By Anita Watkins
Guest Column
The Ithaca Journal
May 2, 2008
As a dual United States and Canadian citizen who has experienced health care in both countries, I’d like to add some perspective to warnings against government health care modeled after the Canadian system.
The Canadian system is publicly financed, but doctors and clinics practice privately while hospitals are independently governed. The government is the single payer for services using federal tax dollars controlled by the individual provinces. In the U.S., in contrast, providers must deal with hundreds of different insurance companies and HMOs. The single-payer system is efficient, and administrative costs are about half those in the United States. More money goes into health care; less goes into paperwork. Canada spends about half what the United States spends per person on health care and achieves better outcomes in terms of life expectancy. The United States also runs a widely-used, effective and popular publicly financed, single-payer health care system — Medicare.
The Canadian provincial governments manage health care dollars so that the vast majority of people receive the care they need in a timely fashion. Critical care is immediately available. In the United States, the majority of people receive health care, but insurance companies and HMOs ration and deny treatments to save costs, and one out of seven Americans are not assured of health care at all, and may avoid checkups and preventative treatments they can’t afford to pay for. Canadians don’t hold bake sales and chicken barbecues to pay for a child’s cancer treatment.
Wait times, a concern in Canada, are largely the result of attempts to keep health care costs under control, particularly by conservative governments. This could be remedied with more money to provide capacity in the system and by removing caps limiting the number of doctors trained or certified to practice.
There are also wait times in the United States To make a realistic comparison of the two systems, we would need to factor in the people who effectively wait forever in the United States because they can’t afford access to the system. The United States rations health care by ability to pay. Canada manages health care by need. The bottom line is that the vast majority of Canadians get the health care they need with no problems.
I have personal experiences with both systems. I have found no faster or better service here than what I received in Canada. Last summer my son Tom, an Ontario resident, developed an infection in a bite on his leg while he was in Algonquin Park. We were seen at a walk-in clinic in Huntsville and treated within 10 minutes on arrival. Two days later, he visited the same clinic for fast, efficient, follow-up treatment. In Toronto, he followed up with visits to change dressings. All of this was covered by the Ontario Health Insurance Plan. The clinics filed the claims electronically and there was no paperwork to deal with. Tom, who was starting his first full-time job, couldn’t have afforded health insurance nor the cost of the treatment had he been in the United States In contrast, for a trip here to a clinic with a tick bite, I spent several hours, mostly waiting to be seen. The visit generated paperwork for co-pays and health savings reimbursement.
Do Canadians pay higher taxes to cover health care services? On average Canadians pay a higher rate of income tax, but it’s hard to make comparisons on the total tax bill because Americans often pay more local and Social Security taxes. What Canadians (individuals or companies) don’t pay are high insurance premiums, co-pays and deductibles, essentially another layer of tax that Americans have to ante-up. Think how much you pay for health care premiums and add that to your tax bill! What Canadians don’t finance is an inefficient bureaucracy to process payments and produce a profit for shareholders.
Would Canadians like to change their system to American-style health care? Resoundingly no. Canadians like to complain about health care and hockey, but I’ve never met any Canadian who would trade. In fact, when asked to name the Greatest Canadian in history, a broad national consensus in Canada chose Tommy Douglas, who was the father of the Canadian health care system.
The Fraser Institute quoted in a letter in March is a conservative, libertarian think tank, with an ideology opposed to taxation and government control (“Canadian health care,” March 7). It advocates more freedom to choose and pay within the Canadian system but keeping the public system intact, modeled after schemes in countries such as Austria, Belgium, France, Germany and Japan. The Fraser Institute is quick to reassure readers that the changes suggested will not lead to the “Americanization” of health care.
Is Canadian health care perfect? No. But it’s the exceptional anecdotes of problems that make the news, not the excellent care that the vast majority of people receive quickly and efficiently. Before people criticize the Canadian model, I think they should talk directly to Canadians — a lot of Canadians — and get a broad picture of the Canadian experience. Despite grumbling, Canadian dissatisfaction with their health care system remains in the single digits. Can the United States say the same thing about its health care system?
Anita Watkins lives in Cayuga Heights.