Shortcomings of Universal Healthcare
While we’ve heard many arguments for private healthcare vs. single-payer or socialized medicine, few people hear about the darker side of Canada’s healthcare system.
As president, Barak Obama intends to establish universal healthcare. But to see what universal healthcare promises beyond 40 percent taxation, it’s important to get the real story about how it works in places like Canada, where physicians are now holding lotteries to decide who gets access to care.
Few people understand the dark side of Canada’s healthcare system than Lee Kurisko, MD, a physician who moved to the United States after attending medical school and working as a physician in Canada. In his recent interview with Peter Nelson for the Center of the American Experiment, Dr. Kurisko explains the darker side of socialized healthcare.
Excerpts:
When they’re generally healthy, I think most Canadians are probably happy with the idea they’re not necessarily paying for health care, and they think they have access to it. On the other hand, I suspect that their tune changes when they actually have a problem and realize that they may have to wait literally years to have the problem addressed, whether it is a hip replacement, diagnostic imaging, a consultation with a specialist, or whatever…When I finished all my medical training and specialist training, I had absolutely no inclination whatsoever to move to the United States. It was the farthest thing from my mind. Yet when I took my job as radiologist at Thunder Bay Regional Hospital, fairly quickly I became director of the department and was faced with the realities of trying to deliver high quality care. I was confronted with things like budget shortages, shortages of manpower, decrepit equipment, and to
some degree incompetence on the part of people that normally in a marketplace would have been culled out…I’ve been in America for almost six years, and I’ve yet to see anybody who’s been turned away for health care—at least in Minnesota. Whereas, the reality is that Canadians are turned away for health care in many different ways—through waiting lists for access. There are also huge inequities in the availability of health care throughout Canada. For example, in Newfoundland they have a waiting list of two-and-a-half years for a diagnostic MRI (Magnetic Resonance Imaging). In some places in the country the waiting list could conceivably be as low as six weeks. If you live in the Yukon Territory or the Northwest Territories, you’re not going to have immediate access to a neurosurgeon. Your level of access is going to be far greater if you happen to live in a place like Toronto…
October 18th, 2008 at 6:21 pm
Canada undoubtedly has some issues to solve in terms of the delivery of healthcare. Were it to spend anything close to what the US government already spends per capita on healthcare, all these problems would be solved. The fact is that Canada spends far less per capita than the US and yet everyone is still covered. Yes, there are longer delays for some procedures, but patient satisfaction rates are similar if not better to patients in the US, the national life expectancy is higher and infant mortality is lower. More important, no one in Canada ever worries about whether or not they can afford to see a doctor and no one ever goes bankrupt trying to pay for medical bills. No one will ever hold off changing jobs or starting their own business because they might lose their healthcare.
As a Canadian who now lives in the US, my taxes here are just as high as they were in Canada, and I get much less value for that money. My family and I have had great healthcare since we’ve moved here, but it’s been no better than what we experienced in Canada. The only difference I’ve seen is that my employer (a university) pays over $12,000 a year to cover my healthcare, and I pay about $3000, not to mention co-pays. These costs paid by the university get passed on directly to my students through tuition.
The big difference between Canada’s single payer system and the US system is not the amount of taxes we pay or the amount the government invests in paying for peoples’ healthcare (remember, the US govt. already pays about twice what Canada’s government does per capita). The key difference is how much money gets sucked out by the layers and layers of bureaucracy that get created by the hundreds of insurance companies that doctors and hospitals have to deal with on a daily basis. Canadian doctors’ offices and hospitals don’t need billing offices or people to deal with the various insurers. They submit one bill to the government and it gets paid. I laugh when I hear people here south of the border worrying about what would happen if we put government in charge of things rather than private for-profit insurance companies. Believe me, you really don’t know what you are missing. If you got rid of this extensive network of middlemen, and did not invest ANY more tax money than you already do paying for healthcare, you truly could have the best medical system in the world. At the moment, it truly is anything but. Just ask anyone who’s had the chance to experience what universal health care really is.
October 18th, 2008 at 6:50 pm
As per your recommendation, I’d like to hear how universal healthcare works but it’s hard to chat with people in countries like North Korea and Cuba.
October 18th, 2008 at 8:14 pm
How does price controls on medical care affect it?
October 18th, 2008 at 8:51 pm
Well, only Americans have any trouble visiting Cuba. You could, though, talk to people from throughout Europe, the UK, Australia, and New Zealand.
Doing a quick Google search, I found this site that does a nice job of outlining the major myths about what a single-payer, universal healthcare system would mean for the US:
http://cthealth.server101.com/the_case_for_universal_health_care_in_the_united_states.htm
I do completely understand why some Americans react so negatively to this idea. The propagation of the myths about what this would mean to the US has been well orchestrated by the insurance industry (who obviously have a lot to lose) and has been parroted by politicians from both parties (McCain made a crack the other night about the healthcare systems in Canada and England).
The facts just don’t support this, though. The US has fantastic facilities and doctors. A single-payer system would save billions of dollars every year here and would allow for an even greater investment in medical facilities and research in the US.
October 19th, 2008 at 7:51 am
Yeah, I’m in the tank for Big Oil, I mean the Big Baddies at Big Healthcare! They sure pay me good to tank for them (unlike Mr. Obama, who was never in the legislative tank for Fannie or Freddie in spite of all those campaign donations, or in the tank for the welfare lobby in spite of all the money he’s been paid directly and indirectly from those very “poor” folks).
Now, getting back to reality, one of the points Mr. Obama made at the debate was that Mr. McCain’s $5,000 credit wouldn’t come close to covering the annual for the average Joe. Then he sniffed like any fool would know that.
‘Course, any fool would know that Obama’s free health care plan for everyone really is free, too. Right?
There are few things I look forward to more than paying for other peoples’ goodies ’cause I’m fool enough to believe one should work for what one gets in life. How crude, old fashioned, and so irresponsible! Those poor folk need HELP, dontcha know, and Barry’s the only savior with a plan that won’t interrupt their lifestyles.
October 19th, 2008 at 10:56 am
When discussing Canadian and American healthcare, it is common to get sucked into an either/or dichotomy. Both are highly flawed. The more meaningful discussion is whether or not the United States should move towards a system of centralized control (government delivered universal health care) or towards a system of individual empowerment with market reforms such that individuals control the flow of dollars as opposed to government and insurance companies. As an advocate of freedom, I favor the latter.
It is a specious argument to point out that Canada spends less of its GDP on health care than does the United States. Although true, throwing more money at a flawed paradigm will only result in marginally better results. A healthcare system that is paid for by government will inevitably be controlled by government. Inevitably there will be Soviet style central planning and wage and price controls both of which are proven failures with disastrous results. Both American and Canadian healthcare have elements of centralized planning and wage and price controls to varying degrees with detrimental effects. In true marketplaces, millions of consumers provide input with every dollar that they spend about the rational allocation of resources. Every exchange is a “win” for the buyer and seller resulting in both parties becoming better off as a result of the transaction. Hence market oriented economies result in prosperity and socialist economies result in a squelching of wealth development or in the extreme, outright impoverishment.
The intrusion of a third party, whether government or an HMO, results in the imposition of conditions that are inherently non-satisfactory to the original two parties. That is why people should pay directly for much of their health care. Providers must then provide value for the dollar. This does not obviate the need for insurance which is needed for expensive and less likely events. Homeowners insurance is a good idea if you are robbed or your house burns down. It would be grossly expensive if it covered floor polish and kitchen renovations.
Outcome statistics are invariably wheeled out as an argument for embracing a Canadian system of health care. Again, this is a specious argument. Longevity and infant mortality are highly impacted by factors outside of the health care system. For example, race greatly impacts upon both of these. Unfortunately, even when controlling for economic status, blacks do not do as well as whites on these matters. Canada is more racially homogeneous than is the United States. Canada has more people of European caucasian origin than does the U.S. with its greater racial mix, including far more blacks. Furthermore, there are other factors in the United States that are outside of the control of the healthcare system. There is more violent crime, more teenage pregnancy and more obesity which all impact negatively on outcomes.
It is commonly stated that people don’t go bankrupt in Canada because of healthcare issues. The most common cause of people going bankrupt in the United States is not medical bills but the loss of income that occurs as a result of being sick. Again, this is a factor outside of the scope of the healthcare system. Because of Canada’s bloated welfare state, unemployment is always higher than in the United States. The per capita income is lower. Such stifling of the economy, jobs and wealth not being created that otherwise would have been in a more free economy. The jobs never created are unseen but just as real is CNN’s coverage an American family in financial distress because of illness.
Food, clothing and shelter are even more immediately important to the maintenance of life than is health care. All three of these are provided for almost entirely by the free marketplace and only the most destitute in our society need a hand up for these. Contrast this with healthcare with its blizzard of government interference and 15% of the U.S. populace being uninsured. A true free market would try to get as many people as possible to have a version of their product. There is no money to be made by not covering these people. They remain uncovered largely because of the massive government subsidizes to health care which drive up costs and the government created third-party payer system which divests the patient from his role as a consumer and results in health care hyperinflation. Healthcare being the most regulated industry in America also drives up cost.
About 15 percent of Canada’s population has no access to primary care. In the three Canadian provinces in which I have been licensed and worked, specialist consultation can only be obtained with primary care referral. Such people are effectively locked out of the health care system. If you do have a family doctor, it may take weeks to get an appointment, weeks, months to even years to see the specialist, weeks or months for surgery and weeks or months to get imaging with CT or MRI scans. Patients are hamstrung by government and essentially disallowed from seeking out better faster care.
In the United States, you may not be given insurance on a silver platter (although 40 billion dollars of charitable health care is given out annually outside of programs like Medicaid) but a least you have sufficient freedom left to seek the care you need even if it means pleading charity.
The fundamental question in politics is whether or not decisions and freedom of action should be left in the hands of individuals or if decisions should be handed over to an external collective agency (government). I believe that individuals acting singularly and in voluntary concert with others, can run their lives better than can any overarching government no matter how benevolent it may claim to be.
October 19th, 2008 at 9:19 pm
I don’t believe in universal health care because I like my money more than a stranger’s well-being.
October 24th, 2008 at 4:01 pm
So who are the rich people Cuba taxes to pay for their universal health care?
Oh wait, they all pay their “fair share”, that explains why Cuba is such an economic powerhouse.
August 22nd, 2010 at 5:49 am
My mother in law just got diagnosed with diabetes - our health is so important. Thanks for a such an enlightening read.