Canadian and U.S. healthcare – a debate

I can never resist a good debate, especially when politics is involved. Recently I had the opportunity to debate Canadian versus American healthcare on Facebook. It was short-lived. I guess the person whose Facebook page it was decided they didn’t want the debate there! EAVB_YHQVSKDEAR

No problem. I’ll continue the debate here. I don’t have the original comment about Canadian healthcare, which I don’t remember being particularly negative, or my comment, but I do have the comment I’ll be responding to. Thank you, Facebook, for emailing responses to me.

Here’s the comment (verbatim):

And i’m sorry Alain….you have absolutely no idea what your talking about. Those so called greedy corporations that your mocking…just so happen to be the reason that the U.S. has become the super power that it is. It’s called “free market”. And no thanks to these liberal jack offs in our govt they are ruining what we have spent 200+ years building and defending.

You really wanna get in a debate with me over socialized heath care? Let me tell you a little something about your perfect system.

Do you have any idea how many other countries come to the united states for health care??? You don’t see Americans flocking to Europe or Mexico for heath care do you? Hmmmm i wonder why. Also…do you have any idea where most of the drugs and health treatments come from in the world??? They sure as hell don’t come from Japan. Germany. France. etc. They come from HERE. So educate yourself before you mock my country sir. Here’s just a tidbit on how messed up socialized health care is.

1.In socialized medical systems, the doctors work directly for the state. In Canada (and many other countries with universal care), doctors can run their own private practices, just like they do in the US. The only difference is that every doctor deals with one insurer, instead of 150. And that insurer is the provincial government, which is accountable to the legislature and the voters if the quality of coverage is allowed to slide. which means they control every aspect of your health because your on a federal file….

2.Doctors are hurt financially by single-payer health care. Because they don’t make crap compared to those “evil” american greedy doctors who’s only goal is to take your money. Funny thing is… unlike your “lotto” system when your govt runs outta money to fund your health care. They take whoever no matter who is sicker or not. Ours have the best interest in keeping you alive because if your dead….they don’t get paid!!!

3.You have to wait forever to get a family doctor. where i can choose from any list of private health care providers.

4.Wait times in Canada are horrendous… and on…and on…and on…and on….

So, Trevor, while I don’t have my original comment to refer to, what I do know is that I never claimed the healthcare system in Canada is perfect, but I prefer it to the US system. I readily admit that it’s not perfect.

I also was not mocking the US system, but criticizing it. The US healthcare system is definitely worthy of criticism. How is it that what is arguably the wealthiest country on earth cannot have healthcare for all of its citizens? How many are left out? 10 million? 30 million? Estimates vary, and I’m talking about US citizens, not illegal immigrants.

Even for those who do have healthcare, if you’ve got a health condition under one insurer, you may not have that condition covered if you were to move jobs or try to get a different healthcare provider because it’s a “pre-existing condition” with the new insurer. It effectively turns patients into slaves of those healthcare providers and potentially your employer.

If your health condition was sufficiently serious, you’d be crazy to change jobs, at the risk of your health care coverage ceasing in relation to that condition. How is this considered ethical or just? Is this the kind of society we want? I don’t.

From an economic perspective, it certainly limits labour mobility. That’s not a bad thing from a company perspective, I guess, but not an employee perspective. I can’t imagine an unhealthy employee is going to be particularly productive either.

Also, health care coverage in the US, from what I understand, can also be limited, as you’re saying apparently happens in Canada. I understand that in the US, health care companies routinely decide which procedures will be covered and which won’t. If there’s not a likely positive outcome or it’s not included in your policy, etc, it’s not covered. I’ve also heard of many cases where people had their coverage dropped completely.

That’s a superior system alright. Your coverage gets dropped when you actually need it most.

People say that in Canada bureaucrats decide on treatment, which actually isn’t true. Your doctor decides on the appropriate treatment, and yes, you may need to wait in line. Waiting lists in Canada are a problem that our governments are working on. How successful are they? Jury’s out on that right now. If cases are serious enough, they can be moved up quickly though.

Contrast this with the US where, in my opinion, it’s actually worse. Your case may not be decided by a government bureaucrat, but a corporate one! Brain tumours can’t be a profitable thing, so I can see why companies would routinely deny people coverage for serious medical procedures. After all, if you deny many of the most serious procedures, the shareholders will be happier. Sorry, but I don’t want my case decided on when there’s a profit motive involved. If insurance companies could get away with it, they’d be happy to collect your premiums and never pay anything out

I’m not aware of any countries seeking care in the US, but I know some citizens of other countries do seek care in the US. The US is blessed to have a large number of skilled, experienced and well-trained physicians. There’s no doubt about that. Treatment can happen quickly, provided you have the money. Sometimes governments or private insurers will help to pay the cost.

Sorry Trevor, but Americans are also seeking treatment abroad. It’s called medical tourism. And what is the most common reason for this? Price. Many Americans can’t afford the treatment at home, so they get it elsewhere. That’s a superior system at work. Many Americans also like to buy prescription drugs in Canada. Why? It’s cheaper.

I acknowledge that many leading edge treatments and drugs are developed in the US, but the US is hardly the only place where health treatments and drugs come from. This typifies the ‘ugly American’ attitude that the US is the centre of the universe and ‘how come they don’t do it like we do in the good old U S of A?’ kind of thinking.

I don’t really see the need to start listing off medical discoveries and drugs discovered outside the U S of A. I don’t need to mock the US, but I will criticize it. Don’t take it personally. I criticize the Canadian government too.

Socialism – so what?

The US is 31st at 78.1 years. Even Bosnia is higher.

The funniest thing about the whole healthcare debate in the US is the hysteria over socialism. If our socialized healthcare in Canada is so bad, how is it that Canada is fourth in the world in terms of life expectancy? The US is 31st. Not too hot for what’s supposed to be the best medical system in the world. Looking over the top 10 countries for life expectancy, how many have a socialized healthcare system? Those citizens don’t seem to mind.

I don’t understand the fixation so many Americans have with anything resembling socialism. I guess they look past the socialism at work in their own communities like firehalls, police stations, roads, libraries and other evil, socialist institutions.

How’d you like the firehall to come to your house when it’s burning and leave when they notice you’re not covered by their firehall? Not that it ever happened in America. Or a cop that doesn’t investigate your car being stolen because you don’t pay into their police fund? How about a toll on every single road you travel?

Another way to look at socialism is that it’s a pooling of resources for the common good of a group of people. Countries are kind of like that. It’s community. People unite around a common belief. Nothing wrong with that.

So, who cares if some doctors in socialized medical systems work for the state? Really, who does, other than some Americans? In Canada, our doctors run their own practices and they don’t seem to mind it. We do have some private clinics here and there is some debate about how much private care to allow and how that might work.

In fact, on a per capita basis, Canada spends just over half what the US does on healthcare. Another source of information on per capita spending on healthcare (PDF).

That’s some system in the US that doesn’t cover everyone. Where does all that money go? Seems rather inefficient to have 150 health care insurers with all the overhead to administer each company. It certainly simplifies things from the doctor’s perspective too.

For the record, I don’t believe US doctors are greedy, nor do I believe Canadian doctors are. In fact, I’m sure there are many US doctors pissed off at the whole system there because the decisions on treatment are often decided by the insurers and not them. Your health records are available to private corporations and mine are held by my doctor. The billing information and some treatment info is held by government. So what?

Government accountability, especially on an issue so important to everyone, is a good thing. I’m glad my governments are accountable in that way. Accountability in the US system is elusive at best and non-existent at worst. Health care companies, from what I’ve heard, are the biggest lobbyists on Capitol Hill.

Oh, look at that. Health is in second, just edged out by real estate, finance and insurance. $3.8 billion for lobbying? I think lobbying is synonymous with bribery.

If Canadian doctors have a problem with how much they’re paid here, and they’re paid well, I guess they could go to the US. We still have doctors here. I guess they don’t mind. Physicians and health workers in Canada, as in the US, are consistently among the top earners.

And Trevor, I’m not sure where you get the idea that somehow US physicians have a higher purpose and dedication to keeping you alive because they want to get paid. So Canadian doctors don’t care whether their patients live or die? What an asinine statement. I think that’s also an insult to professional physicians in the US who are doing the best they can for their patients, no matter what.

I think you illustrated the key difference between the US healthcare system and the “evil” socialized healthcare systems around the world: “They take whoever no matter who is sicker or not.” You’re right. Insurers in the US have no interest in you if you’re sick. It’s double jeopardy if you’re sick and don’t have the money to pay. You’re as good as dead in the US then.

At least in socialized healthcare systems you have the opportunity for coverage and treatment. I wouldn’t have it any other way. This is why if you ask most Canadians or citizens of countries with a socialized medical system, they’d never want the US system in their country.

As for getting a family doctor, I’ve never had an issue in finding a family physician here in Canada. I know it’s been tough for some. The same baby boom bubble there is happening here and many doctors are retiring. Our governments in Canada have also made mistakes in the past by restricting the numbers of physicians and nurses being educated. I guess they forgot about statistics.

Free market?

Tell us how you really feel.

Perhaps you haven’t been to Canada. You should come and visit some time. You might find that we also have a free market economy, and a still healthy one at that. How’s that free market working for you lately? Nothing like a little deregulation of the financial, real estate and insurance markets, combined with those “greedy corporations” to unravel your entire economy .

Fortunately, Canada’s economy has remained relatively healthy, all things considered, through the near collapse of the world’s economy. See, a little banking regulation is necessary, despite the attempts by Canadian banks and some Canadian politicians to go the virtually complete deregulation route in the US. Had we done that, we’d be as screwed as the US. I’m not particularly fond of the big banks here, but they’re among the strongest in the world now

I believe in a balanced approach when it comes to regulating business. Regulation and enforcement is needed to protect citizens, employees and consumers, but also to allow business to operate. It’s a sensible, Canadian approach and it’s generally worked pretty well for us here.

What’s happening in the US right now is sad. So many US citizens are still caught up in the “us versus them” style of politics between Democrats and Republicans, but they fail to see that both parties are the same. They’re beholden to special interests and lobbyists and are consistently screwing American citizens.

We can blame much of what is happening right now on the Republicans though. It was under George W. Bush’s reign that the US went from a $250 billion annual surplus from Bill Clinton in 2000 to $1 trillion deficit in 2008. US debt in that time went from about $5 trillion to $10 trillion. So much for the idea that Republicans are brilliant money managers.

I am certainly sympathetic to the plight Obama found himself in: an almost ruined economy and two unfinished wars, one of which was completely unjustified (Iraq – there were no weapons of mass destruction).

Americans have every right to be angry right now, but that anger should mostly be directed at the Republicans for what they did (or didn’t do) during their 8 years in power. That doesn’t absolve the Democrats of their duplicity either.

The problem in the US is far from being the “liberal jack offs” as you say. Your country is being ruined by rampant greed and outright theft of public money. Bush started the ball rolling on paying out companies like Goldman Sachs, Citibank and others with public money. Now the US taxpayer is on the hook for their criminal behaviour. You can’t blame it all on Obama.

If Americans are going to pull out of this nosedive successfully, it relies on Americans seeing their current politicians for who they really are. America used to command a lot of respect around the world, but that is not the case these days. So many Americans still hold outdated views about how the world sees them. Things will only change there when Americans open their eyes to what is really happening and how they’re being screwed by their own government, financially and in many of its corrupt actions around the world. Good luck.