Dr. T. Rand Collins PhD, MD, LLC
The most unfortunate aspect of the health care debate in both countries is that the real issues, and the real strengths and weaknesses of each philosophy, get lost in the flag-waving.
There is a great deal of sniping back and forth across the border from those who would use both systems’ problems for their own political ends. Sadly, both systems are broken, but in different ways. The United States has excellent health care and world-class technology that is available quickly, but a significant part of the population cannot afford it. And another large segment of the population can just barely afford it, surrendering the equivalent of their mortgage each month just to be protected against a medical catastrophe. Canadians are privileged to receive complete care for a nominal cost – but to the patient who waits months with a painful and debilitating condition, this can be cold comfort.
In many cases involving cancer patients or acutely ill patients needing emergent care, the Canadian system performs well. My father had bypass surgery, and though there were no bedside phones and the surgery ward had last been repainted about ten years ago, he received excellent care, with home care provided for a nominal fee. That is the beauty, equality, and power of the Canadian system. However, for an extremely large number of patients with “non-emergent” conditions, wait times are long, services are limited, and patients experience significant pain and disability while they wait for treatment. “Non-emergent” does not mean that the condition can safely wait months for resolution.
The problem with the Canadian system is that it is totally government run, with no alternative available, and no competition to goad officialdom to improve services. Consequently, Canadians are stuck with what government provides – sometimes very good, and sometimes deadly slow.
The problem with the American system (and here I beat a personal drum) is that it depends entirely on the free market, and provision of good health care, I believe, does not fare well in an atmosphere oriented to profit. Sick people are not profitable, and in the end, they get the short end of the stick from an insurance industry that basically wants them to disappear. One of the elements of my belief system that I absorbed with my (Canadian) mother’s milk is that health care, like the ability to vote and express myself freely, is a right, not a privilege. Having lived for a quarter century in the U.S., I am still not convinced that many Americans have grasped this concept. I’m not sure that those who campaign fervently for the right to carry a Smith and Wesson really believe that their fellow citizens should be able to take their children to the emergency room without worrying about whether they can pay for it. Personally, I think that it is my responsibility to fork over a bit more in taxes to make sure that the immigrant kids down the road can get their eyes examined. i find it interesting that the health care systems in the U.S. that really provide equitable care (Medicare and the Veterans’ Administration) are both government run.
What is the answer? It’s complicated. Canadians need more flexibility and the ability to step out of the queue and buy care if they want to. Americans need to be freed from the crushing burden of paying for care that only the rich or the employed can afford.
