Take it from a Patient: Canada's System Works
by Sandy Smith Madsen


Common Dreams News Center
CommonDreams.org
November 10, 2003

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"It is unconscionable that we ration health care by the ability to pay.... your heart breaks. Health care should be a given."
-- Kathryn Anastos, U.S. physician

Although I was born and raised in Tennessee, I was served well by Canada_s universal health-care system during the 13 years that I lived in Canada. As a legal resident, I was entitled to the same high level of health-care benefits enjoyed by all Canadian citizens. I was free to go to any doctor, anywhere, anytime.

Three of my children were born in Canada. The bill for the birth of my youngest Canadian-born daughter was $3.00. This bill covered excellent prenatal care, delivery, and a private hospital room. It included visits to my home by a nurse and by my doctor, visits that were made as follow-up care after a normal, healthy delivery. While home visits by doctors are not standard procedure, in a country that views health care as a public service, it can happen.

There are now 43.6 million Americans without health insurance and another 40 million who are under-insured. U.S. employers are cutting back on health benefits, claiming they can't compete as long as the U.S. is the only major industrialized nation that expects employers to provide health insurance.

And the cost of insurance premiums continues to rise. Just imagine the consequences if a disease such as SARS should strike at some of our uninsured neighbors who are in the habit of taking two aspirins and waiting it out rather than seeking expensive medical care.

Little wonder that Americans are increasingly looking to Canada's single-payer system, and looking with envy. Yet opponents of the single-payer system recite a litany of horror stories. They charge that Canadians are "suffering and dying" while waiting for medical care. They claim that the Canadian system is a "disaster" and that it is "socialized medicine." Oddly enough, I knew nothing about these dire circumstances until after I returned to the U.S.

Canada does not have "socialized medicine." The Canadian government does not decide who gets care or when they get it; doctors and patients decide. Doctors are accountable to patients, not to the government. Most doctors are self-employed; they submit claims for payment to their provincial insurance plan. They are highly paid professionals who have considerable influence in determining their fees.

Want to see a doctor in Canada? Simply show up with your health-care card. Many Americans already know this, as they have been caught helping themselves to Canadian health care by means of counterfeit health-care cards. Canadians are never denied care, or forced to wait for care, for lack of funds or because of a pre-existing condition. Patients requiring urgent care or primary care are never put on waiting lists. While it is sometimes necessary to wait for elective surgeries, or specialist care, if the delay is such that the patient's health will be harmed, all expenses are paid for the patient to access care in another location.

The United States spends almost twice the amount per person as Canada spends on health care, yet Canadians enjoy a lower infant mortality rate and a higher life expectancy. Studies in both the U.S. and Canada have found that survival rates are higher in Canada for most types of cancer.

Since Canadian health care follows you from the cradle to the nursing home, the loss of a job is not the disaster it is in the U.S. Unemployed you may be, but if you are unemployed in Canada, you still have your health care. While Canadians receive quality health care in return for their tax dollars, in the U.S we pay only slightly lower taxes and soaring health insurance premiums. With the loss of a job, all our paid premiums go up in smoke. In Canada, a major health problem does not lead to financial ruin.

Doctors seldom know if they are serving the rich or the poor. Perhaps that's why I found so many doctors who were genuinely responsive to my needs, rather than to my wallet. The way my Canadian friends tell it, there are more Canadians who believe that Elvis lives than there are Canadians who want the U.S. health-care system.

Sandy Smith Madsen, of Nashville, is a doctoral student at Emory University and a member of the Tennessee Alliance for Progress media committee.