Monday, October 29, 2012

Why Can't We Be Like Canada?

     In 1964 Canadians made the decision to adopt a national healthcare plan.  There wasn't a lot of fanfare--it was a common-sense decision.
     First, Saskatchewan--a far-away province which was suffering from a shortage of physicians--passed, in 1946, a bill giving its citizens free access to medical care;  several years later, Alberta followed suit.  By the early 1960's these programs had proved so successful that a universal healthcare system--wherein half of each province's healthcare costs would be borne by the federal government--and half by the province, was established.  
     A series of modifications to the healthcare act have modified the program over the years, and it isn't  perfect yet--but no one in Canada seems to be looking back.  Several of my Canadian friends shake their heads and laugh at Americans when I bring up our tortured way of making the decision to adopt universal medical coverage.  
     What's our problem?  Everyone knows that civilized countries need to guarantee their citizens access to free healthcare and a free education all the way through college.  We can't run a country without a healthy, educated population.  And people who are nervous about how they're going to pay for surgery, or college, can't give their utmost to their endeavors.  So why is the United States "debating" something so obvious?
     Frankly, I think the debate is a waste of time.  Maybe it makes for good news stories about "battles" in Congress, and presidential candidates who "fight it out" and "differ" about what healthcare should look like in America.   More likely, there are too many interested parties who don't want a universal healthcare plan to cause them to lose their booming businesses and ill-gotten profits.  
     Maybe Americans can't do anything without turning it into an Act of Congress.  
     You and I aren't really the ones debating healthcare issues.  When patients ask me what I think about Obamacare, I simply tell them:  It's about time.  Americans need to stop worrying about how they'll pay for what might happen.  Who disagrees?
     Besides, universal healthcare costs less, and people get more, in Canada.  The cost per capita for medical care in Canada is about half that of the United States.
     For one thing, the government negotiates prices for pharmaceuticals, so people don't have to pay astronomical prices for medicines they need.  For another, primary care and prevention are paramount to an effective healthcare system.  Everyone carries a health card, like a driver's license, and gets the same level of care.  Patients don't need to know anything about how "plans" work, and don't have to make co-pays.  The government doesn't tell doctors how to practice and it doesn't threaten them with intimations of fraud, or raids, or "take-backs," or perpetual warnings that payments are headed south.  Physicians don't need to know how plans work either--they can practice medicine.  Pregnancy, infertility, psychological counseling, drug and alcohol rehabilitation--all these are covered without a lot of noise.  Doctors are able to focus on their patients, and make very good salaries, money isn't wasted on advertising, patients aren't misled about what they're getting, and lawsuits against physicians are uncommon.  To top it off, per capita spending for healthcare in Canada is almost half of what it is in the United States.
     Who among us can't imagine the catastrophic effect of an unforeseen health crisis on a family?  Who would deny medical care, for instance, to someone with a ruptured brain aneurysm, simply because that person was playing the odds and decided to take his family to Disney world instead of buying health insurance?  Are we that punitive?  If I had to choose between a lineup of insurance products with widely differing "coverage" caveats, explained in fat packets of jargon-filled "policies,"and a new roof-- both costing $16,000--I'd probably choose the roof.  Or the family vacation.
    Health problems can come out of the blue.  We should not have a system of healthcare, then, that punishes people for having disease.  Since state and federal governments pick up the cost of health crises anyway, via Medicare and Medicaid, why not simply extend these programs to cover everyone?   

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