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The Truth About Canadian Healthcare

Colin Horgan

Perhaps the most interesting thing about the debate over a public healthcare option in the US is that in some ways, it's turning into a debate over the efficacy of the healthcare system in Canada. Canadians have taken a keen interest in the discussion in the US, not simply because it's familiar territory (we debate the efficiency of our healthcare system endlessly), but because our name keeps getting dragged through the mud.

The most shocking of these disdainful remarks on the Canadian system has come from a Canadian. Shona Holmes, from Waterdown, Ontario is currently featured in US ads run by the Americans For Prosperity Foundation (through a group called Patients United Now), warning of the dangers of Canadian-style healthcare. Holmes was told she would have to wait to be treated for a "rare type of cyst at the base of the brain", so she went to the US to pay for the treatment. She now warns Americans: "If I had relied on my government for healthcare, I'd be dead."

These ads began running only days after Fox host Glenn Beck flew into a rage on his radio show at a caller who suggested that the US adopt universal healthcare. During his rant (before he called his listener a "pinhead" and told her to "get off my phone!") Beck mentioned Canada's healthcare system. He said sarcastically:

Canada has a great healthcare. That's why people are suing. That's why, in Canada, they have a lottery. They have a lottery system. Who gets to go see a doctor this month in Canada?

Are they right? In a way, yes. Canada's system isn't perfect, and Canadians will – evidently – be the first to admit it. But there is a problem with the way it is being portrayed – namely that both Beck and Patients United Now (PUN) are leaving out the details. It's easier to scare people that way.

The Canadian healthcare system is complicated and is in many ways much different than the public healthcare systems in the UK and France. In effect, it's predominantly a provincial system with coverage, hospital wait times and access to private, for-profit clinics differing in each region. The funding comes from the federal government and is distributed to the provinces under the Canada Health Transfer, with the poorer provinces receiving more than the rich ones.

The 10 provincial programmes differ, but all fall under Medicare, the largest public health programme. (The federal government is directly responsible only for a few groups in Canada, like the military and Aboriginals.) Canadians who aren't covered by a private insurer will sometimes pay premiums to their province, depending on where they live. It's not much and varies depending on income, but it guarantees treatment. In each province, there are private practices and clinics, with public hospitals overseen by regional health authorities.

Canadians are obviously also covered if their employer offers private insurance, or if they can afford it themselves.

Both Beck and PUN argue that if the US system were so terrible, people from other nations – nations with universal healthcare – wouldn't be lining up to pay for treatment in America. This is supposed to be an indictment of the universal systems that exist, but all it means is that these individuals had money. Holmes re-mortgaged her house to pay for her treatment and is now suing the Ontario Health Insurance Programme to recoup her losses – an experience that is admittedly terrible. But the fact remains: she gathered the necessary cash.

If you have the money, the US system works very well, but it also allows for, and often encourages individuals or companies to make a profit, and generally caters most to the rich. People make money in the Canadian system, too, but the system itself is not as exclusive. Profits can be made, but everyone has to be treated.

Both PUN and Beck only truly defend the US healthcare system on the fact that the government is barely involved, rather than its effectiveness. Beck, specifically, is boastful of US health innovation but ignores the fact that it is unavailable to a large portion of Americans. Those who don't qualify for coverage from Medicaid and aren't rich enough to pay insurance premiums or get private help are basically on their own. And with businesses shedding their insurance coverage due to cost, more and more Americans will find themselves in that lonely middle ground. What do they do then?

They may have to do the same as Holmes.

Are there wait times in Canada? Yes, sometimes lengthy ones. Are taxes higher because of universal healthcare? Yes, but a hospital visit is worth something. Will you be treated, no matter your coverage or income? Yes.

Does the government decide what treatment you get? No, your doctor does. Does your insurance company decide what treatment you get? Again, no, your doctor does.

The universal healthcare system in Canada is a source of pride here. In a CBC poll to find the Greatest Canadian, the winner, Tommy Douglas, was the man who first introduced it. Canadians also smugly enjoy having something that the Americans don't.

But Americans can have it, if they want. People like Glenn Beck believe that a public healthcare option is a step toward socialism. It's not. Essentially, it comes down to knowing that you're taking a hit so someone else who can't doesn't have to, and knowing the same would be available for you if it were reversed. It's simple: it's about people, not profits.

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Colin Horgan is a freelance writer and blogger for the Calgary Herald and Macleans. He lives in Vancouver.

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