health Care

Debunking the profiteers' lies about healthcare

What Shona Holmes wants for you......Here are the facts

Tommy Douglas

The Greatest Canadian - Tommy Douglas

Prairie Giant: The Tommy Douglas Story

Kiefer Sutherland introduces the Tommy Douglas Showcase

Tommy Douglas Showcase

Douglas, Thomas Clement - The Canadian Encyclopedia

7 comments:

ken said...

An excellent post. I am going to post it on Allvoices with a short introduction so that it will get more publicity. Your links are also helpful.
I expect that there are Christian left groups that support single payer in the US as well but that their voice is not loud enough to be heard but you are correct that the Christian left was a significant part of the CCF.

rww said...

This just in:

Harvard University study finds 45,000 deaths annually linked to lack of health coverage

rww said...

I just have to add this blog post:

DTK: The Horrors of Socialism: An Open Letter to Americans

rww said...

Just listen:

LeDaro: Healthcare in US - Keith Olbermann

rww said...

Another one I just had to add:

News of the Restless: NYT: Anything in favor of single-payer medicare is not fit to print

rww said...

Names of the Dead

rww said...

Another link I have to add.

In Praise of Canadian Health Care, Warts and All � Those Emergency Blues