11 August, 2009

The Truth about Canada

Heard on National Public Radio
These days, we can hardly turn on our TV's without seeing political ads telling us how horrible Canadian health care is.

Now, just so you know, no one in Congress or the White House is suggesting that the US adopt the Canadian design. [Though why they aren't, I don't know--it's a great system. Oh--that's right--the insurance companies don't want it. I forgot.]

Sarah Varney, reporter for NPR member station, KQED, decided to check out health care north of the border. See what you think.
Varney opened her piece with a visit to a doctor's office. She interviewed John Riley who was being treated for colon cancer in a small doctor's office in a gritty, working class neighborhood. He and his wife have been seeing the same doctor for over twenty years. They are allowed to choose their own physician.

Varney asked John if he had been required to wait for treatment. "Nothing but good. Everything has been going bang, bang, bang."
Did he have out-of-pocket expenses? "Other than gettin' there. No. Everything is good. I'm covered. I'm covered."
So, how does the Canadian health care system work? It's paid for by income tax and sales tax. All Canadians are covered and can see any doctor they want, anywhere in Canada with no co-pays or deductibles.

Some things aren't paid for: optometry, dental care or prescription drugs. Some people carry additional insurance to pay for those--others pay out-of-pocket for them.

American opponents to a new health plan like to call Canadian health care "Socialized Medicine [HORRORS!]." That's not an accurate description. Actually, it's socialized insurance--meaning that the risk is pulled together and paid for by the government.

While individual provinces and territories set their own overall health budgets and administer the health plans, the delivery of the actual care is private. Doctors run their own practices and bill the government rather than the patient or a 3rd party provider.

A physician Varney interviewed [Dr. Barsalai] told her that doctors earn a good living in Canada and don't have to handle the hassles involved with dealing with hundreds of different insurance policies--each with its own rules.
The article didn't say so, but I would imagine the issues of pre-approval or preexisting conditions don't come up.

Barsalai said that medical costs in Canada are half of what they are in the US. Infant mortality is lower. Life expectancy is longer. Obesity is lower and accessibility is higher.
Canada must be doing something right.

The Commonwealth Fund, a respected and non-partisan health research organization surveyed the 19 top industrialized countries in regards to deaths that could have been prevented had appropriate care been available. Canada rated 6th in positive outcomes while the US rated last.

Steve Morgan, a health economist at the University of British Columbia in Vancouver, said, "I think a lot of it has to do with access. Canadians who need to manage a chronic condition or are faced with an urgent situation don't think about their pocketbooks. They seek the care and, more times than not, they get the care they need."

Varney met with Morgan and his colleagues at the UVC Center for Health Policy Research to find out what the data they've collected over the years reveal about the Canadian health system. Varney advised them of what the American public is told about the Canadian process: that health care is rationed, there are long waiting lists and a government bureaucrat gets between the patient and his/her doctor.
Professor Bob Evans, one of the grandfathers of the health economics field, said, "An illusion has been created that there are long lines of people who are near death waiting for care. That's absolute nonsense!"
Evans has been studying the two systems [Canadian and American] since they were founded about the same time during the 1960's.
He went on to say, "Are there people lined up not getting the appropriate care they need in appropriate times? Of course there are. It's a huge system and a very complicated one. And things do go wrong. But, as a general rule, what happens here is: when you need the care--you get it. We're not a third world country! [He sounded downright incensed.]

When federal funding for health care declined when a recession occurred during the 1990's, lines for nonessential services [and even some urgent ones] grew. The Canadian Supreme Court did find that, in some serious cases, patients had, in fact, died as a result of waiting for medical services. Stories of the deaths and of people traveling to the US for medical care dominated Canadian news. As a result, the Canadian government poured billions of dollars into reducing waiting times in the areas that were the most critical including cardiac care, cancer and joint replacement surgery.
As a result, the amount of wait time has been dropping. Most provinces now report waiting times on publically available websites. No such data or accountability is available in the US.

That's not to say there aren't frustrations regarding waiting for health care in Canada. At BC Children's Hospital, Jocelyn Tomkins, a young woman born with a condition similar to spina bifida, stated, "I haven't been able to walk since I was eight. I've had lots of surgeries and interventions but, beyond that, I hold a job and I live a pretty much normal life."
Jocelyn credits an army of doctors and physical therapists for that normal life but she admits there have, on occasion, been roadblocks.
"Of course there were some times when I had to wait for care and those were always the most frustrating moments."
A few years ago, when she was on a wait list for a pain clinic, she traveled first to Seattle and then to Texas. The care she required cost $1,800.00. Very few Canadians do go south for health care. It's a bit like getting struck by lightning--it's rare but, when it happens, everyone talks about it.

On some occasions, provinces pay for people to receive specialty care in the US. One such instance is the fact that a shortage of neonatal beds in Canada leads some women with high risk pregnancies to travel to the US [at Canadian expense] to deliver. It doesn't happen often and polls show that the vast majority of people are happy with their health care.

A few people would like to purchase private health insurance. Currently that is not allowed.

Canadians share some anxieties with their counterparts south of the border: a concern regarding their aging baby boomer population; overuse of emergency departments and a shortage of primary care doctors. But what Canadians don't worry about are losing their health insurance or going bankrupt because of a health crisis.


LeftLeaningLady said...

My ex-boyfriend was Canadian, stationed here in the US when I was AF. His father had a heart attack and needed a bypass (triple or quadruple) and had it within days at no out of pocket expense.
I work with 2 Canadians now, one loves the system because she has seen how it can save a life. The other one hates it because it takes so long to get service.. for non life threatening issues.

They do pay a lot more in taxes, as do the Brits, but I think it would be worth it!

two crows said...

hi, LLL--
Canada and all of western Europe pay lots more in taxes than we do.

and they retire earlier, live longer, their health care is paid, their schooling [through college] is paid, etc. etc.

they aren't clamoring to change their system to look like ours in order to get lower taxes. gee, I wonder why that is?