A Canadian doctor diagnoses U.S. healthcare by Dr. Michael M. Rachlis

A Canadian doctor diagnoses U.S. healthcare
The caricature of 'socialized medicine' is used by corporate interests to confuse Americans and maintain their bottom lines instead of patients' health.
By Michael M. Rachlis
Los Angeles Times
August 3, 2009

Michael M. Rachlis is a physician, health policy analyst and author in Toronto.

Universal health insurance is on the American policy agenda for the fifth time since World War II. In the 1960s, the U.S. chose public coverage for only the elderly and the very poor, while Canada opted for a universal program for hospitals and physicians' services. As a policy analyst, I know there are lessons to be learned from studying the effect of different approaches in similar jurisdictions. But, as a Canadian with lots of American friends and relatives, I am saddened that Americans seem incapable of learning them.

The U.S.' and Canada's different health insurance decisions make up the world's largest health policy experiment. And the results?

On coverage, all Canadians have insurance for hospital and physician services. There are no deductibles or co-pays. Most provinces also provide coverage for programs for home care, long-term care, pharmaceuticals and durable medical equipment, although there are co-pays.

On the U.S. side, 46 million people have no insurance, millions are underinsured and healthcare bills bankrupt more than 1 million Americans every year.

American democracy runs on money. Pharmaceutical and insurance companies have the fuel. Analysts see hundreds of billions of premiums wasted on overhead that could fund care for the uninsured. But industry executives and shareholders see bonuses and dividends.

Compounding the confusion is traditional American ignorance of what happens north of the border, which makes it easy to mislead people. Boilerplate anti-government rhetoric does the same. The U.S. media, legislators and even presidents have claimed that our "socialized" system doesn't let us choose our own doctors. In fact, Canadians have free choice of physicians. It's Americans these days who are restricted to "in-plan" doctors.

Unfortunately, many Americans won't get to hear the straight goods because vested interests are promoting a caricature of the Canadian experience.

Please read the complete article at:

http://www.latimes.com/la-oe-rachlis3-2009aug03-test,0,1645187.story

Better to make the military-industrial complex rich than all Americans healthy.

Good find.

Recommended.

Health Care is definitely a touchy subject. As a Canadian who lived in Canada for 35 years and now 5 years in the U.S., I am delighted with the care my family has received here in the U.S. I’ve had two children born in the U.S. My wife has needed medical treatment and received first class treatment. I have needed treatment and received first class treatment. I’m always amazed at the quality of the facilities. The quality of care is second to none.

U.S. facilities are modern. People who need treatment, can get it almost “on demand”….if they can afford it....but...that’s the rub…if they can afford it. I have insurance, but more than 50 million American do not. For a country as wealthy and advanced as the U.S., it is shameful to deny treatment to anyone who needs it. Sure, hospitals are required to treat those in a life/death situation – but what about the millions of Americans who need other types of “non life threatening” treatment? What about those who are suffering with hip problems, knee problems, severe back problems, mental disabilities. If they don’t have insurance or they can’t afford it – they don’t get the care they need.

The article does not really talk about the issues in Canada. Canadians CAN chose their own doctor. Sure! But, with so little doctors to go around (the good one’s move to the U.S.) – your chance of finding a doctor is significantly diminished. Many (most?) Canadian doctors are not accepting new patients. There are Government hot lines (with 40 minute waits) that can help you locate the “new kid out of medical school” who is accepting patients.

Canada also suffers from what I will call “Regional Health Care Issues”. The care in Ontario for example is superior to that in Alberta (of course people living in Alberta deny this!). Within each province, you have micro-regional health care issues. The care in downtown Toronto might be better than say a small town like Orangeville, Ontario.

Let’s face it – Doctors work for years studying and most are looking for a reward (financially). If you were a doctor – would you want to be on a Government salary or would you want to work in the U.S. where you had no ceiling on your earnings?? Many of Canada’s Doctors are from India or the Caribbean – because some of the “Canadian” born Doctors have moved south.

If the thought in the U.S. is that we will get the same level of care and it will be free – give your head a shake. Nothing is free. If on the other hand, the thought is that we will offer an alternative – so no one can be denied coverage – that is a noble idea.

Fundamentally, my thoughts on the matter have changed as I’ve grown into my 40’s. I used to think “fend for yourselves suckers”. But now, as I’ve grown older (and wiser?) – I believe as a society we have a responsibility to look after each other through sickness and in health (unemployment insurance). Making a profitable industry around someone’s illness is wrong. If someone wants to go get plastic surgery because they want to look younger – let them pay for it. But, if someone is suffering – we cannot as a society allow that person to suffer needlessly.

Doctor Rachlis does not really touch on a subject I feel is as important as universal health care coverage and that is medicine. Since the Canadian Government is the ONLY insurance company (if you can call it that) – they can negotiate hard with the drug companies on the cost of medicine. Those savings are passed on to the Canadian consumers. Keeping drug costs under control will certainly be the next big challenge the current U.S. administration will face.

Today, the most successful health care setups are “two-tiered”. One for public hospitals and one for private. England has had great success and Canada is moving in this direction too. If you have money – you can pay – and get your treatment “on demand”. If you cannot afford to pay – you may have to wait a few days/weeks – but you will get treated and you will not be denied for any reason.

What the U.S. is trying to accomplish is revolutionary. Basically, they are trying to create a Government Medical Insurance plan with wide reaching coverage. The American ignorance the Doctor speaks of is spot on. Living here has been a huge eye opener. Americans are less knowledgeable of the world around them than perhaps any other developed nation. Perhaps Canadians know so much more about the world around them because quite frankly, there really isn’t much exciting going on in Canada (other than hockey of course). We don’t have any wars. We’re not trying to rescue hostages. We’re not carrying out secret military missions. We’re not bailing out our banks and financial institutions. We’re not prosecuting Bernie Madoff. And we’re certainly not worrying about Jon and Kate plus 8.

At the end of the day, Americans needs to sit back and ask themselves “what kind of nation do we want to be in the 21st century?” The world around us is changing. India and China are taking over as the new economic super powers. America is facing significant social and economic challenges. But America has the best and the brightest. America has a wonderful entrepreneurial spirit (despite the complete uselessness of the SBA – but I’ll leave that for another discussion) and America continues to strive to be the standard for which all other countries are measured. And tackling health care head on is a good first step.

but you knew that already. The only Canadians touting the public/private two-tier system are harperite neocons aka republican wannabes. I live in Alberta, my children live in Alberta and we have had excellent care. I moved to Alberta from British Columbia and while I lived in B.C. I received excellent care. My parents lived in Ontario and they received excellent care.

83% of Canadians support the current universal healthcare system. It is not perfect and needs to be 'tweaked' consistently to ensure it addresses the needs of Canadians.

You are fortunate in that, as a Canadian (assuming you haven't yet given up your citizenship) you can always come back if you end up uninsured in the current United States HMO/Pharmacare/for-profit hospital system. Americans don't have that choice.

Edited to add: Here is a link to a study on how Canadians feel about the system in place. I thought you might like to catch up seeing as you haven't lived in Canada for five years:

http://www.theglobeandmail.com/life/health/canadians-happy-with-primary-health-care-study-says/article1229169/

Many of Canada’s Doctors are from India or the Caribbean

What's the matter - don't want someone with darker skin that yours treating you?

Foreign trained doctors still have to qualify (often by returning to medical school) to practice in the Canadian system.