In a recent article published by Don Brunell, president of the Association of Washington Business, titled It's Official: The Canadian Health Care System Isn't Working, Mr. Brunell makes some very broad and seemingly uninformed accusations of the Canadian Health Care System. To start with, Mr. Brunell states that "American shoppers crossing the border are shocked when they have to shell out 15 cents on each dollar for sales tax." Being from Washington State, I am sure Mr. Brunell knows that the sales tax in his neighbor (or neighbour) to the north is actually 14%. Granted, not a big difference, but it sure makes the story sound better to round up and seems to set the precedent for the rest of the story. Besides, American shoppers are able to get some of this sales tax refunded when they cross the border.
Mr. Brunell states that "Canada's national health care system is expensive and inefficient." In a report put out by the PNREC (Pacific Northwest Regional Economic Conference) based out of Washington State, it shows that the U.S. spends $1,901 per person in public funds for health care as opposed to Canada's $1,517 per person in public funds spent on health care. So Canada spends less per person on health care and everyone is covered, as compared to the U.S. where a huge segment of the population has no health care coverage. How is that either expensive or inefficient? In addition to public spending, private funds of $2,194 in the U.S. are spent on health care as opposed to Canada's $658. The United Nations has also ranked Canada far ahead of the U.S. for effectiveness of medical systems. In the same report by the PNREC it shows that Canadians have the second highest life expectancy at an average 79 years as compared to the U.S. with second lowest at an average 76.7. The PNREC report also shows that Canada outperforms the U.S. for health indicators, such as infant mortality rate and heart disease, and scores almost the same for others such as cancer. So it isn't exactly like Canadians are dying for lack of health care. And in fact, it would appear that Canadians are healthier then their American neighbors.
The PNREC report concludes with some interesting survey statistics. When asked whether their health care system needed to be totally rebuilt, 33% of Americans said yes as opposed to only 23% of Canadians. 14% of Americans said they did not get needed health care in the past year compared to 10% of Canadians. 5% of Canadians said they had problems paying medical bills in the past year as opposed to 18% of Americans. And only 9% of Canadians said they paid more than $750 for medical care that was not covered by insurance as opposed to a staggering 29% of Americans. When asked whether the medical care they and their family received in the past year was good or excellent, 54% of Canadians said yes as compared to 49% of Americans.
I can say from my own experience living in the U.S. and being self employed that I paid $500 a month for private health insurance for my family. This was not 100% coverage and we still had out-of-pocket costs and deductibles. We averaged well over $2,000 per year in out-of-pocket costs. Taxes are higher in Canada, but for us, it is well less than the $8,000 per year in health care and medical insurance costs we had living in the States. I believe this is probably true for your average family, unless they have very good company-paid medical insurance.
Mr. Brunell's article is specifically directed at discrediting the Canadian Health Care system as a good model for the U.S. to follow. Apparently, there is a growing sector of the American population that would like to see a universal national health care system. I wonder what American small business owners think about a national health care system. Since Mr. Brunell represents Washington State's Chamber of Commerce, it would be interesting to know if he has surveyed his own members on this issue. I owned and operated a small business (50+/- employees) in Oregon and I know that significant time and resources were spent managing and paying for medical coverage as an employee benefit. I also know that as a small business we were not able to pay full coverage and the employees were sometimes saddled with a significant portion of their paycheck going to pay medical insurance coverage for themselves and their families. When I moved to Canada, there was a certain comfort level in knowing that I could go out and try something entrepreneurial (risky) and my family at least had medical coverage. I would think the chamber of commerce would want to encourage entrepreneurial behavior.
Small businesses (and large for that matter) in Canada do not have to worry about providing medical coverage as an employee benefit like their American counterparts. In the States, companies have whole departments set up for the management of employee benefits, primarily medical coverage. Imagine if companies could concentrate on their business instead on whether their employees had medical coverage and spending significant resources trying to analyze different plans every year at renewal time. Sounds kind of efficient.
Mr. Brunell's main point for discrediting the Canadian health care system, is pointing to Canada's recent supreme court ruling in Quebec that struck down the ban on private medical insurance. Mr. Brunell believes that this shows that the Canadian national health care system as a whole doesn't work. He goes on to say about the American system, "Our system isn't perfect and needs improvement.." Why is this same philosophy not afforded the Canadian health care system. I would agree that the Canadian system isn't perfect and needs improvement also. And isn't that what this ruling is all about in Canada. Canada realizes it needs improvement. Every health care system in every country in the world could use improvement. This ruling is one step closer to a public/private health care system, just like that in almost every other developed nation (except the U.S.).
Mr. Brunell wonders where Canadians will go to get timely, quality health care if the U.S. adopts a single-payer system. Granted, some Canadians do travel to the U.S., but I assure you a significant number travel to many other countries other than the U.S. for health care. Does that show that the Canadian system doesn't work. Hardly, I personally know more U.S. residents that have traveled to the Scandinavian countries and even Mexico for health care than I know Canadians that have traveled outside Canada for health care. The difference is, Canada is willing to acknowledge that they are not the best provider of all medical procedures and cannot always provide it the quickest. For this reason, quite often, the Canada Health Plan will reimburse the costs of a Canadian traveling to another country for health care.
It seems there is a fundamental misunderstanding on both sides of the border. Having lived on both sides I am in a unique position to see the different systems in use. Americans hear horror stories about Canadians dying while they wait in line for health care. Canadians wonder how health care can be a for-profit business and what kind of decisions are made by health care providers when profit is the motive. These are, for the most part, urban myth. Both systems need work, but both systems are in fact working. Perhaps the truth lies somewhere in the middle.
