Allan Tweddle responds to Uwe Reinhardt on “one size fits all”

(Quote of the Day for April 16, 2013

I am no expert, just a Canadian born US Citizen with family still north of the border.  I have seen the personal value of their system many, many times.  From horrific cancer in children, to heart and cancer in elderly, to total hip replacements, all covered at zero expense to the citizen patient.

And even that needs clarification.  In the Canadian Immigration web page, once a person is accepted by their immigration department, a new arrival into Canada will get full coverage within 3 months after arrival.  That is remarkable, considering that that person has not yet contributed one dime to the system.

Their system, like in Britain, provides basic health care for all and lets the private insurers pick up the tab for luxury items like fancy hospital suites, Viagra, etc.

The Canadian system is controlled, designed and managed by each province.  It has Federal dollars in each plan, so while their experience is NOT “One size fits all”, they have made it work for 30 years or more.  Did we make any attempt to study their success and learn from their mistakes?  I doubt it.

However, there are only 10 provinces.

Our ACA plan that tries to take into consideration 50 States does look far too complicated. I’ve been in briefings for the West Virginia plan alone, and it’s too complicated.  We need to just lower the eligibility age of Medicare to age zero less 9 months!

We need a single payer for the basics so we eliminate bankruptcy due to unexpected and financially catastrophic health care costs to individuals.  It is my understanding that in the U.S., medical debt contributes to 62% of all bankruptcies. In Canada that number is ZERO!

Shouldn’t we be protecting the citizens and not the greed-driven insurance industry?


Our emerging manufacturing company has been considering a location for our production operations.  We have concluded, like so many automobile companies* have, that Southern Ontario would be financially attractive due, among other reasons, to the differential in payroll burden.  Aerospace payroll burden here is about 36%, whereas it is 15 to 18% in Ontario.  That’s a significant differential…20%!  And from everything we have been able to determine, the difference is health care expense. (*Did you know that the expense of health care is almost always cited as a primary reason for the announcement of new plants in Ontario, so that now more cars are made and assembled in Ontario than Michigan?)

The financial/economic value of a universal single payer system is obvious to us.  And when you learn that the system they have there has better health results, then the choice becomes clear.  And if any right-wing free enterprise enthusiast who has an open mind would pay attention to the sheer economic advantages, they would join us on a bandwagon to get it here.

But we cannot wait for that to happen, so we will in all probability be locating there.

Allan Tweddle, of Charleston, West Virginia, is Chairman and CEO of an aerospace manufacturing firm. His email address:

We should listen to this Canadian-born, U.S. businessman who is very familiar with the health-care systems and the business climates in both the United States and Canada. The lure of Canada’s health-care system may be too great for his company to establish production operations here in the United States. That should awaken us all, especially the business community.

Much less important, a comment on “one size fits all” is warranted. That phrase has been used endless times to dismiss single payer reform. Used this way, it implies that there are many “sizes” in health care. In reality, when you need health care, you aren’t checking out “sizes.” You merely want unrestricted access to the health care delivery system that we have.

The “sizes” they speak of usually refer to different insurance products, ranging from almost worthless mini-med plans to comprehensive, integrated HMOs. (For purposes this discussion, integrated health care delivery systems such as Kaiser and Group Health are considered components of our health care delivery system rather than as intermediary insurers.)

When individuals select their own insurance plans, which do they choose most often? They select high-deductible, preferred provider organizations. That is, they select a “size” that works if they stay healthy. Should they develop significant health problems, that particular “size” will prevent them from being able to have free choice of their health care professionals and institutions, and it will leave them with out-of-pocket financial burdens – neither of which is the “size” that they really wanted, especially when they find out too late that it didn’t fit.

Mr. Tweddle points out that Canada’s single payer system is not “one size fits all” since it is separately administered in each of their ten provinces. But, refocusing, the Canada Health Act does pull all of the provinces together into one “size” that is universal, comprehensive, accessible, portable, and publicly administered. Quite clearly, this is not a “size” that is inflexible to varying needs, but rather it is a comprehensive program that fits all.

When you shop for health insurance, it is important to keep in mind that all of the private insurance choices are the wrong size, to varying degrees. The only right size out there is the health care delivery system which can be readily accessed by getting all of the wrong-sized insurers out of the way, except for the one right-sized program that really does fit everyone – a single payer national health program, or improved Medicare for all.