‘Tis nature’s precious boon to die*, it was once said. True as this may be, and when and how our unavoidable fate greets us we are forbidden to know, we should all at the very least hope that when the clouds ultimately obscure our mental light*, that we shall pass with a little bit of fucking dignity.
Imagine, then, quarreling over a doctor’s upfront commission while your wife lays limp and breathless on some hospital sidewalk in dire need of a treatment that your private insurance company denies her. This is a true story from Canada’s pre-Medicare days.
An embarrassing death of this sort is exactly what Canadian Healthcare is designed to prevent—where possible, of course. It is for this reason, if for no better one, that Healthcare in Canada should be defended and criticized only when it wavers from this principle.
The Conservative Party of Canada, then, is trying to erase what we currently have, medically speaking, as the seize an April 18th report that squawks about a foreseeable Healthcare crisis as provinces across Canada spend a great deal more than they make.
Canada’s Fraser Institute released its new Healthcare report detailing how the state of Healthcare funding is blowing a financial bubble at the brink of implosion. In terms of yearly averages, 7.5% increases in Provincial spending but only 5.7% available provincial revenue are unsustainable tendencies.
The recommendations, therefore, are made to sound furry and companionable:
“Suspending the Canada Health Act on a trial basis, to allow provinces to test market-friendly experiments, such as abuse-discouraging user-gees and private health insurance”
Charming. Congrats, foremost, to the Fraser Institute for packaging herein so much fatuity into one proposition. Chicanery of this caliber requires, for most, the modest length of a small paragraph. Then again, businessmen don’t shovel money into the Fraser Institute’s treasury and expect something less.
In researching for this column I was elated to find actually how strong the evidence is in favor of Canadian Healthcare and how degrading private medicine is to both patients and doctors. In America, Doctors have begun to revolt against private healthcare providers because they make it against a doctor’s economic interest to provide adequate care. In that country, doctor rights have slowly been supplanted by the middleman; private insurance makes a mockery of patient-sector confidentiality because the equation now becomes patient-insurer-doctor.
Some Doctors make money for prematurely discharging patients to free up beds, some have supplied surplus care because the more tests run the more money made. In Nevada, where a Supreme Court ruled against this sort of assembly line madness, HMO’s had to be told that:
- They can’t offer incentives for doctors deny care to patients care;
- They can’t make a doctor not be able to inform a patient there are options outside their existing insurance plan;
- They aren’t they ones that determine the length of stay—this applies especially to mastectomy patients, i.e. females, who are treated to ‘quickie’ operations and sent home prematurely to free up beds.
Again, HMO’s had to be q not to engage in these unscrupulous practices and only after lengthy, expensive court battles did they finally get it.
The practice of medicine is uniquely ill-tailored for market society. The thought of a surgeon trying to ring a health insurance company (HMO in America) to find out if the specimen that lays before her indeed has coverage, while, say, beguiling the weary hour of a long shift, while prepping for surgery, is a disgrace to humanity. The solemn and career-enhancing ‘no’ delivered by a pencil pusher over the telephone wire doubles the offense. But hey, at least the doctor knows she isn’t wasting her time.
To ask the question what was Healthcare like in Canada before it became a non-profit public utility is to ask something as internally illogical as what came ‘before’ time itself. Oh, there were doctors and hospitals, to be sure, but ‘care’ was an unpracticed concept and the system didn’t operate for the purposes of maximizing ‘health’ either.
If you can find it, I would recommend skimming Life Before Medicare by Helen Heeney (its only 90-odd pages). It is factual stories by our seniors who, closer as they are to life’s finish line, understand exactly what a private system was like. Most green in my mind is in Alberta—the heartland of today’s Canadian Conservatism, and headquarters of the only party not to pledge to keep Medicare public—where Albertans had 1 doctor, traveling on horse, to cover 3000 square miles. Talk about wait times.
In America, 60% of medical costs are paid through taxes. So, technically, there are only two things private about their system: (1) where the profits go; and (2) the decision over if you will get treatment or not.
The healthcare system in ‘the land of the free and the home of the brave’, in fact, effaces the entire concept of ‘choice’ from the equation. It is actually the HMO that chooses you and the likelihood of getting chosen is inversely proportional to how sick you actually are.
As densely and intriguingly as I could, I have called forward the best reasons why Canadian Medicare is superior. These ten are from the Physicians for a National Health Program, similar to our own Canadian Doctors for Medicare:
- One third of US health spending goes just to administrative things like bureaucrats and advertising. Canada only spends half of this amount on the same things (32% of total spending to 16.7%).
- Half of personal bankruptcies in America are due to health bills. Of these, 75% occurred despite individuals having a health insurance plan.
- Taxes account for 60% of US health spending. As the PNHP explains, Americans pay for public health care but they don’t get it.
- Canadians are healthier and have much better access to health care than Americans.
- Private contributions to health only account for 20%.
- For profit, privately owned hospitals have higher costs and rank much lower than public systems on nearly every measure of quality of service provision.
- The poor performance of the American system cannot be blamed on immigrants or political correctness.
- 45000 deaths a year come from a lack of health insurance.
- By eliminating the exorbitant Admin costs, America could cover 45000 uninsured people.
- ‘Competition’ raises costs and lowers quality.
- It is not uncommon in America for insurance companies to incentivize NOT providing care for it’s expanding the profit side of the balance sheet.
Canada’s rising health care costs are actually due to privatized aspects of the system, like the cost of prescription drugs of which the costs has tripled in 20 years. Studies conducted by actual physicians, like Canadian Doctors for Medicare (and not pampered and paid think tanks like the Fraser Institute) have demonstrated that the public option, according to every measure and instrument, can control costs and facilitate choice to a superior degree than anything else.
Head here for a proper debunking of the supposed benefits of privatized medicine as applied to Canada:
There is, finally, a rule of thumb when dealing with people who begin to tout the invisible benefits of a private system (remember: not private; see point 3 above): the more eloquent and well-put the case of private medicine sounds, the more it should raise your suspicion.
* This paragraph has borrowed heavily W.H. Auden’s Thoughts on Death