I am not American, and certainly how Americans decide to change or not change their health care system is not my business. But when the Canadian Health Care System is dragged into the current American debate, and denigrated and lied about in order to scare Americans, I feel a need to defend our system, and to get the facts out on how the Canadian system works. For example, Louie Gohmert, a Republican congressman from Texas said “I know enough about Canadian care, and I know this bureaucratic, socialized piece of crap they have up there. One in five have to die because they went to socialized medicine.” That is crazy nonsense! And Republican Paul Broun of Georgia said on July 10, “Life is precious. Some would say, ‘Well, she’s 85 years of age; we should just let her die.’ And that’s exactly what’s going on in Canada and Great Britain today. They don’t have the appreciation of life as we do in our society, evidently.” Does he really think we let people die?? That's offensive, not to mention untrue! And as for that TV commercial about the Canadian Shona Holmes who claims she had brain cancer - well it turns out she did not have brain cancer, but a benign cyst, and she chose to go to the States to get it removed immediately. I'm in no way suggesting that the Canadian system is perfect, but neither is the American one which leaves 50 million people with no insurance at all. Most Canadians would not trade our system for the American one, and poll after poll suggests we Canadians are happier with our system than Americans are with theirs.

Bob Rae, a Canadian politician, suggested that when it comes to the goals of health care, "The questions are simple.

• 1) Should anyone be denied health care because of their income, disability, or illness? (No.)
• 2) Should patients be able to choose their doctors, and advocate for speedy, effective treatment? (Yes.)
• 3) Should insurers, taxpayers, and premium payers be worried about how to control costs as an ageing society combines with great technological advance to produce an expensive mix? (Yes.)"

My impression is it is goal number 1 that Americans want to fix through health care reform, and it is this goal that the Canadian system addresses very well. In Canada, everyone that needs a hip replacement will eventually get one, even if they have to wait for it. In America, if you have no health insurance and you need a hip replacement, you won't get one at all. You can't go to an emergency room of any hospital and demand a hip replacement - it simply won't happen, so you are left to suffer. I would think that people not getting care would be a real drag on the economy, as they would be unable to be as productive at work, or perhaps unable to work at all.

Goal number 2 American propaganda suggests does not happen in Canada. According to what I've seen coming out of the States recently, we have no choice of doctors nor treatments, and our care is not at all speedy. This is false. So, let's break it down. With respect to choice of doctors, as far as I can tell, Canadians have far more choice than Americans do. I can go to any doctor I want in Canada, as long as they have room on their appointment schedule. Normally if I want to see a specialist, I need to get a referral from my general practitioner, the GP can then recommend someone, but I can also request to see whomever I want. If I want to see a doctor on the other side of the country I can do that, as with a universal insurance provider, I am not limited by Provincial boundaries. My understanding of the American system is that one is limited to the doctors covered by whatever insurance plan one is on, which is dependant largely upon one's employer. So, if the insurance plan covers only three cardiologists, then you only have a choice of three. And many insurance plans don't cross State lines. To me, that doesn't seem like very much choice at all. A single-payer insurance plan allows for more choice, not less.

"Rationed care" is another term that is being thrown around with respect to the Canadian system. I'm not too sure what exactly that means, but to me it implies a lack of treatment choice, perhaps? I don't know how many choices one needs, but if you are diagnosed with a disease, say breast cancer, you get a choice of treatment options in Canada too, along with the pros and cons of each treatment, and then the patient can decide which option feels right. So, mastectomy, lumpectomy, radiation, chemotherapy, hormone therapy, biological therapy are all available. If the patient suggests that they want to treat their breast cancer by drinking five litres of soy milk a day and wants the government to fund that, well the answer will be no. But I doubt American insurance companies would cover such a treatment either. The point is that all the kinds of treatments that one would expect to be available for a particular health condition are available and covered.

The last part of goal 2 deals with speedy treatment. Everyone has heard about the wait-time problems in Canada, and that is the one issue that dogs the Canadian system when it comes to NON-life-threatening health issues, like knee replacements, hip replacements etc. However, if the issue IS life-threatening, the care is very fast and very good. A friend went in for an angiogram, and it was discovered that the coronary (heart) arteries were pretty much completely blocked. He had a triple by-pass surgery that same day, and was kept in the hospital for almost two weeks until the physicians felt he was okay to go home. That seems like pretty good care to me! Another friend was tested, diagnosed with breast cancer, decided upon her course of treatment, and had her surgery all within three weeks. I think that is pretty good too. I have more stories like that, but you get the idea. With respect to wait times for imaging diagnosis, if something is deemed urgent, the patient get in
quickly. Also, even though Canadians wring their hands about it, the fact of the matter is that there is private care in Canada too. So, if you want that MRI and are willing to pay for it, you can get it today.

Goal 3 is probably the most challenging one to deal with for any system, and will only get more challenging with our aging population. I think that all governments can best address this by looking at the prevention side. There is much governments can do to improve the quality of the food we eat, such banning trans-fats and high fructose corn syrup from the food supply, not allowing "imitation" foods, which tend to be far worse for us than the food they are trying to imitate, and by finding a way to make fresh produce less expensive than fast-food meals. By helping people become healthier, perhaps we can slow the flood of people that develop health problems and need care.

Another argument I hear all the time is that a government-run system by definition must be less efficient and more wasteful than a privately run system. In Canada, because so much of the government's budget goes to health care, it is in their best interest to make the system as efficient as possible. Governments are accountable to their electorate, and health care is ALWAYS a top issue, so if people are unhappy they vote the government out. I don't believe that insurance policy holders in the States can vote out the people that run their insurance companies every 2 to 4 years if they don't like the care they are receiving - and they are completely at the mercy of what the insurance companies decide with respect to coverage. It is not in Canada where we regularly hear stories about people being denied care due to various insurance loop-holes. Canadians simply don't have to worry about receiving a huge medical bill, unless they travel to the States. And when there is profit involved as in private care, prices must be higher for the company to make money, and I would think it is at least possible that corners might be cut to boost the bottom line. In a non-profit system, that goes away.

The Canadian system is by no means perfect. The biggest problems are doctor shortages, especially in rural communities, and wait-times for non-life-threatening health issues, which can be quite long. But all in all, most Canadians are pretty happy with the system, and would not exchange it for the system that currently exists in the States. Hopefully our American neighbours will focus on achieving the above goals with their health care reform, and not get bogged down in politics and fear mongering. And please, if you are going to discuss the Canadian Health Care System, get your facts straight.

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Related Posts:

Hospital food - an opportunity waiting?
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Bobbie Sage What is Universal Health Care? About.com

Bob Rae Keep Canada Out of the U.S. Health-Care Debate The Mark News, Aug. 5, 2009.

Maurice Tougas Canada Dragged Into U.S. Health Care Debate See Edmonton News Aug. 6, 2009.

Copyright 2009 Vreni Gurd

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