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Globe and Mail

An Inconvenient Truth for the GOP: Canada's System is Better

Eugene Lang and Philip DeMont

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.

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Eugene Lang is a former senior economist at Finance Canada. Philip DeMont served as a senior policy adviser to Ontario's health minister.

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