Rebuttal info sought: Candadian Health Care System

[Catch22Dem]

I posted a thread here late last night, but I think it got a little buried. This will be my last one. I'm not trying to spam, but I can't do this one alone.

I'm looking for rebuttal information to use against one of my wife's co-workers. This co-worker is Canadian, yet spends every waking moment bashing Canada. She is *'s wet dream. Anyway, she's constantly going on and on about how poor the health care system in Canada is. She says her brother, for example, has to wait like a year for knee replacement surgery.

I don't know enough about it to respond intelligently, so if you folks could educate me a little, I'll pass it along to my wife, who will then confront this co-worker.

Thanks in advance.

[JHB]

1. Don't have what you're looking for myself...

but you could always point out that in the US, if you cant afford the knee replacement surgery (or if you don't have insurance that will cover it), you'll probably have to wait a lot longer than a year...

[papau]

2. If you have money, no wait in Canada - or in US - or in Brittan

If you are poor or middle-class, no care in the US is a real possibility, but not so in Canada or Brittan.

Health care results - infant deaths,etc might be of interest to your co-worker.

[iverglas]

3. bad timing!

I and others have posted tons of stuff at the old board, and I even have some of those threads bookmarked -- but alas, you can't read 'em right now.

For basic info, geared for USAmericans, about the Cdn health care system, I recommend the New Rules Project's pages:

http://www.newrules.org/equity/CNhealthcare.html

Health Canada's basic info -- probably not tremendously useful for your purposes, but handy for reference maybe:

http://www.hc-sc.gc.ca/datapcb/iad/hcsystem-e.htm

The United Steelworkers' submission to the Romanow Commission on the Future of Health Care, which reported last year:

http://www.uswa.org/hcwc/politicalaction/uswasubmission.htm

Some stuff about NAFTA and health care:

http://collection.nlc-bnc.ca/100/201/300/cdn_medical_association/cmaj/vol-154/1549.htm

Quite a long one on that question:

PDF document

Google's cached html version

Information about why there have been some problems in the Cdn health care system -- the problems are mainly from defunding, not structural:

http://www.rnao.org/html/policy/speakout/st_costs.asp

I'll give you some of my DU bookmarks for threads about this, so you can save them and check them once the old board is available for consultation:

www.democraticunderground.com/duforum/DCForumID66/16784.html#

For personal anecdotes -- my dad died in March; I described some of the care he received before his death here, and I believe others offered their experiences (I've chopped up the links for the sake of post format; copy and paste):

www.democraticunderground.com/cgi-bin/duforum/duboard.cgi?az=
show_thread&om=32286&forum=DCForumID60

I think this one was my thread about health care and NAFTA:

www.democraticunderground.com/cgi-bin/duforum/duboard.cgi?az=
show_thread&om=7305&forum=DCForumID70

And there is tons and tons of stuff at the site of the group working to protect and preserve the Cdn health care system. One of the group's leading lights is Shirley Douglas -- actor and activist, daughter of Tommy Douglas, the "father of Canadian medicare", and mother of Kiefer Sutherland. ;) The Coalition critiques the health care system from the left.

http://www.healthcoalition.ca

Now, there are always anecdotes. Joint replacement surgery is in fact one of the things that people may find themselves on waiting lists for.

On the other hand, when my father was diagnosed with cancer (two days after presenting at an ER with what looked like hip and shoulder deterioration that would have needed replacements), he received, in the space of the 6 weeks he was in hospital (mostly in the first 10 days or so): x-rays, bone scans, CAT scans, radiation therapy, complete in-patient treatment (internist, orthopaedic surgeon, oncologist, pain management ...) -- and would have had an MRI and a hip replacement (purely for pain relief, since his life expectancy was very short), both of which were scheduled on two days' notice, except that his pacemaker made the first impossible and his overall condition meant that he was not a candidate for surgery. The pacemaker itself was installed urgently last summer -- complete with a couple of weeks' total hospitalization both for the 3 days before the surgery could be done (he had to be transferred from a small city to a big city) and while being treated for one of those damned hospital infections (staph) that meant his surgery then had to be delayed -- but all the ambulance transfers back and forth, about 75 miles each way, were free of charge. ;)

Anecdotes say very little about how a system operates. If your co-worker's brother had been unable to obtain knee surgery in the US simply because he did not have insurance coverage and could not pay for it, would this make the US system better or worse than the Cdn? That's pretty much a matter of opinion, and one's opinion often depends on which end of the stick one has hold of ... and/or how much one values the ability of other people to get essential health care.

It's a big topic with few short answers. I hope some of the links help give you a handle on some basic data, and what some of the issues are. The big one from the point of view of those who are knowledgable is that pressure to privatize health care in Canada (including permitting a parallel private system, which is not permitted now) is that US health care providers -- HMOs, insurance companies, hospital chains, specialized surgery clinics, etc. -- are just salivating to get their teeth into the Canadian market, and of course they have many friends among the corporate-interest politicians up here. It is therefore to those interests' and politicians' benefit for the system to "fail" and people to demand private options; but the thing is, the Romanow Commission (you can also google for that) found overwhelming support among Canadians for the existing system. NAFTA protects us for now, but that protection is somewhat fragile, and the slightest chink in the wall could bring it down.

Have a bit of a read, and then ask away! (I'm a little busy this week, but I imagine there are other Cdns around who'll respond -- myself, of course, I tend to query both the intentions and the knowledge base of the bashers who sometimes appear in these threads.)

[Friar]

4. this is just an anecdote

but my parents were Canadian immigrants and modt of my family still live there. Last November we went to Calgary for a visit (I know, wrong month-it was 30 degrees below 0!) and as an experiment I asked many people we met if they would switch their health care system model for the US system. They all either burst out laughing or stared at me like I was crazy. Noone said that it would be a good idea.

[iverglas]

6. and that was Alberta!

Alberta is to Canada as Texas is to the US.

Of course, Calgary is to Alberta as Austin is to Texas. ;)

[DiverDave]

5. I read a study

A while ago that basically boiled down to the cost of treatment in the U.S. for low income folks (read no insurance) and Folks in Canada.
The study showed that the U.S. folks waited so long to get treatment for symptoms, the disease that they had had progressed to the point of costly treatments.
On the Canadian side, folks would go RIGHT AWAY to get checked, if the disease doesn't progress very far, it is easier, and cheaper, to treat.
Makes sense to me, I have waited out an fever, seeing if it would get better, ...Turned out I had one of the 1st cases of the Bejing strain of the flu in Oregon. (This was early '90's)
I was sick for weeks, had a cough for a long time. Missed alot of work, got way behind on bills.
So much for the comparison.

Dave

[morstyranni]

7. I don't know, my fiancee did an internship in a Toronto hospital...

The Canadian health care system does kind of suck. Particularly because you need to wait for weeks to have certain surgeries and simple procedures like MRI's
The really bad thing is that any Canadian with money comes to the US for treatment if they get sick or if they need a procedure. I'd listen to the Canadian on this one.

[Friar]

9. "...any Canadian with money..."

Exactly. If you have the money the US health care system is for you. No doubt it's the best money can buy. Like our government...

[Liberal Veteran]

10. That may be so, but at least in Canada...

...people don't have to go to the emergency room for basic health care.

There are very few perfect things in the world, but Canada is heavenly by comparison to the US system that only caters to those with money or health insurance.

I find it obscene that we spend more on defense than the next 25 countries combined but that we have millions who are going without a basic health care plan.

[iverglas]

12. the Canadian

That will be, e.g., me? As compared to your generalities and unsubstantiated allegations about things said and done by unidentified persons?

Did you try reading what Canadians -- e.g. me -- have said here?

"... you need to wait for weeks to have certain surgeries and simple procedures like MRI's"

My father was scheduled for an MRI on 2 days' notice. This was a diagnostic procedure in a cancer/bone deterioriation case. He also received radiation therapy (another service in which there have been shortages) on similar notice.

"Wait for weeks to have certain surgeries"? What surgeries might they be, pray tell? You are of course correct -- but you kinda do need to specify the urgency of the surgery, if you're going to say that waiting periods aren't acceptable, doncha think?

My father was scheduled for a pacemaker implant on 3 days' notice, and kept in an intensive care unit until he could be transferred 75 miles to a tertiary (and world-class) cardiac care centre from the small-city primary/secondary hospital he had gone to initially.

MRIs have indeed been too scarce. The health care system has been defunded by right-wing federal and provincial governments. Anybody see a possible connection? Anybody?

"The really bad thing is that any Canadian with money comes to the US for treatment if they get sick or if they need a procedure."

And the amazing thing is that such Canadian doesn't even need to have a red cent in the bank if the treatment is medically necessary -- insured under the public plan -- and not available at home within the appropriate time. Because the public plan will pay for it. Damn, eh?

I am a Canadian with money. Quite a fair bit of it -- at least the top 1/20 of the population in income terms. I wouldn't go to the US for treatment to save my life, as it were. Partly because I would be very unlikely to need to, partly because I have absolutely no desire to, and partly because despite my high income it would probably eat up much of my retirement savings to do so.

Am I concerned that Canadians with even higher incomes than mine might choose to go and pay their money for treatment in the US? Not especially. Do I think they should be able to undermine our universal plans by purchasing health care privately in Canada? Nope.

This question is actually before the Supreme Court of Canada as we speak; the case will likely be heard sometime in the next year: does the prohibition on purchasing private insurance coverage and medical care violate the Canadian Charter of Rights and Freedoms unjustifiably? So far, the Quebec Superior Court and Quebec Court of Appeal have said "no". I'm with them.

"I'd listen to the Canadian on this one."

Good advice.

[Frederic Bastiat]

20. Ah the exception that proves the rule

Hey iverglas, do you have any information on Canadian hospital waiting lists (besides anecdotal)?

The Canadian government does track them, and why would they? What incentive do they have to do so?

I find it deeply ironic that for the largest single government expenditure program in Canada, you know astonishingly little about what you get for your money. You have no idea of how long the waiting lists are because there are no statistics and hence zero accountability.

Kinda like the Pentagon LOL

[iverglas]

22. copied and pasted

And heard it all before.

Now you trot out the tales told by your wife the McGill trained professional who you claim is working outside the health care plan, which is of course illegal if the services being provided are covered by the plan. Never heard your answer to that one. But I'm sure they're not "anecdotal evidence", somehow.

Do I have any information other than anecdote? Gosh, you read my posts so carefully, you must have read the first one I wrote in this thread. Any anecdote there -- or anywhere else -- was offered specifically to demonstrate that anecdotal evidence is not really too useful, i.e. it was offered in response to anecdotal evidence to the contrary -- which was not in fact even anecdotal, or evidence; it was merely sweeping generalization based on nothing I could see -- and simply cancelled it out.

(On the other hand, I do find it kind of interesting that I have NO personal anecdotes to tell about dreadful waiting lists, and have just all kinds of personal anecdotes to tell about excellent service provided in a timely manner. But then I'd probably be making it all up.)

Hmm, anecdotal evidence ... kinda like your sweepingly general statement that Canadians who can afford it go to the US for treatment? What's that one based on? And I'd be the exception that proves that rule, wouldn't I? (Oh, by the way, I'm sure you understand that the word "prove" in that maxim is being used in its original sense -- "test" -- from the Latin probare, I believe it would be ...) Rule: tested and found wanting.

"The Canadian government does track them, and why would they?"

I assume you mean "doesn't" track (waiting lists). And I'm not sure why I'd believe you on that point anyway. And interesting that you refer to "the Canadian government", when the health care plans are under provincial jurisdiction and operated by the provinces. Hmm.

I'm not at all convinced that what you say is true, when it comes to the provinces compiling data in their own systems. As a matter of fact, I happen to have read the testimony given some 20 years ago by an official with OHIP (the Ontario provincial plan) who testified under oath as to waiting times for certain types of orthopaedic surgery. Gosh, I wonder where he was getting his info? Or ... am I just making it up?

YES, the left deplores any excessive waiting time for essential medical services. And there ARE waiting times that are reasonably regarded as excessive for some services in some locations.

NO, the left does not believe that creating a two-tier system in which the wealthy can purchase anything they want in the private system while the poor and middle-income wait for service in the public system will solve this problem. What it will inevitably do is cause the public system to deteriorate as the wealthy withdraw their support (read: votes and taxes) from the public system that they are no longer benefiting from.

You have also yet to explain where all these new resources are going to come from to service that private sector market without that service being provided at the expense of the public sector market. You an adherent of Social Credit maybe? -- you recall Abraham Lincoln's greenbacks? just print some more money?

Voodoo economics. Nonsense. And pullease, no more of your Sweden babble. The Canadian system is not the Swedish system, and more importantly, Canada is not Sweden. Check out the Gini indexes for the two countries -- measures of income inequality -- just for starters.

You give me Sweden, and I'll give you the UK's National Health Service. You ever experienced the Swedish system first hand? I've experienced the UK's, so my anecdotes will be better than yours.

[Interrobang]

23. Here's a study on mortality rates in for-profit versus ...

...not-for-profit hospitals:

http://www.cmaj.ca/cgi/content/full/166/11/1399

Canadian hospitals are *all* not-for-profit, and are split between publicly and privately operated.

You are going to run into a few people who have bad stories to tell (the Romanow report said that 5% of Canadians prefer the US system), but you're also going to run into lots of people who have had good experiences. Also, it's in the Canadian nature to complain about things, without necessarily wanting to get rid of them. :)

[Frederic Bastiat]

18. Canadians that can afford it travel to the U.S for healthcare

And it makes perfect sense. Why is this? It's because the US is at the forefront of cutting edge medical technology, innovation and delivery, oh and choice, a fundamental ingredient of any democracy.

What do I mean by choice? The Canada Health Act explicitly forbids any Canadian from buying from the private sector a medical service that is already covered under the public health system. What this means is that even the Canadians that can afford better healthcare are denied access to private clinics, unlike the more pragmatic French, Swedes and Germans who allow this and which inturn frees up the overburdened public health system.

Lookup how long it takes to get a cranial MRI scan in Canada.

Tick tock.

[Heddi]

19. well it's no better in the US

last November I had to have back surgery.

I had insurance (luckily)

It took me about 2 months to get the MRI scheduled, and another 2 months AFTER the MRI to get my surgery scheduled.

So it's not like you can get procedures done the same day in the US.

And my grandmother just got double knee replacement through medicade. She was unable to walk, drive, sleep, sit.....

She applied for the surgery 2 years ago. She just got approved in October of 2002, but was unable to get the surgery scheduled until May of 2003 (a few months ago).

But again, I'd rather have to wait in Canada for procedures which are available to EVERYONE regardless of income, than have to wait in the US where health care is only available to those who can afford it.

[southernfried]

8. had a Caadian friend with cancer

she was working here but basically had to return to get the free care. Trouble was she also had horrible delays getting into the system and then working through it. A pretty lousy choice to have to make.

[prolesunited]

17. Some questions for you

What you're saying is that she would have fallen through the cracks here and that her only option was to return for FREE care. Am I reading this right? What would have happened to her if she had stayed here? What if she did not have the option of going back to Canada for care?

So, what was the lousy choice?

I just read where changes in a way state distributes Medicaid will force many with severe health problems to pay A LOT more out of pocket costs. One man in renal failure has a $3,000 a month retirement/disability income. With the changes, his treatment and prescription costs will exceed his monthly income.

His solution: Go off five of the nine prescriptions he is taking. What do you think this will do to his health? Do you think it will shorten his life span?

The Canadian health care system may not be perfect, but we are literally killing people with ours.

[Bandit]

11. I'm sure it is better than their military

They spend more on health care than they do on their military which in my opinion makes them far far more civilized than the US. They are no where near as wealthy as the US and yet they take care of their citizens while we go murder people from other countries with our wealth. Kinda Sucks.

[Spazito]

13. I can give you a personal experience as a Canadian

I was in a car accident while away from my home province and, thank goodness, was not injured bad enough to need an ambulance but was still able to go to the hospital and receive immediate care at no cost to me. When I returned home to my own province, I was able to receive immediate and follow-up care. My cost for this is 648.00 a year.

Another example: my daughter needed a caesarean for the birth of my latest grandchild, she was able to receive this and all followup care with no additional charge.

The Canadian system is not perfect by any means but it is universal, no one is without coverage.

[Liberator_Rev]

14. See http://www.LiberalsLikeChrist.Org/healthcare

This is just one of the MANY issues we tackle at our web site.
Check out http://www.LiberalsLikeChrist.Org/healthcare .


at http://www.LiberalsLikeChrist.Org .
WE are the Answer to the "Christian Coalition" & "Religious Right" .
YOU are the way to get the word out, because unlike THEM,
WE are the friends of the POOR and the downtrodden,
who can't give US the kind of support that
the RICH give to our opponents.

[Friar]

15. on another note

If you are lucky enough to still have a job under this Republican economy you will notice a deduction for your health coverage. Whether you call it a tax, a fee or a contribution, anything that takes from your take home pay is a tax. Americans do pay a health care tax but here it goes to wealthy CEOs of insurance companies who do everything in their power to deny you proper care while lining their own pockets.

[Lydia Leftcoast]

16. Some of these anecdotes sound like Limbaugh mythology

rather than people's actual experiences.

About your Canadian friend who bashes the health care system, I know from watching News World International (basically CBC with programs from other countries as well) that there are a few right wingers in Canada as well, and we all know that a lot of right wingers just have a gut-level hatred of anything that's a government program. It's like the sheep in Animal Farm: "Private good! Public bad!"

So they will go on about waiting lists for hip replacements (note that it's always hip replacements, not emergency appendectomies, diabetes screening, prenatal care, or cancer treatment), ignoring the fact that millions of Americans couldn't afford to have a hip replacement even if they waited ten years.

My health insurance premiums are climbing toward an unsupportable level, with copayments rising right along, and $648 a year (or the income-based premiums in the less generous Japanese system) sounds absolutely wonderful.

[Classical_Liberal]

21. My cousin had to wait a year for knee replacement surgery too

he lives right here in the US, and is on an HMO.