All debates in Canada begin and end with "At least it's not the American system" or "At least we're not American." And that's that. End of discussion. Let us not improve our lot.
A physician in the United States, a rational fellow if I've ever heard one, who worked in Canada for a time, made an astute point on the radio. We often here about how much "healthier" we are up here (which I always took with a grain of salt) without defining exactly what we mean by this.
Here's the reality: If you get a serious, life-threatening ailment in Canada, you're on a waiting list - my father had an aorta condition and was told he could die at any moment. They canceled his surgery three times. He waited over a month for such a grave illness!
If you happen to be one of those who weren't put on one, then God bless you but there's ample evidence to suggest this is the exception rather than the norm. Many Canadians are not willing to wait six months to begin any treatment so they head for the States to be treated immediately. Usually, the provincial government will cover the costs if it's a service we can't provide here - and there are many services we don't offer. By the way, in Ontario if a surgeon decides to go public, the government will not allow him to perform specific surgeries even though he's trained in the same schools as those who are in the public system! In other words, he can do a small knee procedure, but not ACL surgery. Insane. I know.
I remember during my time at FPC at how many requests I got from Quebecers to see a rheumatoid specialist because there aren't any here. The closest one to be found was in Vermont. I consulted a few people who were in the medical tourism business and they assured me it goes well beyond rheumatoid shortages.
This got me thinking. Has the American system subsidized and contributed to our well-being? After all, we don't have the timely access to doctors and advanced equipment they have.
This, in turn, reminded me of a History of the Canadian arctic course I took in university. Canada's policy in the arctic was so patently naive mixed in with indifference it shook me to the very core of something - of what I'm not sure. One story in particular blew my mind. After years of neglect, Canada's sovereingty in the region was being increasingly challenged. The first test came from the hands of American whalers on Herschel Island in the Beaufort sea in the late 1880s.
Canada responded by sending in the Mounted Police - six in total. Charged with, if my memory serves me right, ensuring foreigners obeyed the law (despite no real legal framework), protect the Inuit and exert Canadian sovereignty. That's a lot of responsibilities for six officers in a land as big as the arctic. With little or no support by Ottawa, the police were soon, predictably enough, basically destitute. They had to rely on the whalers for equipment and provisions!
Now you tell me if they were that commited to bringing American whalers to justice.
Which reminds me of another story, this time in amateur sports, of a female Canadian cyclist (I forget her name) who won gold for Canada in Sydney. While she celebrated, her coach was back home in an Edmonton bar because there was no funding to get him there! How we win anything is a miracle.
Typically Canadian. But hey, as long as we're all equalized it's all tolerated.
Anyway, I see a parallel in what the Mounted Police went through and patients of the public health system.
If I understand correctly, the issue in the U.S. is not quality of care or whether Americans are unhappy with their system they seem genuinely pleased with it. Rather, it's how to get everyone covered. No one disputes this fact - not even conservatives. Insurance companies clearly are a problem and the debate, at least it should, surrounds their role in it specifically. However, the language the governement is using in the bills is scaring people who are actually reading it. They feel it amounts to an eventual government take over of health and this is where Americans have lashed out - only to be demonized by the White House.
So much for dissent being healthy.
Look my friend, write and say anything you want about Obamacare or our universal system. I was involved in setting up our system from the very beginning in 1973. It does not do all we wished it to do...but I saw my grand parents slowly die because they did not have the money to get medical care and the family could not do more, one died in 1954, the other in 1956.
ReplyDeleteI was there when an ambulance picked an unconscious guy with a possible skull fracture, bleeding from the ears and the officers, the police then were the emrgency crews, looking through his paper to see if he was insured. He was not and I heard them saying:" the poor guy will be dead before we get him St-Luc". We were minutes away from another hospital.
On another occasion riding the ambulance with a wounded man, also taken to St-Luc, when we got to the emergency ward the first question was...you know what!
At least this has been eliminated and I'll fight tooth and nails to preserve it. Could it be improved, certainly, but conservatives, baby boomers and the Y generation would have to, shudder me timber, accept to share the burden.
My dear Paul, where does it say I advocate the dismantling of it? Have I not made it clear time and again that it should be preserved?
ReplyDeleteHowever, the "mission accomplished" of having everyone covered (but not all services) created a whole different set of problems. We seem to think because we're all covered we should tolerate waiting times that can be just as life-threatening! The system is monopolistic and it rations health. Not any better in my book. If Europeans realized this why can't we?
I DO advocate the smashing the monopoly though.
Doesn't our system date back to the 50s and 60s? Are you referring to the health care act provisions?
One small tidbit: the U.S. has medicare and HMO's so I don't know if people get turned away. Nor do I know what the differences were between Canada back then and contemporary America.
But it's interesting to note, neither society fell to bits even without public health.
What Canada in reality needed, sounds like, not a NATIONALIZED program but a way to insure people without a government monopoly. Same with the U.S. Why MUST it be a public option? They say pure capitalism doesn't work so why do we think pure welfare works?
And you didn't address my overall point. The irony of possibly the American system helping to keep our health stats, erm, healthy.
ReplyDeleteThe American system helps because our public system pays otherwise it would not.
ReplyDeletePrivate insurance companies are in the business for profit and have to keep their investors happy with healthy returns not healthy citizens. So true that when you get really sick they cut you off.
Is that what you want us to go back to.
The HMO are for those who can afford them not everyone can. We have a kind of that with some cooperative clinics in some remote Québec regions...but still you must be an investor to benefit from them and some do not have the means to.
Our system is about sharing, without what you call a monopoly it can not work.
Agreed it does not work as we would like but are you ready to pay more income tax to fill the voids? It's easier to say serve those who can pay and damn the others...as we had before our so called socialist monopoly.
No, I didn't say that either. The way the insurance companies operate down there is wrong. But again, why not simply regulate them?
ReplyDeleteBut Canada should and will allow for private insurance options. There's nothing wrong with this. If we can regulate banks (even though they lack transparency) we can regulate private insurance.
I don't know how it works in the U.S., but between HMOs and medicare I don't think people are turned away. People forget: there's already government intervention in the U.S. system which in part contributes to the overall costs.