America's Stupid Health Care Debate

When President Barack Obama made his quick dash up to Ottawa last week, it's too bad he didn't suffer a gastrointestinal attack, or slip on some ice and twist an ankle or something. If he had, he might have had a chance to do what he should have done anyhow: visit a Canadian health clinic.

Maybe then he would have had his eyes opened to a better idea: government-run health care.

It is a sad commentary on the pinched and strictly censored level of political discourse in this nation that any serious consideration of Canada's successful approach to health care is simply out of bounds in America. It is nothing short of absurd that even though the nation that is closest to the US geographically, culturally, linguistically and economically has, since 1973, had a system of provincially administered single-payer government-run health systems which have kept the country's health costs at about 3/5 of what they are in the US as a percentage of GDP (9.7% vs. 17% for the US), at the same time serving all people and (not surprisingly) achieving better health statistics than the US, no one in Washington has talked about inviting Canadian health authorities down to explain how their system works and whether it might make sense here.

Canadians have complete freedom to choose their physicians. They pay nothing to go to hospital. I interviewed one hospital administrator in Canada who had worked earlier managing a US hospital. He said a whole wing of the facility in the US was devoted to billing and accounting staff, while he had only two people for that job in Canada, "mostly to handle the bills of the occasional American tourist!" (Some 20% of every US health care dollar goes for paperwork.) Interestingly, when I interviewed the CEOs of a number of huge Canadian subsidiaries of US corporations, they universally told me that they were ardent supporters of the Canadian system, and in fact, were involved in lobbying to have it expanded to include long-term care and psychiatric benefits.

There has for years been a huge ongoing propaganda campaign by US health care companies and their lobbies to denigrate Canada's system, but the big truth that they cannot deny is that it is loved by Canadians. The best evidence of this: Despite years of conservative governments in Canada, and in the various provinces, no political leader has ever tried to re-privatize health care in Canada. Clearly such an effort would be political suicide, so popular is the system there. As Canadian resident Joe Sotham explains, "In Canada we complain about wait list length, and the reality is that there is rationing, but everyone gets care and nobody is bankrupted, no HMO clerk stands in the way of treatment. We treat health care like a fundamental right. I took my cat to the vet last year and got a 3-page, $1,875 bill. My comment was 'this must be what it's like in the States for people.'"

Well yeah, Joe, but you'd be hard-pressed to get out of a hospital ER in the US with a bill that small. My wife had an uninsured grad student who had the flu during spring break when the school's infirmary was closed. He went to the ER of Temple University Hospital, got looked at by a nurse practitioner, and was given some aspirin. His bill: $2000. That's pretty typical.

Surely, when President Obama assembles his panels to work out some kind of health "reform" package for the out-of-control US health care system, he should include Canadian health experts and ministers into the mix. It makes absolutely no sense to embark on a $650- billion-to-$2-trillion project without considering all the available options--including options that have a proven track record of keeping costs down, services available to all, and that delivers better health outcomes.

The truth is that every other modern country in the world has long ago figured out that you can't have cost-effective, universal health care unless the government is the paymaster, with prices set by the government. The truth too is that no country that has moved to such a single-payer system has later rejected it--a good indication that the people of these countries are satisfied with the results and with what they're getting for what they're paying.

No one would say that about the US health care system, which is failing over 50 million people completely, that is the leading cause of bankruptcy, that is making US companies non-competitive, and that sucks up over 17 percent of GDP while producing life expectancy and infant mortality figures that make some Third World countries look good.

Next time President Obama travels to Canada, Britain, France, Germany or some other country with a single-payer system, we should all wish for him to "break a leg," as they say in the performing arts. He might learn something valuable from the experience.