Wednesday, September 23, 2009

A Note From Canada (Plus A Bit of Soapbox)

This comment was left at Margaret and Helen's blog, a blog by 2 old ladies who have been lifelong friends.  The blog itself is...well...indescribable.  Helen, who lives in Texas, is usually the one mouthing off.  If you take offense when people make fun of Rush Limbaugh or the rest of the far right wing of the Republican party (and really, people, where are all the moderate Republicans these days?  Why aren't they telling these death-panel people to sit down and shut up while the rest of us use the brains God gave us to figure out health care?), don't bother visiting.  But really, it's a hoot.

Anyway, the comment was by a Canadian; I thought it was worth sharing.  Sometimes it helps to get an outside perspective on our particular brand of crazy.  Purely anecdotal, of course:

We Canadians aren’t quite sure what to make of the hoopla over healthcare in the US. (Most Americans I meet are boggled that we know so much about American politics, but really, when you share a border with a country that has more Bombs than anyone else on the planet, you tend to pay attention to what they’re doing and what wingnut they’re electing next…. That and we get a lot of American TV.)

The healthcare debate to the south of us is sort of the horrifying hilarity of two minicars full of clowns crashing at high speed. Terrible, but come on, they’re clowns. For us, Universal healthcare is a no-brainer. And it costs us next to nothing in our taxes. I read a study last week that surprised me. I honestly and truly believed that we paid more of our income in taxes than Americans. Turns out we pay approximately 2% more. A lousy two percent more of my income goes to taxes and I never have to worry about losing my house to pay for cancer treatments or heart surgery.

It’s true that the Canadian system is not perfect. I had to wait 11 hours in the emergency room to get my finger fixed after I tripped over a snowbank and dislocated it. That, admittedly, was a bit of a pain (pun intended). But I didn’t have to sell my car to pay for the splint or the 8 weeks of physio therapy required to get it working again. I’m currently 5 months pregnant. I will pay exactly ZERO dollars for my prenatal care from my family doctor (I am lucky enough to have one), my OB-GYN, all the tests and ultrasounds, the actual delivery and my postnatal hospital stay (though my supplemental insurance from work will get me a private room instead of having to hang out on the ward). I will also get a full 12 months guaranteed maternity leave, though I will likely not take all of it myself as my hubbie wants to take some of that leave time. (I get 12 weeks actual maternity leave and the other 9 months is technically parental leave that can be taken by either parent at half-salary — which is again paid for by my measly extra 2% in taxes).

And the thing about death panels is laughable. My 90-year-old granny spent a week in the hospital not long ago with an issue with her gall bladder. Nobody executed her or denied her care to save money. Trust me, Granny Alma is still kickin’ and offering up her opinion about how my sister got married in the church while I got married in the showy splendor of Nature.

Our system is definitely not perfect, far from it, but I can’t begin to tell you how wonderful it is to not have to worry that you or someone you love will die or go bankrupt because of a lack of access to reliable healthcare.

[I'm back.] The Canadian healthcare system is not the only universal healthcare system available in the world.  Neither is the British one.  As T.R.Reid points out in his book The Healing of America, there are many ways in which to reach the goal of affordable healthcare for everyone in our country.  Our job now is to figure out which way to go.  The question is not whether reform is needed; it is how to best accomplish this reform. 

So anyone who wants to say reform is not possible, or that it leads to fascism, or that it would cost too much?  Please educate yourself.  Health care reform is possible.  Japan does it.  France does it.  Germany does it.  Almost every industrialized democracy has it.  We can do it, too.  As far as its costing too much?  It already costs too much.  Many of these costs are hidden in depressed wages, etc.  But that's why we need reform.  All these countries spend less than we do and cover more people.  We look like fools.

I personally don't like career-counseling my teens and telling them, "Make sure you get a job with insurance" rather than "Work hard, follow your dreams, be all you can be."  It seems to me that a free market economy cannot function at its most efficient when talent and skills cannot move to where they need to be because of the fear of losing health insurance.  My neighbor isn't happy that her son and his long-time girlfriend can't get married because the son (who is pursuing a Masters) would lose the health coverage he gets through his mother's job.  Another acquaintance of mine has a 62-year-old brother who needs back surgery.  The longer he waits, the more damage he does to his back.  But if he gets the surgery, he'll miss so much work he'll be laid off.  And then - you guessed it - he'll lose his health insurance.  He's going to turn 65 and go on Medicare a lot sicker than he should be, which of course will cost all of us more money in the long run than if he had gotten proper care when he needed it.

Our system is horribly broken.  It needs fixed.  The solution won't be perfect; nothing in this world is.  But it will be, hopefully, several steps in the right direction.  Remember - you don't really know whether you have adequate medical coverage until you actually need it.  Each one of us is just one step from medical catastrophe.  The house that health care reform saves? It may very well be your own. 


  1. Oh no, you got it all wrong. Losing the house and bankruptcy only happens to someone else, mostly irresponsible punks. Things like these could never happen to me. (heavy dose of sarcasm)

  2. That deafening roar you just heard? That was my standing ovation.

  3. I found it ironic that when (almost) my entire life crumbled to bits aruond me and I had to get (gasp) state sponsored health care, it was the best coverage I've ever had outside of the military.

    How is it that my kids and I get medical, dental, and vision, with actually affordable copays, because I was NOT working? (And I think I can stay on this plan, because I won't actually make enough to afford the very expensive, yet under covered plan, offered by my new company...)

    I am not complaining....I'm very, very, very grateful. But why were we working so hard and paying through the nose, and still my kids had never been to the dentist?

    And why does the state seem to encourage UNemployment in this way? (They also said I needed to be on welfare to get immediate help with child care. If I was actually working, I'd need to go on the waiting list. Huh?!)

  4. Yes! Amen! Preach it, sister!

  5. As many times as we have fought to keep insurance, as many jobs as I have held that only *just barely* covered the insurance and the gas to get there, as many times as we have had to pick up the pieces after a medical emergency...


  6. YES!!!

    (and thanks for the link to Margaret & Helen - they are a hoot!!)

  7. Right now I'm trying to find a job...and my number one priority? Good benefits. Which, when you think about it, is sad. I should be looking for something that I enjoy doing, something where I can make a difference. But right now the only thing that matters to me is that I can get my family some good health care coverage, because what my husband's small company is able to offer is complete shite.

    I would SO be willing to pay 2% more in taxes if it meant that everyone would have health insurance. And if that makes me a Socialist, then I think I'm ok with that.

  8. I think everyone agrees something needs to be done. The thing about Republicans not wanting to do anything and wanting the "status quo" is a myth. The argument is how we should do it.

    Universal health care isn't the same for everyone in Canada or Britain or Cuba or anywhere else. It may cost your Canadian friend just 2% in income, but Canada isn't the US and doesn't have our budget or deficit or economy. Besides, we could go back and forth giving anecdotal evidence all day long and not run out of people to throw up as examples. "I know some guy who used to work for my brother and he's from the UK" just doesn't cut the mustard when it comes to proving anything.

    We already have "public options" in the form of Medicare and Medicaid. There are places people can go to get medical care - free clinics, the Health Department (another "public option"), and charities. We don't have a problem with people getting turned away from the ER because they're uninsured - they have to treat you, regardless.

    As has been proven in America's petri dish's for "socialized" health care, or whatever you want to call it - Massachusetts, Oregon. Also states who have implemented "public options" - like Tennessee (TennCare) and Hawaii (KeikiCare).
    The problem with these plans is they were too expensive, because people will drop their regular insurance coverage for the cheaper public option and flood the rolls. That's what happened in Tennessee (I live here) and Hawaii - in fact, there's video somewhere of Hawaii's governor saying that's what happened. That's what will happen with a national public option.

    Rather than jumping in with both feet and spending more money on some big health care plan that will create something like 53 new government agencies, I would like to see health insurance be made available across state lines, and a serious look at tort reform (not just a promise to think about it).

    Yes, it's urgent. But we have more urgent issues (such as the wars in Iraq/Afghanistan and unemployment). I'm also concerned that some in Congress continue to argue for something that they haven't read and have no intention of reading. What happened to this being the most transparent Congress in history? Write something in plain language so everyone can read and understand it...that shouldn't be too hard for ivy league graduates.

    Speaking of transparency, the Senate Finance Committee just today voted 12 to 11 to only post a "summary" of bills online 72 hours before they're voted on. They won't post the whole bill...just a summary...just what they want us to see.

    BTW, my family has been without health insurance for the past six years because it's too expensive - about $12,000/yr. We used to have insurance for the self-employed (we qualified because of his extra work), but it was about 6K per year and paid for nothing...literally.

    We're insured for devastating illness - not cheap, but far less expensive. On the rare occasions we need medical attention, we go to the Health Department. I guess you could say we use the public option. You won't get cable TV or terrycloth robes at the Health Department, but you pay based on income. I pay around $30 for a physical and mammogram every year.

    For generally healthy people, it's a bargain. You pay one price for vaccinations for the kids as well. Even if we paid to go to a regular doctor's office, we wouldn't spend $1,000 for our whole family (5 people) in a year.

  9. Here in Australia we have universal health care. It's not perfect, but it means everyone can be given medical treatment if they need it. I just gave birth 5 days ago and all of my prenatal care, tests, ultrasounds, appointments as well as the birth and hospital stay were FREE.

    You can buy additional cover which means faster treatment for elective surgeries and extras (non-urgent physio, optical cover etc) which is fairly cheap and covers almost everything.

  10. Very nice comment by a fellow Canadian. I see it exactly the same way. Our health care system sure isn't perfect but it's at a very satisfiable level and I am personally happy with it. Plus the costs of our system are just so much lower than the current US system. I read somewhere that US spends about 17% of their GDP on health care, Canada spends about 8%. Now all that money could go to education, unemployed and so many more things. Thanks for a nice post.

    Take care, Ella

  11. How can I distill this into a potent vaccine and administer it to all the ill-informed protesters who lurk on the corner every Saturday morning?

  12. I love you. Have I mentioned that? You are so logical, so eloquent, I wish more people were like you!

  13. And while we're at it? There was a big wave of health insurance companies going from non-profit to for-profit about 15 years ago, starting with California allowing them to. The result was skyrocketing costs and the Wellstone CEO, head of 17 states' Blue Cross plans, getting $54 MILLION in one-year salary and benefits a couple of years ago, while swearing that that didn't impact any subscribers' benefits. Uh huh. Right. At my daughter's premium rates, that would be three and a quarter million people getting not so much as a flu shot for that year just to fill his pockets. There is a special place in hell...

  14. well said and well linked!

    i'm from germany and if i get sick the most i have to pay when i get sick (regular flu, broken bone, apendix etc) is 10euro. add to that another max. of 10 euro for the medication.

    check ups are always free of charge and so is most preventative treatment (fluorizing teeth, check of moles for skin cancer, ob/gyn check ups) unless they find something, then it's the 10 euros again.
    until the age of 18 no fees have to be paid and everyone, be they employed or not is covered.

    does it pain me to see what is being taken out of my paycheck to cover for my medical insurance (a percentage of my pay that is being matched by my employer)? yes. but like that canadian commenter said, i know that should i need an expensive treatment, an operation, a wig because the cancer treatment resulted in hairloss - i will get it without many questions asked.
    and also, should i have an accident there is an ambulance there to help me within minutes. no questions being asked, no ssn wanted. they HAVE TO help, and no hospital can refuse my care until my identity and my insurance status is clear. and even then many hospitals keep the patients who are not insured (eg illegal migrants)

    universal health care does sound scary when you have a working plan, are able to pay it and are not sick so you don't have to worry about possible consequences. BUT i live in a society where the able take care of the unable, where those working support the unemployed, where all children can go to see a doctor and are part of a tight knit network of preventative care, and where i know that my mom who has been handicapped since birth is able to live a fine life in a nice neighborhood without having to worry too much about money - because the handicap was not like a sword of damocles since day 1 of her life.


  15. "I just gave birth 5 days ago and all of my prenatal care, tests, ultrasounds, appointments as well as the birth and hospital stay were FREE."

    No, it wasn't. Someone paid - whether it was you or your fellow citizens. Universal care does nothing about the actual cost of medical just spreads the debt around so everyone is paying.

  16. They just voted France the country with the best health care system in the WORLD.

  17. The death panel thing slays me--we have them already--they're called Review Boards and they're run by your insurance company. I guarantee you that cost motivates them far more than it would the government.

    I can't believe we're debating this.

  18. If the people in the legislature had any morals at all they would regulate the insurance companies and give up their bribes (oh, I mean campaign donations, etc.). That alone would resolve many of the issues we have.

    We pay $1350. a month for our HMO. We have a $30.00 co-pay for every visit and for drugs. Five years ago we paid $800.00 a month and $10.00 co-pay.

  19. I agree, decent regulation of the industry would go a long way to solving a lot of the current problems. France has no public plan, just private (but non-profit) insurers; and as Suzy pointed out above, they have one of the best systems in the world.

  20. Excuse me, I just tripped over the ottoman while trying to stand up to give you the proper ovation.


    ((throwing bouquets of roses at your feet))

  21. I'm not convinced a public plan is the solution to the health care issues. There are so many other solutions other than the public option, but nobody in congress seems to be talking about them. Hmmmm....

    Simply put, when I see how well government runs my local post office, DMV, and IRS, the thought of the government running my doctor's office does not appeal to me. If there are any government agencies out there that do a good job at customer service, I haven't seen it.

  22. According to the WHO, Morocco has better health care than the US! So I'm in the right place.

  23. We are going through the one medical disaster that may make us lose everything. My husband fell and shattered his foot. The job he has (he's an electrician) requires that he be able to use both feet. He's going to have to have surgery and his vacation only runs through this next Thursday after which he won't have a job or insurance. I'm worried as heck but this is the lot that life has dealt us. It sucks to have to worry about how to pay for the surgery he has to have and the bills and everything else. There has to be a viable solution to healthcare. I don't know exactly what it is but I wish the elected leaders would stop their squabbling and do something constructive to just fix it.

  24. I've struggled to understand the US objection to universal health care (free at the point of delivery - though of course paid for by taxes). Kathryn's concerns seem refreshingly free of insurance company-sponsored paranoia.

    It's true that the doctors and nurses of the NHS are not always driven by customer service. But they are concerned to cut waiting lists and get the right sort of care to as many people as possible.

    It's hard to imagine that healthcare professionals in the US wouldn't have a similar sense of public duty.

    The hysteria of some of the arguments against universal health care seem to be stopping the debate about alternative options and that's really frustrating. There are other things about US healthcare that surprise me - is it really true that some states don't even recognise the midwifery profession and say that homebirth is illegal?

  25. "If the people in the legislature had any morals at all they would regulate the insurance companies and give up their bribes (oh, I mean campaign donations, etc.). That alone would resolve many of the issues we have."

    Term limits could solve a multitude of sins! An insurance company exec just had a "fundraiser" at his palatial home for Nancy Pelosi. That's just the one that made the news.