Why Canadian health care is better
I've lived on both sides of the border. Our healthcare system isn't perfect, but from where I sit, it sure looks a whole lot better
I had just endured another colonoscopy, the nasty but necessary screening test so effective in preventing colorectal cancers, when I heard about the colonoscopy sweepstakes. Announced in a 60 Minutes commercial break back in February, it featured an eyebrow-raising prize: a free exploration of your gut by a New York gastroenterologist, plus four nights at a luxury hotel (first night to be spent on the toilet after swilling glasses of the noxious laxative that are required for the procedure).
It was a uniquely American way to raise colon cancer awareness while striking a chord with people who never see a doctor because they can’t afford it. This past August in Los Angeles, more than 6,000 of them lined up for hours and camped out in their cars to attend a temporary free health clinic. In the world’s richest country, some
46 million people have no insurance to cover what every Canadian has taken for granted since the birth of medicare in 1967. The luckiest Americans have employer-sponsored plans—at least while they keep their jobs. The rest can buy insurance, if they have the money. (My friend Elaine, a self-employed Canadian now living in Arizona, had to shop around: Her pretty basic plan costs about US$8,000 for her family of four.) What’s more, even the insured are one health crisis away from financial ruin because their insurer either doesn’t cover all the costs or—unbelievably to us Canadians—cancels their coverage.
No wonder President Barack Obama has staked his legacy on a furiously debated plan to ensure portable, accessible insurance for all Americans. Its most controversial plank—a public option to compete with private plans—has been labelled “socialist” by fear-mongering opponents who heap scorn on Canada’s universal health care.
As an American by birth and a Canadian by choice, I can’t help but take this personally. I remember how astonished and grateful I was to receive no medical bills for prenatal care and childbirth back in 1971, when we were still struggling to pay for groceries. I am glad to be living in a country where cancer patients are not left to die untreated (it actually happened this year in Las Vegas, when a cash-strapped public hospital closed the chemotherapy unit). And like many Canadians, I cringed last July when an Ontario woman, Shona Holmes, became the Joan of Arc of the American campaign to stop the public option. In an inflammatory commercial for a conservative lobby group, Holmes said she was forced to have brain tumour surgery in the U.S.—and mortgage her house—to avoid a six-month wait at home. It turned out that Holmes had suffered from a rare cyst, not a tumour. But she’d been losing her vision, and had I been in her shoes, I too might have taken desperate measures.
I like to think that with the help of my superbly connected family doctor, I could have pushed successfully for timely treatment in Canada. But I pay $1,300 a year to be part of my doctor’s corporate practice and have access to his contacts (so much for the notion that two-tier medicine doesn’t exist here). Most Canadians aren’t so fortunate. In fact, a shortage of doctors has left five million people in this country with no first-line practitioner, let alone a well-connected one to champion their case. And then there are the wait times that still dog our system. The median wait time for common non-emergency surgeries ranges from four to six weeks.
Looking south, I can’t suppress a stab of envy. Insured Americans don’t wait in line, and at its best, the medical care is downright posh—as my expat friend Elaine discovered after surgery in a top-quality hospital with nurses hovering and tasty meals ordered from a menu. “It was like a hotel,” she recalls. Still, she knows her experience is hardly typical, and has made it her mission to answer questions from anxious Americans about Canada’s government-funded system.
For Canadians, health care is the emblem of what we’ve always considered our defining virtue as a people—fair-mindedness. Because our system is more compassionate in spirit than that of our swaggering neighbour, we tend to overlook countries that surpass us. “Canadians think our system is the best in the world, and this is not the case,” says Dr. Robert Ouellet, recent past president of the Canadian Medical Association, which has been working on a blueprint for “health care transformation.” The project took him on a fact-finding tour of England, France, Belgium, Denmark and the Netherlands, which have all done away with wait times. Asked what Canada should do to follow other countries’ lead, he has no shortage of ideas. For instance, hold hospitals accountable for the quality of care they provide (a British CEO was fired for unacceptably high infection rates). Let nurses and physician assistants assume some duties now needlessly assigned to doctors. And encourage competition with the public system by easing restrictions on private clinics.
As the owner of private radiology clinics in Quebec, Ouellet has his biases—and his critics. But there’s no disputing his ultimate goal: better health care for Canadians. “There’s waste in the system,” he says. “We need people taking care of patients, not pushing pencils.”
For me, a dual citizen, the Canadian fear of private care echoes the American horror of public funding. But in Canada we make our points in two-way conversations, not by shouting down the opposition. It seems to me that we have more respect for the art of listening. As Elaine puts it, “Canadians have a mentality of we. Americans have a mentality of me.” That’s why I’m proud to call Canada my home—and why I’m hopeful that one day our health care may indeed be the finest in the world.
This article was originally titled "Be glad you live in Canada," in the November/December 2009 issue of Best Health. Subscribe today to get the full Best Health experience—and never miss an issue!—and make sure to check out what's new in the latest issue of Best Health.
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