Take it from a Patient: Canada's System
by Sandy Smith Madsen
Common Dreams News Center
November 10, 2003
CommonDreams.org is a non-profit news service providing breaking news
& views for the progressive community.
"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,
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
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.