How I Lost My Fear of Universal Health Care


Written by Melissa @PermissionToLive

When I moved to Canada in 2008, I was a die-hard conservative Republican. So when I found out that we were going to be covered by Canada’s Universal Health Care, I was somewhat disgusted. This meant we couldn’t choose our own health coverage, or even opt out if we wanted too. It also meant that abortion was covered by our taxes, something I had always believed was horrible. I believed based on my politics that government mandated health care was a violation of my freedom.

When I got pregnant shortly after moving, I was apprehensive. Would I even be able to have a home birth like I had experienced with my first 2 babies? Universal Health Care meant less choice right? So I would be forced to do whatever the medical system dictated regardless of my feelings, because of the government mandate. I even talked some of having my baby across the border in the US, where I could pay out of pocket for whatever birth I wanted. So imagine my surprise when I discovered that midwives were not only covered by the Universal health care, they were encouraged! Even for hospital births. In Canada, midwives and doctors were both respected, and often worked together. 

I went to my first midwife appointment and sat in the waiting room looking at the wall of informational pamphlets. I never went to the doctor growing up, we didn’t have health insurance, and my parents preferred a conservative naturopathic doctor anyways. And the doctor I had used for my first 2 births was also a conservative Christian. So I had never seen information on birth control and STDs. One of the pamphlets read “Pregnant Unexpectedly?” so I picked it up, wondering what it would say. The pamphlet talked about adoption, parenthood, or abortion. It went through the basics of what each option would entail and ended by saying that these choices were up to you. I was horrified that they included abortion on the list of options, and the fact that the pamphlet was so balanced instead of “pro-life.” 

During my appointment that day, the midwife asked her initial round of questions including whether or not I had desired to become pregnant in the first place. Looking back I am not surprised she asked that, I was depressed at the time, (even though I did not list that on my medical chart) and very vocal about my views on birth control (it wasn’t OK, ever.) No wonder she felt like she should ask if I was happy to be having this baby. But I was angry about the whole thing. In my mind, freedom was being violated, my rights were being decided for me by the evils of Universal Health Care.

Fast forward a little past the Canadian births of my third and fourth babies. I had better prenatal care than I had ever had in the States. I came in regularly for appointments to check on my health and my babies’ health throughout my pregnancy, and I never had to worry about how much a test cost or how much the blood draw fee was. With my pregnancies in the States, I had limited my checkups to only a handful to keep costs down. When I went in to get the shot I needed because of my negative blood type, it was covered. In fact I got the recommended 2 doses instead of the more risky 1 dose because I didn’t have to worry about the expense. I had a wide array of options and flexibility when it came to my birth, and care providers that were more concerned with my health and the health of my baby than how much money they might make based on my birth, or what might impact their reputation best. When health care is universal, Drs are free to recommend and provide the best care for every patient instead of basing their care on what each patient can afford.

I found out that religious rights were still respected. The Catholic hospital in the area did not provide abortions, and they were not required too. I had an amazing medically safe birth, and excellent post-natal care with midwives who had to be trained, certified and approved by the medical system.

I started to feel differently about Universal government mandated and regulated Health care. I realized how many times my family had avoided hospital care because of our lack of coverage. When I mentioned to Canadians that I had been in a car accident as a teen and hadn’t gone into the hospital, they were shocked! Here, you always went to the hospital, just in case. And the back issue I had since the accident would have been helped by prescribed chiropractic care which would have been at no cost to me. When I asked for prayers for my little brother who had been burned in a camping accident, they were all puzzled why the story did not include immediately rushing him to the hospital. When they asked me to clarify and I explained that many people in the States are not insured and they try to put off medical care unless absolutely needed, they literally could not comprehend such a thing.

I started to wonder why I had been so opposed to government mandated Universal Health care. Here in Canada, everyone was covered. If they worked full-time, if they worked part-time, or if they were homeless and lived on the street, they were all entitled to the same level of care if they had a medical need. People actually went in for routine check-ups and caught many of their illnesses early, before they were too advanced to treat. People were free to quit a job they hated, or even start their own business without fear of losing their medical coverage. In fact, the only real complaint I heard about the universal health care from the Canadians themselves, was that sometimes there could be a wait time before a particular medical service could be provided. But even that didn’t seem to be that bad to me, in the States most people had to wait for medical care, or even be denied based on their coverage. The only people guaranteed immediate and full service in the USA, were those with the best (and most expensive) health coverage or wads of cash they could blow. In Canada, the wait times were usually short, and applied to everyone regardless of wealth. If you were discontent with the wait time (and had the money to cover it) you could always travel out of the country to someplace where you could demand a particular service for a price. Personally, I never experienced excessive wait times, I was accepted for maternity care within a few days or weeks, I was able to find a family care provider nearby easily and quickly, and when a child needed to be brought in for a health concern I was always able to get an appointment within that week.

The only concern I was left with was the fact that abortion was covered by the universal health care, and I still believed that was wrong. But as I lived there, I began to discover I had been misled in that understanding as well. Abortion wasn’t pushed as the only option by virtue of it being covered. It was just one of the options, same as it was in the USA. In fact, the percentage rates of abortion are far lower in Canada than they are in the USA, where abortion is not covered by insurance and is often much harder to get. In 2008 Canada had an abortion rate of 15.2 per 1000 women (In other countries with government health care that number is even lower), and the USA had an abortion rate of 20.8 abortions per 1000 women. And suddenly I could see why that was the case. With Universal coverage, a mother pregnant unexpectedly would still have health care for her pregnancy and birth even if she was unemployed, had to quit her job, or lost her job. 

If she was informed that she had a special needs baby on the way, she could rest assured knowing in Canada her child’s health care needs would be covered. Whether your child needs therapy, medicines, a caregiver, a wheelchair, or repeated surgeries, it would be covered by the health care system. Here, you never heard of parents joining the army just so their child’s “pre-existing” health care needs would be covered. In fact, when a special needs person becomes an adult in Canada, they are eligible for a personal care assistant covered by the government. We saw far more developmentally or physically disabled persons out and about in Canada, than I ever see here in the USA. They would be getting their groceries at the store, doing their business at the bank, and even working job, all with their personal care assistant alongside them, encouraging them and helping them when they needed it. When my sister came up to visit, she even commented on how visible special needs people were when the lady smiling and waving while clearing tables at the Taco Bell with her caregiver clearly had Downs Syndrome. 

I also discovered that the Canadian government looked out for it’s families in other ways. The country mandates one year of paid maternity leave, meaning a woman having a baby gets an entire year after the birth of her baby to recover and parent her new baby full-time, while still receiving 55% of her salary and their job back at the end of that year. Either parent can use the leave, so some split it, with one parent staying at home for 6 months and the other staying at home for 6 months. I could hardly believe my ears when I first heard it. In America, women routinely had to return to work after 6 weeks leave, many times unpaid. Many American women lost their jobs when becoming pregnant or having a baby. I knew people who had to go back to work 2 weeks after giving birth just to hang onto their job and continue making enough money to pay the bills. Also every child in Canada gets a monthly cash tax benefit. The wealthier families can put theirs into a savings account to pay for college someday (which also costs far less money in Canada by the way), the not so wealthy can use theirs to buy that car seat or even groceries. In the province we lived in, we also received a monthly day care supplement check for every child under school age. I made more money being a stay at home mom in Canada than I do in the States working a close to a minimum wage job. And none of the things I listed here are considered “welfare” they are available to every Canadian regardless of income. For those with lower incomes than we had there are other supports in place as well.

If a woman gets pregnant unexpectedly in America, she has to worry about how she will get her own prenatal care, medical care for her child, whether or not she will be able to keep her job and how she will pay for daycare for her child so she can continue to support her family. In Canada those problems are eliminated or at least reduced. Where do you think a woman is more likely to feel supported in her decision to keep her baby, and therefore reduce abortions? 

Since all of these benefits are available to everyone, I never heard Canadians talking about capping their incomes to remain lower income and not lose their government provided health coverage. Older people in Canada don’t have to clean out their assets to qualify for some Medicare or Social Security programs, I heard of inheritances being left even amongst the middle classes. Something I had only heard about in wealthy families in the USA.

And lest you think that the Canada system is draining the government resources, their budget is  very close to balanced every year. They’ve had these programs for decades. Last year Canada’s national debt was 586 billion dollars, the USA has 15.5 trillion dollars in national debt. Canada has about one 10th the population of the US, so even accounting for size, the USA is almost 3 times more indebted. And lest you think that taxes are astronomical, our median income taxes each year were only slightly higher than they had been in the States, and we still got a large chunk of it back each year at tax time.

In the end, I don’t see Universal health care as an evil thing anymore. Comparing the two systems, which one better values the life of each person? Which system is truly more family friendly?

Former Quiverfull believer, Melissa is a member of the Spiritual Abuse Survivor Blogs Network at No Longer Quivering – she blogs at Permission to Live.

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  • coralsea

    Bravo on a very well articulated piece on the valuing of people as well as on the provision of health care!

  • cyffermoon

    Nice article, but I think this should read “In fact, the percentage rates of abortion are far lower in Canada than they are in the USA, where abortion is often not covered by insurance and is often much harder to get.

     

    My insurance covers abortion like any surgery.

  • cade

    I was still on my father’s insurance from his job as at a medical university when I had my abortion, but even thought it was for an interstital pergnancy, it wasn’t covered. I don’t recall all the details as to why it wasn’t cover, as it was many years ago, but I did have to pay for it. 

     

  • cade

    The ACA isn’t universal health care. I noticed this blog was tagged under Obamacare, and the tweet that led me here was taged #ACA. ACA provides universal health care INSURANCE coverage, but not health care itself. For people like me, who live in one of the many “health care deserts” here in the US, that means I’ll have health care insurance, but not necessarily access to health care.

     

    The US health care system is extemely unjust and unfair. We have a two-tiered system that grossly underserves disadvantaged populations and the areas where they live. The ACA really won’t change that. Poor people will still be going to the ER for conditions that could have been prevented because they couldn’t  get into to see a regular doctor or the specialist they needed. 

     

    The ACA will likely beneoft middle class people the most, as they live in areas where there are enough doctors and clinics. But for poor people, especially ones lving in a health care desert because doctors don’t want to move there just to treat medicare/medicaid patients, things may not change much at all.

     

     

  • coralsea

    Cade — I agree with you that ACA doesn’t go far enough.  I, for one, along with many other progressives, were disappointed that the legislation didn’t result in universal healthcare.  We have such a messed-up system here in the U.S. — all established more or less by accident as a way of getting around wage controls after World War II.  Now the insurance companies gobble up much of the money that should be spent on healthcare–and medical practices have to spend money on staff members simply to handle the paperwork.  I wish that Americans were more aware that our system isn’t so much a mark of “capitalism” as it is one of accident and stupidity (stupidity that we continued down this road).

     

    I am, one of the middle-class people living in an area where healthcare services are accessible (if you can pay for them) who will benefit.  I have multiple, serious pre-existing conditions that have kept me uninsured and paying insane amounts of healthcare (e.g., CT scan cost to insurance companies, $1,200; CT scan cost to self-pay, $3,600).  However, I also happen to have a job that often has me working in lower-income areas and areas that are isolated (rural as well as some inner city neighborhoods that are seriously underserved by food stores, libraries, medical clinics, and even public transportation on reasonable schedules).  And you do raise an unsettling issue — that as written, ACA will likely benefit people like me, but may still leave low-income families and people who aren’t able to easily access medical services in the dust.   One could make the argument that ACA may make things worse, in fact, by alleviating the suffering of middle-class folks, who are more likely to be listened to by policy makers in Washington D.C. and at the state level, and relieving the pressure to “do something” about our insane health care situation.  I sincerely hope that this won’t happen.  Frankly, I am shocked that, with the number of people who are uninsured or who aren’t able to get the benefits that they need, that there wasn’t an insurrection over the people who die or live with disabilities and impaired health everyday due to our crumby, criminally inequitable system.  My hope is that if people do see that making a dent in the near total control the insurance companies have had over medical care in the U.S. — that has led to inflated, crazy-number costs — may make the public more amenable to ensuring that medically underserved areas receive the resources they need. 

     

    I am aware that such hopes smack of Pollyanna’s “Glad game,” and they don’t go anywhere near far enough to address inequalities in healthcare.  But I believe that a lot of the problems we have had in making any improvements to healthcare (such as ACA) are tied up in arguments and imaginings that are just as fanciful on the part of some of the players on Capitol Hill as well as the fears, ignorance, and prejudice of a large portion of the public.  Clearly, the insurance companies don’t want anything to impinge on their profits — and they pay off key legislators and spread messages of fear to the public.  But others are “against” anything that smacks of universal healthcare because they believe that it is “socialist” or “communist,” and simply the use of such words is enough to send them running in the opposite direction.  The Tea Party types (many of whom are, whether they know it or not, taking their marching orders from business interests who care nothing for personal liberty and simply want to see government regulations gutted), some of the Religious Right, Libertarians, etc. fervently embrace “the market” and reject “evil, anti-capitalist” efforts to provide healthcare to everyone for (weird) ideological or religious reasons that are hard for thinking people to fathom, but that unfortunately resonate with a large portion of the population who have been trained to believe: Government=bad (or at least iffy), Private Enterprise=good (because it’s been more than half a century since incidents such as the Triangle Shirtwaist Factory Fire and all of the deaths and manglings of young children working in factories).

     

    For some reason, a large portion of the public still seems to be unable to go from personal crisis to the need for national change.  I live in a middle-class, mostly white neighborhood.   Five years ago, I found that very few people had any idea of what it was like to be unable to get insurance coverage because THEY all had it.  More recently, I hear horror stories of how so-and-so lost his/her job and now the insurance is gone, too, and “have you ever heard of such an outrage?”  And yet a lot of these people still feel that the government should stay out of healthcare because, er, um, well, that’s socialism–and then in the same breath mention how well Medicare works for their parents!

     

    So we need to get it through the thick skulls of the public (and no, I don’t think “the public” is stupid; but I do think they have been so bombarded by Right-Wing, Government-bad, Americans-stand-on-their-own-two-feet, and anyone who doesn’t is a loser, propaganda that they can’t think rationally about healthcare) that times have changed, work (where people used to get their insurance) has changed, and private insurance has run its course.  (Personally, I also think we need to overhaul medical training in this country so that more doctors can be graduated without incurring the insane amount of debt that now appears to be the hallmark of American higher education — but this post is already too long.)

     

    Finally, you might wish to take a look at the requirements that U.S. EPA is attempting to put into place for public involvement in cases of suspected environmental injustices.  U.S. EPA has begun looking at communities that are overburdened by pollution and other environmental problems and in doing so, they are looking at the environmental, health, social, and economic aspects of those communities — like the availability of healthcare resources.   If EPA is successful in pushing forward with this holistic approach to environmental health, then private industry may find that it behooves them to ensure that the communities in which they wish to operate have healthcare resources accessible to residents.  For more information on U.S. EPA and Environmental Justice, you can visit the EPA website: http://www.epa.gov and search on environmental justice.  You can also review a summary of the “Indicators” EPA is using to assess possible environmental injustices (which include availability of healthcare resources as well as the ability of lower-income and/or minority groups to participate in dialogues regarding environmental conditions and environmental quality) on the following website: http://www.rosehillcommunications.com/environmental-justice.html  The summary is somewhere on this page (I haven’t looked at it in a while, but their is a link to download it).

     

    Keep the faith.  Hopefully, we will someday (soon) live in an America where everyone has access to decent healthcare.

  • warrensenders

    It’s good to hear that you shed the irrational fears of universal coverage – fears which are still avidly promoted by people whose own health insurance is excellent, but don’t think anyone else deserves it.

     

    The abortion issue always seems to be politically/philosophically fraught.  To help clarify the discussion, we need to hear more stories of people whose lives were saved by medically necessary abortions.  People like my mother.  I wrote about her here:

     

    http://www.dailykos.com/story/2009/06/01/737756/-My-Mother-s-Abortions

     

    Warm regards,

     

    Warren

     

  • valentinelogar

    This was wonderfully done, especially given the comparisons you have made. No system is perfect, ever. It seems though many of imperfections were overcome with the ‘greater good’. My argument has always been when the greater good is considered we find a more perfect solution.

     

    Birth control, early education and yes even abortion will always find opponents. Sometimes for very legitimate reasons. We should be respectful of those reasons and the individuals who hold those views, but not allow those views to hold societies or nations for ransom. We do far more good when we seek more pragmatic answers as Canada and many other nations have done.

  • conny123

    Tthe writer doesn’t paint an accurate description of Canadian healthcare. True, Canada gives healthcare to everyone, but you better don’t need glasses, a hearing aid or dentures, because you pay through the nose for those.
    She talks way too much about pregnancy. Personally I am disgusted that mom’s get a year maternity leave. Six weeks is more than enough. Some come back to work after maternity leave, only to announce that they are pregnant again and again. And they get to keep their jobs. I for one very much object that my taxes go to child support. I can understand child support for one child, maybe two, but the writer and countless other women don’t know when to stop.

    Four kids!!! Does she have any idea how much her kids cost the tax payer?  And what does she do?  Has she ever worked a day and contributed to paying taxes? 
    Not to mention how she soils the environment with the endless diapers.

  • j-rae

    First of all there is the disgust that women who have children get pregnant “year after year”.

    False = Average fertility for Canadian women is equal to 1.58 children. (US is 2.06)

    Of course some women have more children but it is balanced by women who have none or fewer than average.

    http://www.globalhealthfacts.org/data/topic/map.aspx?ind=87 for birthrates per country.

    Next lets talk about dental care, eyeglasses and hearing aides.

    I only know that here in the US none of these are available unless you have money, are under 18 and your state covers the need with medicaid, or your over 65 and have a supplemental coverage. (none of these are covered with Medicare)

    To complain that Canada does not cover these items is an attempt at misdirection since neither country routinely provide coverage.

    There is the complaint that the writer talks “way too much about pregnancy”.

    Pregnancy is a MAJOR medical need of adult women of childbearing age. It may be the first time a young woman has routine contact with medical personal. For many many woman it is the first time they are a patient in a hospital. For many, many women this will be their adult introduction to the healthcare system, US or Canadian.

    The last and most insulting comment “Six weeks is enough”.

    Enough for what? Baby’s first shots are at 6 weeks, just when a woman is going back to work. It can take several months for a woman to firmly establish breastfeeding. A baby can be exposed to staph, gastritis, and other pathogens that are avoidable if they are placed in care too soon.

    At six weeks an infant is not sleeping through the night. So a woman who has to return to work is expected to work all day and be up frequently during the night leading to exhaustion and possibly poor work performance during the day and frustration during the night.

    I don’t know if your an American or Canadian but if I had to guess I would say American.

    Here in the US we like to brag about how caring the people are. Well, that might be true 1:1, but as a country we are pretty heartless and selfish. If you have any doubts just review the presidential debates where the audience was yelling “let him die” and cheering. Very Lord of the Flyish.

     

     

  • bcswowbagger

    As a right-wing Republican myself, I am very grateful for this commentary, which is much more credible coming from a former right-winger than one of the dyed-in-the-wool partisans who usually write Canadian love songs.  It sounds like, in your case at least, the Canadian system served you very well.  It’s far from converting me to a “let’s implement it here!”, but it does soften my stance somewhat.  Some questions worth asking from a public policy perspective: (1) is the Canadian system sustainable, given its aging demographic?  (2) Would its generous maternity policies (free money!) be fiscally feasible in the our higher-fertility nation?  (3) How much of the Canadian financial advantage stems from price controls its restrictions on the use of cutting-edge drugs?  I know some people are very comfortable with the cost-benefit of a panel like IPAB, but I emphatically am not.

     

    In any event, I could never support adopting a system that pays for any direct abortions — or, indeed, subsidizes abortion providers in any significant way.  I oppose it when Medicaid pays for abortions here, and it’s a showstopper for me whenever people start talking about universal health care that includes abortions.  I’d be interested in discussing the pros and cons of a universal health care system in the U.S. that *exempts* abortions (which would be paid for out-of-pocket or with supplemental abortion insurance), but I fear that will never happen, because of the way American ideologies happen to line up on these issues.  At least all Americans from all political perspectives can agree on one thing: universal health care is better than what we’re going to have under Obamacare!

     

    In the meantime, there are some obvious reforms we should make to the U.S. health system, which the ACA inexplicably overlooked, like severing the link between employment and health insurance by restructuring the bizarre World War II-era tax system surrounding benefits.  That would help with a lot of the problems Mrs. Garrison points out right there.  No one should have to stay employed just to keep health benefits.

  • pip333

    Thank you for the well-written article. I recognize that most opponents of Universal Health Coverage will not be the primary readership, but I would like to contribute my story as well. My husband and I are middle class, and I have health “coverage” through my work. When we became pregnant with our first child, we were both amazingly excited until I was told that my insurance did not cover prenatal care or maternity. The cost of a birth without insurance at my hospital is $15,000 and a C-section is $35,000.  We were devastated and had no idea how to cope. Even with a comfortable dual income of $50,000 a year, we don’t have the resources to pay $35,000 out of pocket, and we certainly didn’t qualify for Medicaid. I’m not asking for a handout, but some type of affordable care is very important. I ended up miscarrying at 12 weeks, so we never had to face the $15,000 bill. The miscarriage was heart-breaking. It is also heart-breaking that had we not lost the child, we would have lost our apartment and lived with debt for the next decade. It is little wonder to me that so many Americans would turn to abortion under such circumstances.

  • pcbedamned

    (2) Would its generous maternity policies (free money!)… 

    I just need to correct this one thing. It is not ‘free money’. It is paid maternity leave through EI (Employment Insurance). You can only receive it if you are working (therefore paying into the system), and have put in the minimum amount of hours to qualify. As well, you only receive 55% of your average insurable weekly earnings, up to a maximum amount.

    Peace.

  • jonjoensen

    Actually Denmark provides from 52 to 114 weeks, depending on whether you ask for an extension. Your number for Denmark is incorrect!

  • mycroft

    you get 39 weeks paid leave (although the last 33 are only required to be at a statutory minimum – many companies pay more though), plus there is a little bit of paternity leave, and a good few weeks of unpaid parental leave that you can take.

     

  • much-afraid

    Vyckie says, “And lest you think that the Canada system is draining the government resources, their budget is  very close to balanced every year. They’ve had these programs for decades.”

    The federal government hasn’t had a balanced budget in years and the $30B deficit in 2011 is not  insigificant in a budget represented by $235B in overall revenues.

    Secondly, the Canadian healthcare system is a huge drain on taxpapers and is only going to get worse. Read the Drummond Report, Vyckie. No jurisdiction in Canada sees an annual increase in healthcare spending of less than 2.5%. Ontario sees an annual increase of 7%. Further, healthcare expenditures represent nearly 50% of government expenditures in some provinces including Ontario, which has a debt of over $200B. This is only going to worse given the coming fiscal squeeze whereby healthcare expenditures increase and taxpayer contributions decrease due to the aging population in Canada.

    Wake up, folks.

  • ahclem

    is the alternative?

  • much-afraid

    You would agree that the solution is NOT government-run healthcare, correct? Or do you think healthcare expenditures that consume 50% of a province’s budget are sustainable?

  • polyorchnid-octopunch

    I like your use of the misdirection “in years”. It’s been four years, actually, and it’s not really a surprise, because the conservatives are in charge, and historically in both our countries the conservatives have been the people who borrow and spend rather than tax and spend. The Conservatives were given a healthy set of books by the (gasp) Liberal party and promptly screwed it up. They’re working as hard as they can to bring the US style of life here, despite the objections of ~70% of the citizenry.

     

    The Drummond report was authored by a banker, who will get to profit as his institution offers insurance services if we move back to private insurance. Most of us don’t give it a lot of credence; most Canadians suffer no illusions about whose interests bankers have at heart. A more useful report would have recommended going back to the system extant from the sixties to the early nineties, when health insurance was a monopsony offered by a wholly publically owned crown corporation; in my province that would have been the Ontario Health Insurance Corporation, with the ability to levy a payroll tax. This was better because it allowed people to have more info about where their money was going, and because that way health care costs didn’t compete politically within cabinet for the other priorities for provincial governments: education, roads, etc.

     

    Yes, annual increases often outpace inflation… just like everywhere else in the West. This is mostly due to the absolutely insane IP structure around drugs and medical equipment, passed (here) in the eighties by (surprise!) a conservative government rewarding their cronies in those industries (I’m talking about Mulroney here, in case you didn’t get it), and under pressure from the Reagan administration in the US who was doing the same thing. 

     

    The simple truth is that a government-run monopsony keeps costs lower and results in better outcomes. Only fools or the mendacious try to suggest we can’t afford it. The truth is that we can’t afford to not have it, given the aging population constraints you mention… which is pretty much the only thing you’re wholly truthful about in your post.

  • much-afraid

    So tell me: after how many unbalanced budgets can I say – without misdirection – that our federal budget hasn’t been balanced in years? After, maybe, 5 years? We’ve had 5 budgets that have/are running deficits (2008-2012). I notice you’re not as quick as to point out the misdirection in Vyckie’s statement where she suggested that federal bugets are balanced almost every year. This is fallacious. As is your revisionism of the Liberal Party. Go back a little further than Pat Martin. You’re going to find some deficits. 

     

    Your conspiracies about bankers are a red herring. Healthcare expenditures are a huge strain on public funds right now. Vyckie is simply wrong on this point. Be honest enough to admit it instead of obfuscating with conspiratiral tales about the banking industry. 

     

    As for your further conspiracies about IP, again, off topic. And not really helpful anyways even if on topic. Whether we’re discussing the medical-industrial complex, the military-industrial complex, or whatever, both conservatives and liberals engage in cronyism. Of course, you’ll have the eHealth scandal in Ontario fresh in your mind as an example of liberals feeding the medical-industrial complex. Politicans, whether of a blue or red stripe, will be politicians. 

     

    It’s bordering on insanity to suggest that a government-run monopsony keeps costs lower. Not only is there no incentive for governments to keep costs lower, it is the very nature of democratically elected governments to (over)spend. The third-party payer system is a huge part of the reason why we’re in the mess we find ourselves in today.

  • polyorchnid-octopunch

    Everywhere there is a government-paid-for healthcare, costs are lower and outcomes are better. I prefer to put my faith in empiricism rather than ideology, thanks.

     

    Yeah, healthcare is expensive. I’m shocked, shocked I tell you to learn that this is so. This doesn’t mean that we can’t afford it. The question is not whether we can, but whether we want to. It appears that you don’t want to.

     

    Intellectual Property as a source of growing health care costs is not a conspiracy. When drug companies are permitted to re-patent drugs over and over again by tweaking what they’re for a little bit, therefore allowing them to continue to charge rentier prices for them, well, you can say I’m engaging in conspiracy mongering if you think it will convince anyone.

     

    Federal budgets have been balanced for 15 of the last twenty years… and the reason they’re not balanced now is not because of changes in spending but because of changes in taxation. It’s the Conservative Party of Canada that put us into structural deficit, and they did so for ideological reasons. I prefer pragmatism, thank you.

     

    Yeah, government run monopsony doesn’t keep costs lower, I mean, take a look around you. There’s no incentive, amirite? The fact that the most expensive system with the worst outcomes (by far!) is the only one that doesn’t do this doesn’t matter! I would like to ask everyone here other than Much-Afraid; who are you going to believe… the free-market ideologues and their theories, or your lying eyes?

  • coralsea

    Sorry, Much-Afraid, that you don’t like government.  In the U.S., it’s hard to say how much medical care costs because our system is such a Gordian Knot, thanks to all of the cost distortions imposed upon it by “big insurance.”  As I’ve written before, here, a CT scan (three years ago — haven’t been able to afford the follow-up one my doc is after me to get for my lungs, which are filling up with scar tissue thanks to rheumatoid arthritis) costs $1,200 if you are an insurance company.  If you are a “self-payer,” the cost is $3,600.  Huh?  Who is subsidizing whom?  Doctors rarely know what diagnostic tests cost — my rheumatologist wanted me to have one that he was sure wasn’t TOO expensive — it was $1,100!  After that, I always tracked down the cost, which invariably takes several days and lots of phone calls, because no one knows (and we are lectured about being good “health care consumers.”  Yeah, right.  If you can get the information.

     

    Doctors also often load you up with diagnostics that don’t make a lot of sense if insurance is paying (they figure, why not?).  In addition, because of concerns regarding malpractice, they practice “defensive testing.”   Malpractice isn’t so much of an issue when you know that any medical issues will be covered, is in the case of single-payer insurance.  Malpractice is a big issue if you are injured by bad care and then lose your medical coverage and still have to pay for left over medical care. 

     

    Ironically, when I have had no insurance–scary as that is, because I’m always afraid of the BIG BILL–I think I get better health care, because when I am paying out of pocket, the doc and I sit down and figure out the most logical way to handle the diagnostics, e.g., try this test first because it is cheap and rule out “X”, then, if we need more information, do this test next.

     

    Insurance companies in the U.S. also cost medical practices a lot of money.  Medical practices all have to have extra people to deal with the insurance companies — and doctors lose patient care time dealing with them, too.  And the insurance companies pay their executives multi-million dollar salaries that border on the ridiculous (not a slam at being well paid, but really — there is a point at which it is obscene).  One of the things that the Affordable Care Act will do is cap insurance company profits at 20% — the rest has to go into actually operating expenses and patient care.  This will be a jolt to them because, despite rolling in money, they don’t pay out anywhere near the 80% minus operating costs now.

     

    Government actually does a lot of things well.  This, I believe, could be one of them.  Getting rid of the bloated middle-man insurance companies will save money.

  • linus-bern

    It is nice to see that you approach this with the possibility of having your mind changed.

     

    I just wanted to address one point you raised which is the question of the affordability of Universal health care, and whether the US, with its higher birth rates, could afford things such as the generous maternity leave that Canadians enjoy.  The US currently has the highest per capita healthcare costs in the world.  It is not even close.  Last time I looked into it, for example, the Swiss paid less than half what Americans pay.  Perhaps if outcomes were significantly better that would make some sense, but the US lags behind many developed countries in measures such as life expectancy and infant mortality.  The reason the US pays so much more seems to come down to profit.  The corporations that run the health care system have conflicting motivations.  Provide healthcare vs earn the greatest profit possible for shareholders.  Of these two, the second is most important to them, and the way to accomplish it is to do as little of the first as possible (unless of course the patient is on medicare, in which case you prescribe the most expensive tests, whether necessary or not, and you soak the taxpayer with the bill.).

     

    The ACA did fall well short of what was needed to fix healthcare in the states, but hopefully it is a good first step.  Canada’s healthcare system didn’t emerge fully formed.  Universal healthcare started in Saskatchewan and when residents of other provinces saw its success they began to demand the same.  Province by province it spread across the country, and today you probably couldn’t find more than a few hundred Canadians that would trade it away.  In fact Tommy Douglas, known in Canada as the father of medicare, (and in the states as Kiefer Sutherland’s granddad) was named the greatest Canadian ever in a national poll.  I understand Vermont is intending to use the flexibility that the ACA allows in order to create something like Canada’s system.  Hopefully they will be successful and others will follow.

  • john-west

    Ya …. it’s just great, I can hardly walk and my doctor is telling to wait untill the pain is completely unbearable before he will put me on a wait list for a knee. I am a healthy 69 year old and I have never used the system other than for check ups. Where’s my F’n Knee?

     

    This sytem is only functioning becasue most of us are deferred until we are either dead or wish we were.

     

    We need some private options.

  • linus-bern

    If you are unhappy with your doctor, see another one.  You aren’t required to stick with him/her.  I guess you could move to the states, but with your bad knee nobody will give you insurance.

  • bvl

    I wonder wether high abortion rates in the U.S. are due primarilly to potential mothers being afraid of uncovered delivery or health care costs. The use of anti conception is simply much less accepted in the States than in any other developed nation. Direct result: more unwanted pregnancies (and more teen pregnancies). It seems to me that abortion rates are – again in developed nations – related primarily to the amount of unwanted pregnancies. At least they are heavily correlated.  

  • john-west

    I did that, and the got the same answer. Doctors are mandated to stall, stall, stall …. there’s no money for the patient, lots for the unionized idiots who run the failed system though.

  • john-west

    l

  • jhaytol

    So I read this, and then I get the vancouver Sun delivered to the hotel room.  I read this quote:

     

    “Administrators maintain waiting lists on purpose, the way airlines overbook. As for urgent patients on the list who are in pain, the public system will decide when their pain requires care. These are societal decisions. The individual is not able to decide rationally.”

    — Dr. Charles Wright, current member of the Health Council of Canada and a former vice-president at Vancouver General Hospital, quoted in a Reader’s Digest article.

    And I can see there are two very divergent views on Canada’s system.  

    Article Link:  http://www.vancouversun.com/opinion/op-ed/right+private+health+care/6978170/story.html

     

     

  • lchic

    These are some valid points on the health insurance system in America versus Canada. This may be true about expectant mothers, but what about the seniors who face these kinds of issues in their life day to day? This isn’t just a few months these citizens have to worry about health insurance and a care facility option, they have to go through years of worrying about these issues. Many seniors cannot function properly without a second party present, that can become very expensive without the proper health insurance. There are many senior care resources available out there as well as for expectant mothers. You just have to look in the right places. Many states offer free insurance to expectant mothers that covers the majority of hospital and doctor visits.

  • canadianhealthsystemparticipant

    Single-payer works really well for acute care, and keeps costs down.  When you’re in serious need of medial attention, you’re taken care of no matter what.  You won’t go broke.  As this article demonstrates, opstetrics is a big part of that.

     

    Palleative care, however, can be left to be desired, since it’s not deemed to be high priority.  That’s where our private insurance system comes in (and for medication, though we have good price controls to begin with, and many provinces also have drug plans, such as BC Fair Pharmacare).

     

    Basically, if you’re seriously injured or ill, you get the most cost-effective treatment available, and it’s nearly impossible to go bankrupt due to medical expenses.

     

    If you are older and have bad joints, you have to wait — often too long.

     

    This is where the private system can pick up the slack, and many provinces are experimenting with that (with public funds); however, it’s definitely a Made In Canada solution.  The US system is a whole different animal.

  • arachne646

    It’s a real waiting list nightmare for this kind of surgery across the country, and for a few other “non-urgent” surgical procedures. Operating room time is the usual cause. OR time in hospitals requires many things, and the limiting factor is often trained OR nurses. It sounds heartless to say your condition isn’t urgent, since it is so painful and limits your life, but it won’t spread or actually cause other illness. You’re not a candidate for replacement surgery at this time, I’d think, as you can still bear weight, and your pain isn’t 10/10, so you can’t be on the wait list until you’re a candidate right now. OR time is scheduled like an airport traffic control tower, and different priorities, from trauma patients in the Emergency Department, to cancer or appendicitis patients, or those with broken bones, that need operations now, today, this week or along the line can be scheduled in day by day or in the emergency shift in the wee hours of the morning on call. It’s very expensive, and sometimes, impossible, to run more emergency rooms, but the emergency and urgent operations always get done.

    In Vancouver, there are private clinics which do knee replacements; perhaps there are in your city. You will be astounded at the cost–below US rates.

  • arachne646

    One reason that Canada officially prohibits two-tier systems in our provincial (state) medical plans is because the rich and powerful are drawn off into the private clinics and the motivation to preserve and keep the funding adequate for public health care is lost. Obviously, if only the poor elderly need affordable nursing home care, affordable nursing home care will no longer be of much importance to middle and upper-class voters. In many provinces private surgical clinics and “concierge” medicine is springing up anyway. That’s not to say doctors and other practitioners work for the government–private hospitals, doctors, labs, medical clinics, bill Government Health Insurance along with provincial health care bodies.

    When the government provides health care insurance, no employers’ conscience is bothered by the medical services the employee decides to consume, whether abortion, contraception, male or female sterilization, or Viagra.

  • arachne646

    One reason that Canada officially prohibits two-tier systems in our provincial (state) medical plans is because the rich and powerful are drawn off into the private clinics and the motivation to preserve and keep the funding adequate for public health care is lost. Obviously, if only the poor elderly need affordable nursing home care, affordable nursing home care will no longer be of much importance to middle and upper-class voters. In many provinces private surgical clinics and “concierge” medicine is springing up anyway. That’s not to say doctors and other practitioners work for the government–private hospitals, doctors, labs, medical clinics, bill Government Health Insurance along with provincial health care bodies.

    When the government provides health care insurance, no employers’ conscience is bothered by the medical services the employee decides to consume, whether abortion, contraception, male or female sterilization, or Viagra.