By Jane Bryant Quinn
CBS Moneywatch, Aug. 12, 2010
You have to leave the country to get a proper perspective on the high cost of health care in the United States. Even if itâs just over the border.
My husband and I spent a long weekend in Canada last month, lapping up plays at Stratford, Ontarioâs justly famous Shakespeare Festival. At our bed-and-breakfast, we lapped up waffles and strawberries, and got an earful from Brenda, our host, on the craziness of American medical bills.
She was planning a trip to Florida, where her brother lives, at the end of the theater season. For safety sheâll buy a private travelersâ health insurance policy tailored to costs in the United States. She doesnât dare leave home without it. âIâd go bankrupt if I had to pay even part of an American bill,â she said.
At home, Brenda is covered by Ontarioâs single-payer policy, in a tax-supported system that amounts to Medicare for all. She gets only token coverage, however, if she falls ill or has an accident in another country, and America scares her. Some countriesâ medical systems are affordable, she says, but not the one in the United States. Canadians pay more for travelersâ policies usable in the U.S. than for policies designed for use anywhere else in the world.
Brenda bristled with facts. When her brother in Florida had to be rushed to the hospital last year, the ambulance bill came to $1,300. When her husband had a similar emergency in Stratford, they paid $45. If she needs a Florida doctor, sheâll be reimbursed at Canadian rates, which are significantly lower than the rates charged in the U.S. Brenda tried to be polite but she couldnât understand why Americans endure it.
As luck would have it, a doctor was staying at our bed-and-breakfast, too. He makes less than his peers in the U.S. and said he didnât care. Life was fine and he was glad not to have to negotiate prices with patients or turn away the uninsured. His bottom line on U.S. care: âThe corporations that own American hospitals exist only to make money, thatâs the problem.â
Americans imagine that Canadians rue their system because of the waiting lists for elective surgery. The rich avoid lines by going to the U.S. (or elsewhere in the world) and paying out-of-pocket. At our Stratford breakfast, however, no one worried about a four-month wait for a hip transplant. They all said they take the waits into account by starting the march toward elective surgery a little earlier than American patients might. As long as they were kept pain free, they saw no reason to hustle toward the knife.
As for rumors running around the web that older Canadians canât get lifesaving or pain-reducing procedures such as heart bypass surgery: Theyâre false.
Yes, but what about taxes? The face of the doctorâs wife got a little grim. âTaxes go up and people just pay them,â she said. For example, sales taxes on many items rose in Ontario in July. She didnât like it, but would she give up her health-care system in return for a lower tax? Not a chance. âNo one in Canada lives in fear of medical costs,â she said.
I prowled around the web, looking for comments on Canadian medical care. Health outcomes are generally better than in the United States.
No system is perfect, of course, and there are grumps. âHealthcare is not free in Canada even though it seems like it. We are taxed to death,â one person complained (while going on to say that Ontario ought to boost the amount it reimburses patients for clinic care).
The stories that affected me more told how reliable access to care can change a life. Hereâs just one:
âMy dad at the age of 50 was forced to go into business for himself. I am pretty sure he would not be able to afford or qualify for any health insurance at his age. But because he was Canadian, he was able to start his own company. I am also pretty sure that, considering the expenses I incurred with three premature children, my employer would be none too happy with me if I worked for a small American firm. Thatâs something Iâm not worried about here.â
Will Americans ever achieve that same peace of mind?
