Canadian Health Care, Part Two
COLUMN By DOUG THOMAS
Sept. 30, 2009
As I said in Part One, there are too many myths about Canadian healthcare circulating in the United States. For the most part these myths do not hold up to statistical scrutiny and are often based on anecdotal evidence. Of course the bad news stories, often enhanced, get quite a bit of circulation. The biggest stone in the American shoe about public healthcare is that it is a social(ist) system and it is perceived as a threat to free enterprise democracy.
One of the persistent myths is that Canadians often give up on our system and pay for treatment in the U.S. either because the treatment is not available in Canada or waiting times are too long.
Indeed, some Canadians do travel to the United States for treatment. Rarely do they pay for these treatments themselves. A quick look at our geography will show it is often cheaper for our health insurance system to send a patient to a state immediately south of a province for treatment when that treatment might also be available in another part of Canada that is much farther away. The Canadian patient does not pay for this - our health care system does.
The transfer of patients across regions is a reality generated by our small population and large geography. Saskatchewan, for example, is roughly 1.54 times the area of California, but has 3 percent of California's population. Any given disease has a far lower statistical likelihood of occurrence in Saskatchewan than in a place like California. Having medical equipment there that might rust out before it wears out is highly inefficient.
Wait times are certainly a concern with forty-two percent of Canadian patients waiting an average waiting two hours or more in emergency rooms compared to twenty-three percent in the US. On the other hand, Canadians who need help after hours or on weekends do better at getting attention than their American counterparts.
Other myths are, unfortunately, at least partly true. There are too few doctors in Canada and to make matters worse, they tend to gravitate to larger urban centers. In fact, Canada has fewer doctors per capita than the United States. Two factors have caused this:
1) Young doctors think that they will be better off financially in the United States and they emigrate.
However, this myth has proven untrue since higher costs of living and such professional expenses as malpractice insurance premiums more than match higher incomes. In 2005, statistics from the Canadian Institute for Health Information indicate that more physicians returned to Canada than moved abroad.
2) Canadian governments, both federal and provincial governments have reduced funding to universities for medical schools.
This unfortunate tendency to try to emulate the American system has taken its toll on our health care system in this and other ways.
Can a system like Canada's work in the U.S.? Probably not, at least not totally.
For one thing, much of your infrastructure is privately owned. However, remember, the really public part of Canada's healthcare system is the insurance part. In our case, everyone is covered equally in a universal plan.
At least in the beginning the U.S. system may be able to cover only those who cannot afford private health insurance. What Americans have to get their minds around is that social programs like healthcare do not create a slippery slope that erodes democracy.
Doug Thomas is an English teacher and novelist, an agnostic member of SOFREE (Society of Ontario Freethinkers), and an active member of the Humanist Association of Canada. He is also Managing Editor of Canadian Freethinker.