Re: Ten lies about Canadian healthcare busted


"Scotius" <yodasbud@xxxxxxxx> wrote in message news:MPG.221637a7713f99ed98971e@xxxxxxxxxxxxxxxx
In article <0794e858-6e64-4d22-bc26-82f81a9cb7b8
@v4g2000hsf.googlegroups.com>, PopUlist349@xxxxxxxxxxx says...
Subject: Ten lies about Canadian healthcare busted
From: Kickin' Ass and Takin' Names <PopUlist349@xxxxxxxxxxx>
Newsgroups: alt.politics

10 Myths About Canadian Health Care, Busted
By Sara Robinson, TomPaine.com
Posted on February 5, 2008, Printed on February 6, 2008
http://www.alternet.org/story/76032/
2008 is shaping up to be the election year that we finally get to have
the Great American Healthcare Debate again. Harry and Louise are back
with a vengeance. Conservatives are rumbling around the talk show
circuit bellowing about the socialist threat to the (literal) American
body politic. And, as usual, Canada is once again getting dragged into
the fracas, shoved around by both sides as either an exemplar or a
warning -- and, along the way, getting coated with the obfuscating
dust of so many willful misconceptions that the actual facts about How
Canada Does It are completely lost in the melee.

I'm both a health-care-card-carrying Canadian resident and an
uninsured American citizen who regularly sees doctors on both sides of
the border. As such, I'm in a unique position to address the pros and
cons of both systems first-hand. If we're going to have this
conversation, it would be great if we could start out (for once) with
actual facts, instead of ideological posturing, wishful thinking,
hearsay, and random guessing about how things get done up here.

To that end, here's the first of a two-part series aimed at busting
the common myths Americans routinely tell each other about Canadian
health care. When the right-wing hysterics drag out these hoary old
bogeymen, this time, we need to be armed and ready to blast them into
straw. Because, mostly, straw is all they're made of.

1. Canada's health care system is "socialized medicine."
False. In socialized medical systems, the doctors work directly for
the state. In Canada (and many other countries with universal care),
doctors run their own private practices, just like they do in the US.
The only difference is that every doctor deals with one insurer,
instead of 150. And that insurer is the provincial government, which
is accountable to the legislature and the voters if the quality of
coverage is allowed to slide.

The proper term for this is "single-payer insurance." In talking to
Americans about it, the better phrase is "Medicare for all."

2. Doctors are hurt financially by single-payer health care.
True and False. Doctors in Canada do make less than their US
counterparts. But they also have lower overhead, and usually much
better working conditions. A few reasons for this:

First, as noted, they don't have to charge higher fees to cover the
salary of a full-time staffer to deal with over a hundred different
insurers, all of whom are bent on denying care whenever possible. In
fact, most Canadian doctors get by quite nicely with just one
assistant, who cheerfully handles the phones, mail, scheduling,
patient reception, stocking, filing, and billing all by herself in the
course of a standard workday.

Second, they don't have to spend several hours every day on the phone
cajoling insurance company bean counters into doing the right thing by
their patients. My doctor in California worked a 70-hour week: 35
hours seeing patients, and another 35 hours on the phone arguing with
insurance companies. My Canadian doctor, on the other hand, works a 35-
hour week, period. She files her invoices online, and the vast
majority are simply paid -- quietly, quickly, and without hassle.
There is no runaround. There are no fights. Appointments aren't
interrupted by vexing phone calls. Care is seldom denied (because
everybody knows the rules). She gets her checks on time, sees her
patients on schedule, takes Thursdays off, and gets home in time for
dinner.

One unsurprising side effect of all this is that the doctors I see
here are, to a person, more focused, more relaxed, more generous with
their time, more up-to-date in their specialties, and overall much
less distracted from the real work of doctoring. You don't realize how
much stress the American doctor-insurer fights put on the day-to-day
quality of care until you see doctors who don't operate under that
stress, because they never have to fight those battles at all.
Amazingly: they seem to enjoy their jobs.

Third: The average American medical student graduates $140,000 in
hock. The average Canadian doctor's debt is roughly half that.

Finally, Canadian doctors pay lower malpractice insurance fees. When
paying for health care constitutes a one of a family's major expenses,
expectations tend to run very high. A doctor's mistake not only
damages the body; it may very well throw a middle-class family
permanently into the ranks of the working poor, and render the victim
uninsurable for life. With so much at stake, it's no wonder people are
quick to rush to court for redress.

Canadians are far less likely to sue in the first place, since they're
not having to absorb devastating financial losses in addition to any
physical losses when something goes awry. The cost of the damaging
treatment will be covered. So will the cost of fixing it. And, no
matter what happens, the victim will remain insured for life. When
lawsuits do occur, the awards don't have to include coverage for
future medical costs, which reduces the insurance company's liability.

3. Wait times in Canada are horrendous.
True and False again -- it depends on which province you live in, and
what's wrong with you. Canada's health care system runs on federal
guidelines that ensure uniform standards of care, but each territory
and province administers its own program. Some provinces don't plan
their facilities well enough; in those, you can have waits. Some do
better. As a general rule, the farther north you live, the harder it
is to get to care, simply because the doctors and hospitals are
concentrated in the south. But that's just as true in any rural county
in the U.S.

You can hear the bitching about it no matter where you live, though.
The percentage of Canadians who'd consider giving up their beloved
system consistently languishes in the single digits. A few years ago,
a TV show asked Canadians to name the Greatest Canadian in history;
and in a broad national consensus, they gave the honor to Tommy
Douglas, the Saskatchewan premier who is considered the father of the
country's health care system. (And no, it had nothing to do with the
fact that he was also Kiefer Sutherland's grandfather.). In spite of
that, though, grousing about health care is still unofficially
Canada's third national sport after curling and hockey.

And for the country's newspapers, it's a prime watchdogging
opportunity. Any little thing goes sideways at the local hospital, and
it's on the front pages the next day. Those kinds of stories sell
papers, because everyone is invested in that system and has a personal
stake in how well it functions. The American system might benefit from
this kind of constant scrutiny, because it's certainly one of the
things that keeps the quality high. But it also makes people think
it's far worse than it is.

Critics should be reminded that the American system is not exactly
instant-on, either. When I lived in California, I had excellent
insurance, and got my care through one of the best university-based
systems in the nation. Yet I routinely had to wait anywhere from six
to twelve weeks to get in to see a specialist. Non-emergency surgical
waits could be anywhere from four weeks to four months. After two
years in the BC system, I'm finding the experience to be pretty much
comparable, and often better. The notable exception is MRIs, which
were easy in California, but can take many months to get here. (It's
the number one thing people go over the border for.) Other than that,
urban Canadians get care about as fast as urban Americans do.

4. You have to wait forever to get a family doctor.
False for the vast majority of Canadians, but True for a few. Again,
it all depends on where you live. I live in suburban Vancouver, and
there are any number of first-rate GPs in my neighborhood who are
taking new patients. If you don't have a working relationship with
one, but need to see a doctor now, there are 24-hour urgent care
clinics in most neighborhoods that will usually get you in and out on
the minor stuff in under an hour.

It is, absolutely, harder to get to a doctor if you live out in a
small town, or up in the territories. But that's just as true in the
U.S. -- and in America, the government won't cover the airfare for
rural folk to come down to the city for needed treatment, which all
the provincial plans do.

5. You don't get to choose your own doctor.
Scurrilously False. Somebody, somewhere, is getting paid a lot of
money to make this kind of stuff up. The cons love to scare the kids
with stories about the government picking your doctor for you, and you
don't get a choice. Be afraid! Be very afraid!

For the record: Canadians pick their own doctors, just like Americans
do. And not only that: since it all pays the same, poor Canadians have
exactly the same access to the country's top specialists that rich
ones do.

6. Canada's care plan only covers the basics. You're still on your own
for any extras, including prescription drugs. And you still have to
pay for it.
True -- but not as big an issue as you might think. The province does
charge a small monthly premium (ours is $108/month for a family of
four) for the basic coverage. However, most people never even have to
write that check: almost all employers pick up the tab for their
employees' premiums as part of the standard benefits package; and the
province covers it for people on public assistance or disability.

"The basics" covered by this plan include 100% of all doctor's fees,
ambulance fares, tests, and everything that happens in a hospital --
in other words, the really big-ticket items that routinely drive
American families into bankruptcy. In BC, it doesn't include "extras"
like medical equipment, prescriptions, physical therapy or
chiropractic care, dental, vision, and so on; and if you want a
private or semi-private room with TV and phone, that costs extra
(about what you'd pay for a room in a middling hotel). That other
stuff does add up; but it's far easier to afford if you're not having
to cover the big expenses, too. Furthermore: you can deduct any out-of-
pocket health expenses you do have to pay off your income taxes. And,
as every American knows by now, drugs aren't nearly as expensive here,
either.

Filling the gap between the basics and the extras is the job of the
country's remaining private health insurers. Since they're off the
hook for the ruinously expensive big-ticket items that can put their
own profits at risk, the insurance companies make a tidy business out
of offering inexpensive policies that cover all those smaller, more
predictable expenses. Top-quality add-on policies typically run in the
ballpark of $75 per person in a family per month -- about $300 for a
family of four -- if you're stuck buying an individual plan. Group
plans are cheap enough that even small employers can afford to offer
them as a routine benefit. An average working Canadian with employer-
paid basic care and supplemental insurance gets free coverage equal to
the best policies now only offered at a few of America's largest
corporations. And that employer is probably only paying a couple
hundred dollars a month to provide that benefit.

7. Canadian drugs are not the same.
More preposterious bogosity. They are exactly the same drugs, made by
the same pharmaceutical companies, often in the same factories. The
Canadian drug distribution system, however, has much tighter
oversight; and pharmacies and pharmacists are more closely regulated.
If there is a difference in Canadian drugs at all, they're actually
likely to be safer.

Also: pharmacists here dispense what the doctors tell them to
dispense, the first time, without moralizing. I know. It's amazing.

8. Publicly-funded programs will inevitably lead to rationed health
care, particularly for the elderly.
False. And bogglingly so. The papers would have a field day if there
was the barest hint that this might be true.

One of the things that constantly amazes me here is how well-cared-for
the elderly and disabled you see on the streets here are. No, these
people are not being thrown out on the curb. In fact, they live
longer, healthier, and more productive lives because they're getting a
constant level of care that ensures small things get treated before
they become big problems.

The health care system also makes it easier on their caregiving adult
children, who have more time to look in on Mom and take her on outings
because they aren't working 60-hour weeks trying to hold onto a job
that gives them insurance.

9. People won't be responsible for their own health if they're not
being forced to pay for the consequences.
False. The philosophical basis of America's privatized health care
system might best be characterized as medical Calvinism. It's
fascinating to watch well-educated secularists who recoil at the
Protestant obsession with personal virtue, prosperity as a cardinal
sign of election by God, and total responsibility for one's own
salvation turn into fire-eyed, moralizing True Believers when it comes
to the subject of Taking Responsibility For One's Own Health.

They'll insist that health, like salvation, is entirely in our own
hands. If you just have the character and self-discipline to stick to
an abstemious regime of careful diet, clean living, and frequent sweat
offerings to the Great Treadmill God, you'll never get sick. (Like all
good theologies, there's even an unspoken promise of immortality: f
you do it really really right, they imply, you might even live
forever.) The virtuous Elect can be discerned by their svelte figures
and low cholesterol numbers. From here, it's a short leap to the
conviction that those who suffer from chronic conditions are victims
of their own weaknesses, and simply getting what they deserve. Part of
their punishment is being forced to pay for the expensive, heavily
marketed pharmaceuticals needed to alleviate these avoidable
illnesses. They can't complain. It was their own damned fault; and
it's not our responsibility to pay for their sins. In fact, it's
recently been suggested that they be shunned, lest they lead the
virtuous into sin.

Of course, this is bad theology whether you're applying it to the
state of one's soul or one's arteries. The fact is that bad genes, bad
luck, and the ravages of age eventually take their toll on all of us
-- even the most careful of us. The economics of the Canadian system
reflect this very different philosophy: it's built on the belief that
maintaining health is not an individual responsibility, but a
collective one. Since none of us controls fate, the least we can do is
be there for each other as our numbers come up.

This difference is expressed in a few different ways. First: Canadians
tend to think of tending to one's health as one of your duties as a
citizen. You do what's right because you don't want to take up space
in the system, or put that burden on your fellow taxpayers. Second,
"taking care of yourself" has a slightly expanded definition here,
which includes a greater emphasis on public health. Canadians are
serious about not coming to work if you're contagious, and seeing a
doctor ASAP if you need to. Staying healthy includes not only diet and
exercise; but also taking care to keep your germs to yourself,
avoiding stress, and getting things treated while they're still small
and cheap to fix.

Third, there's a somewhat larger awareness that stress leads to big-
ticket illnesses -- and a somewhat lower cultural tolerance for
employers who put people in high-stress situations. Nobody wants to
pick up the tab for their greed. And finally, there's a generally
greater acceptance on the part of both the elderly and their families
that end-of-life heroics may be drawing resources away from people who
might put them to better use. You can have them if you want them; but
reasonable and compassionate people should be able to take the larger
view.

The bottom line: When it comes to getting people to make healthy
choices, appealing to their sense of the common good seems to work at
least as well as Calvinist moralizing.

10. This all sounds great -- but the taxes to cover it are just
unaffordable. And besides, isn't the system in bad financial shape?
False. On one hand, our annual Canadian tax bite runs about 10% higher
than our U.S. taxes did. On the other, we're not paying out the
equivalent of two new car payments every month to keep the family
insured here. When you balance out the difference, we're actually
money ahead. When you factor in the greatly increased social stability
that follows when everybody's getting their necessary health care, the
impact on our quality of life becomes even more signficant.

And True -- but only because this is a universal truth that we need to
make our peace with. Yes, the provincial plans are always struggling.
So is every single publicly-funded health care system in the world,
including the VA and Medicare. There's always tension between what the
users of the system want, and what the taxpayers are willing to pay.
The balance of power ebbs and flows between them; but no matter where
it lies at any given moment, at least one of the pair is always going
to be at least somewhat unhappy.

But, as many of us know all too well, there's also constant tension
between what patients want and what private insurers are willing to
pay. At least when it's in government hands, we can demand some
accountability. And my experience in Canada has convinced me that this
accountability is what makes all the difference between the two
systems.

It is true that Canada's system is not the same as the U.S. system.
It's designed to deliver a somewhat different product, to a population
that has somewhat different expectations. But the end result is that
the vast majority of Canadians get the vast majority of what they need
the vast majority of the time. It'll be a good day when when Americans
can hold their heads high and proudly make that same declaration.

Next week: More mythbusting on common conservative canards about
efficiency, innovation, and competitiveness.


Help us spread the word about these important stories...
Email to a friend
Sara Robinson is a twenty-year veteran of Silicon Valley, and is
launching a second career as a strategic foresight analyst. When she's
not studying change theories and reactionary movements, you can find
her singing the alto part over at Orcinus. She lives in Vancouver, BC
with her husband and two teenagers.

(c) 2008 Independent Media Institute. All rights reserved.
View this story online at: http://www.alternet.org/story/76032/



Of course this is all pretty much true, but don't expect people
who get paid a lot to lie about to acknowledge any of that. They do the
equivalent of holding their fingers in their ears while yelling "Not
listening! Not listening!" because they want to, not because they
"believe" otherwise.
We have a federal government here now that seems to be trying to
help the American big pharma lobby keep their status quo intact by
mucking up our system too.

It's our own fault. We let the politicians, bureaucrats and lobbyists go about their organized crime activities without so much as writing a letter of protest. The US Constitution is very clear about how things should operate. THE FEDERAL GOVERNMENT IS SUPPOSED TO REGULATE INTERSTATE COMMERCE, NOT OPERATE IT!!! So, if the American people had any sense they would demand that the prices of insurance be regulated or disallow the companies to operate across state lines so that the people in the individual states to keep closer tabs on those operating in their states. Our founders were not stupid.


--
People should quit whining about everything,
get off their lazy butts and do what it takes to make their
own way and stop acting like some Skid Row beggar?

http://www.reason.com/
www.ij.org

JC

.