COLUMN By DOUG THOMAS

For HumanistNetworkNews.org
Sept. 16, 2009

Lately, Canadians have listened to a multitude of American distortions about our health care system. These have ranged from misinformation, through selectively quoted statistics, to outright lies and pure fantasy. In spite of an aversion to commenting on American affairs I must respond to this defamation. Our system is not perfect, but everyone who lives in Canada, whether in a mansion or under a bridge, has access to health care.

The central component of Canadian health care is the public health insurance system-nothing more, nothing less. Really, this system is very simple, once one has a fundamental understanding of Canada's constitution as it applies to health care. Health care is a provincial responsibility. The federal government influences provincial health care systems through grants governed by the Canada Health Act (1984). This act encourages uniform national standards of "medically necessary" health care across Canada. It does not impose specific rules on the provinces, nor does it interfere in the doctor-patient relationship.

We Canadians select our own doctors and referrals to specialists are not affected by any government agency. In fact, there is no such government agency. Doctors are independent business people. They are paid on a fee-for-service basis by the provincial health care insurance in their area.

There are no provincial or federal agencies that decide who will be treated or the type and extent of their treatment. Those decisions are entirely up to individuals and their doctors. Regardless of age, perceived value to society, or pre-existing health conditions, every legal Canadian resident is covered by our health insurance and receives medical treatment appropriate for providing the best quality of life possible.

The health insurance system is very simple. Health insurance "premiums" are included in our income tax. In some provinces, well-paid individuals pay a surcharge that goes directly to the health insurance system. In other words, we pay premiums in accordance with our ability to pay. If one's income is low, one pays neither income tax nor health care surcharges. Yes, that means that the wealthy subsidize those with less money just as we subsidize other inalienable rights like public education.

In addition, one can acquire more health care benefits through private companies. These private policies may be expensive and do create a new layer of payment, but they dovetail with the provincial systems to fill in the gaps in the public system. These policies also include dental, optometrist and pharmaceutical support.

Some concerns about waiting times have been raised by Canadians. The average waiting time is, however, much lower than critics of the system claim. In any case, the problems are not caused by the public health insurance system, but by infrastructure and geographical realities that would exist with or without public insurance.

When someone goes to the doctor of one's choice, the only input from the government is the payment for medical treatment. As far as the individual is concerned, that is the extent of government involvement. As I said, our system is not perfect, but few, if any, of the problems are related directly to the public insurance system.

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.