Message to America about health care

Hello from Canada! I am watching and listening with great interest and much bewilderment over the harsh scare tactics and propaganda being used by those against health care reform in the US. The anti-reform lobby is pulling out all the stops to whip as many people as possible into a frenzy of paranoia regarding how awful universal health care would be. So let a Canadian, someone who lives in a country with (mostly) universal health care lob a view from this side of the fence.

First off, I suspect that the people shouting the loudest have the most to lose. That would be the HMOs and those who support them or benefit by them. Wouldn't it be interesting to see which politicians get donations from health insurance companies? No matter - I cannot imagine any logical reason why access to health care for every living soul would not be in a society's best interest.

Quality of service versus cost is the issue and it's one that the US will have to figure out smartly. In Canada, we have what I would consider to be pretty close to universal access. It makes no difference which doctor or hospital you visit. One thing about universality that has eroded in this country is what is covered and what is not. Basic health needs are covered. The official spin from our government: "Universal coverage for medically necessary health care services provided on the basis of need, rather than the ability to pay." You can supplement your basic government health coverage with 3rd party coverage like Blue Cross, but this may or may not cover everything else. Probably the biggest complaint in Canada regarding our health system in is wait times, which, depending on where you live, can be long for certain procedures (see graph). MRI is a big one. I have an MRI scheduled in October for a problem that evaporated 3 months ago. I could opt to 'pay' for more immediate access, but that neither fits within my budget, nor my expectation of what constitutes universal access. Our next biggest issue is availability of doctors. I know many people still trying to find a family doctor. Once you do find one, moving to another is painful. Many doctors opt to retire early, cut back their hours, go into private (paid) practise (something I wish were illegal in Canada) or move to the US where doctors supposedly get paid more money. But our system is lacking key problems present in the US system. There is no such thing as qualifying for coverage here. You pay - you're covered. There's no paperwork. The doctor's bill is sent to your government health system and they pay. This doesn't include dentistry or prescription drugs of course. That's a whole other story.

What I find interesting is that while America tests the waters of a more Canadian-style health system and the nay-sayers warn of an awful experience under such a system (it's not awful at all), Canada is slowly abandoning the philosophy of universal access and sneaking in a multi-tier system (based on what you're willing to pay) that is slowly tearing apart the fabric of what was once a proud and functioning system. I believe this could be fixed if government allocated enough money to the system instead of trying to cut corners.

So there you have it America - our system is something to look forward to in principle, but make damned sure your government spends what it needs to to make the system work. If the HMOs survive the transition and have their way, there will still be excuses for why people can't qualify for necessary treatment. At least, that's my take on it.

In case you can't read those procedures in the graph, they are (from left to right) cardiac bypass; all cancers; CT scan; prostate cancer; MRI; cataract surgery; breast cancer; hip replacement; knee replacement.