By Bill Mann
MarketWatch, The Wall Street Journal, Aug. 9, 2012
PORT TOWNSEND, Wash. (MarketWatch) — It’s a relief to see hard facts finally emerging on this side of the border about Canada’s single-payer health-care system.
For years I’ve heard Canada’s popular medicare (the Canadian term for universal health care) system slagged by lies, distortions, and outright ignorance on U.S. radio talk shows and other American popular media (where do people GET this stuff?). And for years, I’ve tried to set the record straight in my online and newspaper columns, having lived in Canada and actually having used their system. My son and his family are now covered by it in Vancouver.
Also, for years I’ve heard from Canadians, in Comments under my pieces and in email, thanking me for trying to set the record straight. They overwhelmingly like their medical delivery system, which turned 50 just last month.
I’ve also heard Canadian talk-show callers upset and incredulous about the nonsense being circulated south of the border about their single-payer medical system, which is still evolving as Ottawa pays less and the provinces pay more of growing health-care costs.
Anyone who wants a strong, honest defense of the Canadian system should keep a copy handy (and print out, as I have) a well-written piece — a touchstone, actually — in the latest online edition of the journal of the U.S.’ large and powerful AARP.
The well-researched, fact-based AARP article is written by an American, Aaron E. Carroll, M.D., and is titled “5 Myths About Canada’s Health Care System.” Its subhead:
“The truth may surprise you.” It just might, my fellow Americans.
To separate fact from polarizing talk-show nonsense, Carroll, the director of the Center for Health Policy and Professional Research in Indianapolis, examined the major myths about the Canadian and U.S. systems, myths I hear repeatedly voiced on U.S. talk shows of all political stripes.
The first myth Carroll takes on is the oft-heard one about Canadians supposedly “flocking” to the U.S. to get medical care. An eye-popping pie chart, generated by peer-reviewed journal “Health Affairs,” shows only a tiny sliver of Canadians heading south for care — less than 1%.
Even more telling here is a “Health Affairs” survey of U.S. hospitals near the Canadian border, where you’d expect all these “care-deprived” Canucks to go first. A vast majority saw fewer than one Canadian a month. Bigger hospitals, even those rated by U.S. News & World Report as “America’s Best,” also saw very few Canadians, in either emergency or elective care. And these are exactly the hospitals where you’d expect to well-off Canadians to go.
(I love the metaphorical title of the Health Affairs study, “Phantoms in the Snow: Canadians’ Use of Health Care Services in the U.S.”)
The second myth, about Canadian doctors supposedly taking U.S. jobs, is also debunked by Carroll’s research and facts, which show high Canadian physician satisfaction in Canada and fewer Canadian doctors heading south to practice — less than 0.5% of all Canadian MD’s in the most recent findings.
(Charts and graphs from hard data, something many MarketWatch readers appreciate. Carroll’s well-researched article is loaded with them).
The third myth concerns how Canadians ration health care in specific areas. Every Western nation rations medical care out of necessity. As we’ve mentioned here before, Americans have chosen (so far, anyway) to ration medical care by income.
One favorite argument, heard on the floor of Congress and elsewhere, is that Canada denies hip replacements to older people. Absolutely not true, Carroll documents. Older Canadians get a ton of hip replacements. He can’t resist adding this wry note in the AARP piece:
“Know who pays for care for older people in the U.S.? Medicare. A single-payer system.”
The fourth myth is that Canadians have far longer wait times for medical treatment because of its system. This is one I hear all the time. Carroll says this is true, BUT…there’s a good reason:
Canadians have shown admirable restraint — something normally in short supply here in the U.S. They’ve actually opted to hold down medicare costs by consciously waiting longer and limiting supply, mostly for elective procedures. Imagine that.
Canadians, in other words, have made a choice to be fiscally conservative, Carroll says in his well-documented article. They’re more realistic and less demanding than many American patients are. Carroll says that Canadians COULD, if they wanted to, cut down wait times — by spending more on health care. But they’ve actually made a conscious choice not to do this.
This is no smoke screen: I’ve heard callers on Canadian radio shows state exactly this many times. They’d rather show personal restraint by waiting a bit longer than running up deficits.
The final myth about Canada rationing health care in its system and the U.S. not doing so governmentally, is trickier, Carroll admits. But he points out that although the U.S. pays quite a bit more of its GDP than Canada does on health care, far more Americans in need of care go unseen by doctors. And U.S. medical outcomes, he adds, are middling at best.
Feel free to have a discussion on the two systems, Carroll concludes. His piece has hundreds of Comments below it, not surprisingly — many of them rehashing the same old tired myths about Canada’s popular system his piece debunks).
But, he adds, but if you do have a discussion on this important subject, “Stick to the facts.”
Given the U.S.’ history in this politically charged area, as my Canadian friends would put it, “Not bloody likely.”