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An Inconvenient Truth for the GOP: Canada's System is Better
It is rare for Canada to get noticed in the United States. In fact, it is almost unprecedented for anything Canadian to be the focal point of debate in Washington. Yet we have seen just that in recent months during the congressional wrangling over U.S. President Barack Obama's attempts to reform health insurance.
Canada's medicare system has suddenly been thrust into the spotlight south of the border. It has been pilloried by the Republicans in Congress, the subject of derisive and distorted television advertisements, described variously as a system of medicine by bureaucrat, a statist form of health care afflicted by gross inequities and inefficiencies, one that pales in comparison to the U.S. model. The hysterical tone of the anti-medicare rhetoric among Republicans would make one think Canada is North Korea.
But there is an inconvenient truth that the Republican ideology cannot dispute. Canada's approach to providing citizens with universal health insurance is superior to the U.S. model of private insurance. When we get beyond the anti-medicare ideology and histrionics on Capitol Hill, we can establish this by reference to four basic numbers that give a good sense of our system versus the system in the United States.
Life expectancy is a basic measure of the quality of health care. In the U.S., a citizen will live 77.8 years on average. In Canada, you can expect to live two and a half years longer (80.4 years). Infant mortality is also a vital indicator of health care. In the United States, 6.37 infants die out of every 1,000. In Canada the number is 5.4 out of a 1,000.
But what about the cost differences of the two approaches to health care? Surely our Leviathan-like system, which produces such enviable results, must cost a fortune relative to the U.S. model.
The best measure of health care costs is the percentage a country spends relative to the size of its economy, or its gross domestic product (GDP). Canadians spend about 10 per cent of GDP on health. Americans spend 16 per cent to achieve inferior results on life expectancy and infant mortality.
Finally, it is estimated that there are somewhere around 40 million Americans – about 12 per cent of their population, well in excess of the total population of Canada – who have no medical insurance whatsoever. These unfortunate people are literally on their own in paying for any and all medical treatments they require. That gap in coverage is staggering, making the United States an outlier among all advanced Western nations.
One might ask how many uninsured citizens exist in Canada? The answer is zero – all Canadians are insured. In this country, good-quality, universally accessible medical care is regarded as a basic element of citizenship, kind of like owning a gun is in the U.S.
So to sum up. We live longer than the Americans do. We are less likely to die at or soon after birth than the Americans are. All Canadians have medical insurance, whereas a huge number of Americans don't. And we pay less as a society for health care than they do in the United States. Four numbers paint a stark picture. And when you strip away the anti-medicare ideological rants and falsehoods on display in Washington, Canada's approach to health insurance would probably sound pretty good to many Americans.
To their credit, by putting public insurance on the table as a supplement to private plans, the Democrats in the U.S. Congress are trying to drag the United States into the club of civilized nations when it comes to health care. We've been in that club since the establishment of medicare more than 40 years ago.
Don't get us wrong here. We are not saying medicare is perfect; it is far from that, and it requires constant improvement, as most Canadians understand. But it is not a bad deal for citizens of this country.
The Republican-led anti-medicare lobby in Congress knows these numbers and facts. But they are regarded as inconvenient truths that must be ignored in the crusade to discredit the Canadian approach to health insurance, to ensure no public option creeps into the U.S. system. Anti-government ideology is running amok in Washington, trumping facts and rational debate, distorting one of the most important public policy issues the United States has grappled with in decades.
Ultimately, the U.S. public will pay the price for that.
- Posted in
57 Comments so far
Show AllHow true.
Apparently in America the right of the rich, corporation owners, to make a profit trumps the right of Americans to have non-profit health insurance, universal, accessible health care.
A majority of Americans must pay (cost + profit)a minority of Americans for health care. How asinine.
Demand single payer.
Unfortunately the author erroneously claims the Republicans are the problem and tells us the Democrats are seeking real reform. Bull______ !!!!!!!!!!!!!
The Democrats have controlled both houses of Congress for nearly 3 years, yet they started the "health care reform" discussion (earlier this year) with drug makers and insurers at center stage, a nebulous public option in an etherial background, and orders to the bouncer and security guard to beat the s___ out of single-payer if it came anywhere near the discussion.
Had the Democrats started the discussion at single-payer, they could have ignored the Republicans.
Canandians and the rest of the world better start liking Republicans...Republicans will control both houses of Congress after the 2010 elections.
"Canandians and the rest of the world better start liking Republicans...Republicans will control both houses of Congress after the 2010 elections."
Troll-er-iffic.
This comment hardly seemed like trolling to me. It is the opinion, and sober assessment of most CD commenters. The republicans are loony, but they are developing an edge of populism - albeit in the manner of Hitler's populism. The democrats are beholden to corporte interests to a greater extent than republicans, and simply stink of the snobbish elitism of the high-finance/insurance industry.
The pro-industry health care plan is worse than nothing at all.
The Democrats have lost it entirely when it comes to populism.
The Democrats have lost it entirely when it comes to populism.
You have it right.
Troll-er-iffic?
I don't think so. The Repubs are energizing their misguided base, while the Dems have been busily selling out theirs.
What is going to inspire anyone who is feeling thoroughly sold out by Obama to vote for the Dems again? I think it's obvious that the Republicans are set to win big in 2010 and beyond.
I live just south of the border. Rep John McHugh is my Congressman. When I contacted his office to see what his position was on single payer and the public option, I was told he did not have a position. He has been in office for years and should be very familiar with the Canadian system of health care. If he has any brain or sense of responsibility for his job as Congressman, he should have a position on this issue. He chooses not to fulfill his responsibilities as a Congressman, yet the Obama administration has submitted his name to be appointed Secretary of the Army. I say he's inept.
Then the Secretary of the Army is the perfect place for him!
Poet
Inconvienient truth for the GOP?!! Hahahahaha! This, my friends is a salesmanship opportunity for the GOP peopaganda-meisters!
Can't you just see Frank Lunz, Hill & Knowlton, The Rendon Group, Propeller Head Karl Rove, and all the K-Street pimps just drooling at the prospect of the riches to be had?
**************************
"'When I use a word,’ Humpty Dumpty said in rather a scornful tone, ‘it means just what I choose it to mean — neither more nor less.’
’The question is,’ said Alice, ‘whether you can make words mean so many different things.’
’The question is,’ said Humpty Dumpty, ‘which is to be master — that’s all.’"
— Lewis Carroll (Through The Looking Glass)
Poet
As an American, I have been one of those vociferously arguing in favor of at least a public option. Of the four numbers mentioned in the article, I feel that the most important is the uninsured in America, and it is also the one likely to persuade the most people. If the other numbers were merely comparable, universal health insurance would be enough to justify the public approach. The fact that the other numbers are better proves a good defense against the inevitable attacks on the system, although the waiting periods for certain treatments in Canada is a tough point to counter if we rely only upon the evidence in Canada. The truth is that other nations with single-payer systems do better on this point, which is why I like to provide the broader context and bring the European experience into the discussion.
The other number that could have been mentioned (and I don't have the actual numbers sitting in front of me at this moment) is that the level of satisfaction with the health care system is lower in the US than in any other economically-advanced nation on Earth.
The key point in the article for me isn't any of the numbers it's the word "universal". In Canada, health care is a RIGHT. In the US, it's a privilege that some, like our Congressmen and CEOs get for free (and tax-free), and others (namely much of the working poor) have to pay an arm and a leg (and sometimes a house, job, family) for.
The quality of medical care one gets shouldn't depend on one's social status. That's the principle that guides civilized countries. That's the principle the US violates. From what I understand about the "public option", it wouldn't fix this crime.
-it's the word "universal"
Yeah, Obama wants you to put your life on hold, donate all your money to the Dems, and march around Washington so that his plan can give subsidized private insurance to ten percent of those currently uninsured, Wow!
Congressmen do not get their healthcare for free, the federal health plan they are under entails a fairly stiff employee contribution. I pay $360 a month. Compared to say, the union trash collectors and bus drivers in my town, who get 100% free healthcare, it isn't that good a deal.
And while the employer contributions do come from tax revenue, this is no different than grocery store workers healthcare coming from a consumers grocery budget.
Employee health care contribution are income tax free for everyone. Check you pay check stub, the health insurance should be coming out before the tax withholding.
It may not be free, but given the pay of Congressmen, it's not inconvenient. And it is a better plan than, say, the union trash collectors (if they are lucky enough to be unionized) in most towns. I have a hard time feeling sorry for Congressmen.
Help get Single-Payer (H.R.676) ON the table:
http://www.afterdowningstreet.org/node/46068
Is it possible with a corrupt, paid-for government? Probably not, but every signature helps.
The truth is inconvenient for all Americans.
The biggest, first step to stopping corruption is Single-Payer HR 676.
It's not about political parties. It is about free people taking back their country and their government from corrupt capitalists and bought & paid for members of congress.
HR 676 puts YOU first.
Inconvienient truth for the GOP? From what I'm seeing proposed by the Democrats, it is an inconvienient truth for them too.
My dear Canadians, sorry to break the news, but Obama is as opposed to a Canada style system as the Republicans are. The "public option" is a just another "designed to fail" sham.
And Michael Moore, at a rally and march to a special screening of "Capitalism - A Love Story" at the AFL-CIO Convention in Pittsburgh, voiced his strong support for single payer to the crowd, then in nearly the next sentence, said that the working class has to "get behind Obama". Which is it, Michael?
I don't to reform health insurance.
I want to reform healthcare with Medicare for All!
There seems to be a certain Fascination in Canada with Barack Obama just as there was with Bill Clinton.
It almost by virtue of being a DEMOCRAT, Canadians feel he more like us therefore is likeable.
The myth that there a real difference between the two parties extends up here as well.
That was GREAT!!
Don't forget the Democrats who are siding with the GOP here. My senator Mark Warner calls the system in Canada "communist care". There's a strong Democratic majority in Congress. If they would just shut up and go pro economic populist, we wouldn't have to worry about the GOP. At this time, given the filibuster proof majority, the Republicans need to be left alone completely and the Democrats need to be whacked in line.
"If they would just shut up and go pro economic populist, we wouldn't have to worry about the GOP."
Exactly, and because the Democrats have rejected economic populism and increasingly are becoming the party of Wall Street, USAns are increasingly embracing the fascist populism of the Republicans are offering.
"USAns are increasingly embracing the fascist populism of the Republicans are offering."
That's showing in both gubernatorial races in VA and NJ. I hear that in NJ, Corzine is unable to shake off the 9 point deficit in the polls. NJ is generally a liberal state and Obama won strong there. This would be a bad omen for the Democrats if either or both states went red. The latter appears to be the case. Yesterday, I told Henry8 about the update on the race. My wife got 3 political fliers in the mail. Two from Republican Mcdonnell and one from Democrat Deeds. One of Mcdonnell's fliers are about transportation blues on the highways in Northern Virginia and Hampton Roads while the other is about improving public education. Deeds on the other hand only gave a flyer about "abortion" rights. Can you believe it? For the first time, the GOP hasn't touched a single social issue and even with the NRA doing a switcharoo and endorsing Mcdonnell over Deeds, the Republicans are hitting the heaviliy populated areas of Northern Virginia and Hampton Roads hard and doing their own economic populism and vote targetting. I don't expect much from the GOP but if this succeeds, they will expand this all over the country. This could make states like PA, MI, and WI much easier to grab and possibly turn CA into a swing state. The GOP hasn't changed in what they really plan to do. The only thing that has changed is copying the Democrats in faking economic populism since they reckoned that playing the culture war doesn't work well in moderate to liberal states.
"We'll build more highways (and allow single-occupant drivers to "buy" permission to use HOV lanes)" wasn't exactly the economic populism I had in mind...
I agree, maxpayne. But how do you whack the Democrats into line? Most of them are fat-cat Republicans in disguise, and they will never budge. I agree with those who believe that our government does not belong to us, that it is a tool of the corporations who will never give in to health reform or reform of any kind, for that matter.
I need to see what I can pull out from my workplace that might convince them. No, j/k. Yeah, it sucks that they don't get vetted properly. I didn't vote for either candidate for senator last year. I already knew Mark Warner at his worst the minute he got a major endorsement from the US Chamber of Commerce.
An inconvenient truth for OBAMA!!!!!!!!
raydelcamino September 15th, 2009 11:01 am: Unfortunately the author erroneously claims the Republicans are the problem and tells us the Democrats are seeking real reform.
I share this impression of the article as many of you do. I think there will be a time lag before non Americans tune in to the realization that Obama is "status quo, you better believe it"
It's the Dems who will go down on this one, at least the so-called "centrist" Dems.
Both most D's and all R's have rejected real health reform. The D's by accepting 0's pretense, the R's by rejecting it and health reform in general.
The difference is that the R's have a base that does not want reform. Whether they win or lose their point, their constituents will be cheering.
Let's praise those Dems who hold out against the bogus bill in hopes that they do not get tarred with the same brush as sellouts like 0, Pelosi, & Baucus.
The basic assumption of this article is wrong. The author assumes the primary purpose of the American health care system is to provide health care to Americans. How Canadian of him! The PRIMARY purpose of the American system is to MAKE as much MONEY as possible for as many people as possible. Providing health care to Americans is secondary. That is the same for any private industry.
So when you use that frame then the American system is far superior to the Canadian system because it generates much larger profits for private industry. Plus when you use that frame everything Washington is doing to "Reform" the current system makes complete sense.
So the only real way to reform the American system would be single payer, second best would be a public option. Anything else IMHO is just a joke.
Also I have been hearing that the congressional-critters are talking about fines of up to $3800 if you don't carry private insurance under the new "reforms". I have not heard that on TV or radio yet but it is all over the internet. If it's true it sounds like all that lobbying money big insurance spent was not in spent vain.
"So when you use that frame then the American system is far superior to the Canadian system because it generates much larger profits for private industry. Plus when you use that frame everything Washington is doing to "Reform" the current system makes complete sense."
Same thing for Afghanistan. Who needs an "exit strategy" when any exit would mean an end to the stream of money trickling down from the weapons makers to the congress.
To make as much money as possible for the fewest people possible.
Thanks for the correction.
Life expectancy figures and infant mortality can not be evaluated as simply as the author implies. Demographics must be considered as there is a vast difference in life expectancy among different ethnic groups.
Since Obama is picking and choosing the worst aspects of Canadian healthcare and refusing to consider the areas that could be of benefit in US health care reform, comparisons have become a moot point.
Also, of the widely quoted figure of 47 million uninsured americans, how many of them can afford health insurance but would rather spend the money on something else?
This is never addressed.
"Life expectancy figures and infant mortality can not be evaluated as simply as the author implies. Demographics must be considered as there is a vast difference in life expectancy among different ethnic groups."
Really? Do you have any facts to back up this assertion? Perhaps you are confusing "ethnic group" with "residents of poverty stricken third world nations". I read with no small amount of amusement when even objective measures like life expectancy and infant mortality are suddenly cast into doubt.
As for those families without insurance, perhaps they could do without food, phone, electricity and heat. They MIGHT be able to buy a policy with that money. Maybe the cars and auto insurance could go. How about they move out of their house and live in a box next to railroad tracks. Doubt what I say? Go price a personal health insurance policy for a family of four.
Last time I looked, the U.S. ranked BELOW CUBA in infant mortality, somewhere around 35th or 40th in the world. You don't need to parse that into ethnic groups to see that there is a problem with U.S. health care.
The right wing propaganda machine is running full bore these days. No simple truth can be left unchallenged. Take note of the global warming issue and how that was handled. They don't have to win the debate, they just have to pretend there is a debate. It's an Orwellian Beetlejuice world we live in today where up is down and the door walls are crooked.
Perhaps our right wing brethren can implement some form of "life expectancy hedonics" much like how our Harvard economists solved the inflation problem. That basket of goods you bought this year costs more but that new computer you have is better so we'll adjust accordingly. Voila! Inflation is low! Americans might not live as long as people in other industrialized countries but they get more out of life. Voila! Longer life expectancy.
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1449245
>>The most commonly invoked explanations for racial/ethnic health variation are the genetic perspective, the socioeconomic perspective, and the cultural/behavioral perspective.1,23 The genetic approach to racial/ethnic health differences is problematic17,24–26 and has lost credibility because the evidence shows that genetic variation is often greater within racial/ethnic groups than between them.27 For example, the US Black population is so diverse that some members may be genetically closer to Whites than to other Blacks.28 However, while racial/ethnic classifications have no objective foundation, these racial/ethnic categories are sociologically relevant because they represent how people are both ranked and treated within societies. These categories provide crucial insights into social stratification, but they do not describe genetic distinctions and how these .
distinctions influence vulnerability to illness.15
In other words one can not ascribe expectancies to etnicity. It has much more to do with lifestyle and socioeconomic status along with ACCESS>
>>Next the study shows that while there a Difference in health due to Socio-economic Status in the USA such does not appear to be the case in Canada.
Our initial analysis showed racial/ethnic variation in functional and self-reported health. The pattern of variance did not show that racial/ethnic minority status was a general health disadvantage: some racial/ethnic groups indeed had worse-than-average health, but others had better-than-average health. In contrast to US findings, the Canadian Black population had superior functional and self-reported health, regardless of any socioeconomic or behavioral differences. Indeed, we observed that 22% of Black Canadians fell within the lowest income quartile compared with 11% of English Canadians and 12% of other White Canadians (data not shown). Black Canadians also reported lower family incomes than the majority of the population, even though they had somewhat more education.
Black Canadians living in the LOWEST income quintile are in fact healthier then many White Americans. Black Canadians live longer then Black Americans.
http://www.physorg.com/news144518596.html
This study measures outcomes of Black Canadians receiving Kidney transplants and Compares them to Black Americans.
In Canada the Black Canadians sucessful outcomes for such are the Same as Caucausians. In the USA the outcomes are significantly worse for Blacks when Compared to Whites.
Of ethnic groups in Canada the Aboriginals have the lowest overall life expectancies but again this can NOT be attributed to Genetics. Studies have clearly shown it has more to do with Lifestyle and Socio-economic position along with marginalization in the Society. As a percentage of population Canada has more Aboriginals then does the USA.
"Life expectancy figures and infant mortality can not be evaluated as simply as the author implies. Demographics must be considered as there is a vast difference in life expectancy among different ethnic groups."
This is a common argument by the opponents of single-payer, but there are a few major problems with it. First, in the US, only Asian/Pacific Islander ethnicity has a lower infant mortality rate, and just barely at that. Second, those making the arguments do not even attempt to demonstrate that controlling for these different variables will change the outcome. Third, the people making this argument never seem to be able to come up with any better broad measures of health than longevity and infant mortality. Fourth, the results are consistently in favor of countries with real national health systems (or national health insurance systems), regardless of ethnic makeup.
"Since Obama is picking and choosing the worst aspects of Canadian healthcare..."
Your opinion, and you fail to say what you think the best and worst aspects are.
"Also, of the widely quoted figure of 47 million uninsured americans [sic], how many of them can afford health insurance but would rather spend the money on something else?"
I don't see that as being a convincing argument. Many people theoretically could afford insurance, but in most of those cases it would be a serious financial hardship. They do not eschew coverage because they see it as having little value, but because costs are too high. (BTW, I know what I am talking about on this, having gone 5 years at one point without insurance that I would very much have liked to have.) Single-payer can significantly lower costs, making it more affordable to those who have been going without. Additionally, your argument seems willing to cast aside those uninsured who genuinely cannot afford coverage.
Here's how I recently corked a few R-nuts ranting about how Canada's system sucks:
I told them that Canada isn't relevant, that we Americans will create our own universal health care system, and, being Americans, it will be the envy of the world.
What's relevant, I added, is the inarguable premise that ALL Americans -nay, all humans - have the right to fundamental health care without having to worry about becoming financially destitute because you got e-coli at McD's.
The R-nuts had no response...
Remember - the best way to get to the R-nuts is to remind them, often, that we're AMERICANS and that AMERICANS don't run scared from challenges, like how to provide health care for all, AMERICANS lock and load and solve the problem. Right, patriot?!
R-nuts eat that shit up...
edit
"Don't forget the Democrats who are siding with the GOP here. My senator Mark Warner calls the system in Canada "communist care". "
It's funny/sad hearing this drivel/comedy spouted from these elected representatives wafting its way up across the border.
Communist. what utter nonsense. There is a communist party in Canada. GASP!
Guess what. Our country does not collapse cause they exist.
They get about 1/500 of one percent of the votes in any election.
their influence on policy here is exactly.....
zero.
The US has a Communist Party too. And, a Socialist Party.
This is becoming quite simple. If these buzzards had proposed Single Payer as they have in Canada (And we could certainly have improved on their system...no offense GW)
and many other countries it would have been economically possible, even saved money.
Every single plan proposed by the Democrats is complicated, inept and costs far more than we are spending now and still doesn't cover everyone.
The real reason none of this farce will pass in the end is the simple fact that we cannot afford it. We have reached the "California" limit of economic stupidity.
Your Football is not even as good as ours and you copied it from us.
And people say I'M an instigator...
· Yr Obd't Servant
How 'bout them Allouettes!
Poet
I'm sure you meant "How bout them Boy's"