by Bill Cavanaugh
I lived in Canada as a legal “permanent resident” 2005-2008. There were a number of reasons why I made the decision to return to the U.S., but the American system of health care administration most certainly wasn't one of them! My province of residence was British Columbia (BC). I lived exclusively in rural areas, but it was never difficult to locate and travel to a clinic when needed.
Wait times? No worse than my experience in the U.S.--typically a 15-20-minute wait at a clinic. In BC. There are no deductibles there (maybe a small co-pay for some clinic visits); in other words, no greed-driven additional fees that effectively raise the subscriber's premium. An entity called the Medical Services Plan administers billing for payments residents must make. The purpose is to close the cost gap for what taxes don't completely cover. When I was there those monthly payments were $54/month (at that time around $45/mo US).
When it was necessary for me to visit a clinic, emergency room or hospital there, the beginning and the end of the administrative side of the process was simply showing my Care Card. One quick scan and you're done. Also, not once did I ever receive a letter, bill, or statement in my mail. Under our paper-heavy, inefficient, corporate-controlled U.S. medical system, I would have to fill out reams of paperwork at an appointment, and any contact with a clinic or hospital would initiate an avalanche of paper to my mailbox that typically wouldn't stop for months or even a year or more.
The unrelenting “Harry and Louise”-style propaganda we've had to endure since the 1990s is of course full of lies and distortions. It is true that a system like Canada's isn't perfect--no system is --but like every other health care system in every developed country except the U.S. (even tiny little Ecuador!), imbalances are dealt with by making real time adjustments. For example, when I moved to BC in 2005 there was an issue about wait times for what was becoming a very common type of medicine--joint replacement surgery. Wait times had become pretty bad, 6-18 months. One big reason for that is at that time BC had a premier (analogous to a governor here), Gordon Campbell, who was essentially a Canadian republican wannabe who slashed the health care budget in the early 2000s. This caused some horrendous crises with available health care resources in the major cities. When funding was finally increased to address the problems, wait times for things like orthopedic surgeries dropped to 3-6 months in just the three years I lived there.
Of course the only reason we have to continue tolerating such an inefficient, cumbersome, paper-intensive, non-standardized, over-priced system on the administrative side of our health care is because of our thoroughly corrupted political system--insurance corporations are very effective bribe-masters, and our politicians are very eager bribe-takers. The myth of course is that capitalism makes everything vastly more efficient than government. An outright lie that those corporate bribe-masters perpetrate hand in glove with their on-the-take politicians (from both parties). Insurance company/HMO overhead: upwards of 20% and more; Medicare: 3%.
With regard to compensation, I always believed that the lion's share of the financial reward should go to the people who most deserve it, those directly involved in patient care --the doctors, nurses, therapists, technologists and technicians--not insurance company executives who are the profiteering middlemen that gain from betting against illness and who tenaciously preserve and relentlessly increase their profit margins with frequent and obscene premium increases.
Another point I never hear anyone in the 'mainstream' corporate-owned and controlled American media make is that a national universal single-payer system would give working people the freedom to work where they want. If I was dissatisfied with an employer's working conditions, compensation, benefits etc., I could simply take my skills elsewhere without worrying about losing a provided health care benefit. The collateral effect on the economy would be positive, and the resulting power American workers would acquire from such a progressive change would translate to higher offers of compensation, and better working conditions; i.e. competition to attract and keep good employees would help to grow and strengthen the presently struggling American middle class.
I do miss Canada!