Six years ago, my mother had open-heart surgery. After her cardiologist recommended the surgery, a group of doctors at the hospital to which her cardiologist was attached had to review her case and decide whether she was, in their collective expert opinion, worth it.
Thankfully, they decided she was. But they could have just as easily decided she wasn’t. My mother had the surgery, without which her doctor did not believe she would have survived 2003. She is still here and still remarkable.
In that true story one can find the good and the bad of Canadian healthcare. There are, de facto, death panels. Alarmist terminology aside, in a single-payer, public system, the state will decide how to mete out finite resources. Of course, with private healthcare there are also “death panels.” But at least you can shop around for an insurer who will be generously inclined towards your various ailments.
Had the doctors overseeing my mother’s case decided against surgery, her only option would have been to go to the United States, something she could not have afforded. But they decided in her favour and what came next demonstrated one of the best things about our system. Due to luck of the draw and the hospital to which her cardiologist was linked -- as opposed to wealth or influential friends -- my mother had her surgery performed by one of the best heart doctors in the country.
I tell this story in response not so much to the ongoing debate about healthcare in the United States, but in response to the general Canadian sanctimony about it. We would do well to not preach, in spite of Barack Obama ’s assertion -- during his appearance a few weeks ago on the Late Show with David Letterman -- that Canadians “are perfectly happy with their system.”
Are we? A one-time, extensive US-Canada sponsored study, done in 2004, showed that Canadians and uninsured Americans had similar levels of satisfaction when it came to healthcare. In fact, more Americans (53 percent) than Canadians (44 percent) were said to be "very satisfied" with the state of their healthcare.
My preference would be for Canada to adopt a multi-tiered approach to healthcare, in which the private and public intermingle. For those concerned this would be “unfair,“ they are fooling themselves if they think there aren’t Canadians who, through personal and professional connections, bump queues and otherwise receive favourable treatment.
I lived five years in France, and a couple more in Japan, countries that came in first and tenth respectively, in the World Health Organization’s most recent healthcare rankings. Both offer a blend of private and public care which in my experiences translated into more efficiency and a greater variety of options in terms of coverage.
Healthcare is a difficult thing to get right, but some factors make it easier. Recently, I attended a conference of the Atlas Economic Research Foundation, a group devoted to furthering freedom and free markets. An academic I met there made the point that developed countries with small, homogeneous populations find it easier to agree on which healthcare path to follow. The WHO rankings seem to back that up, with a majority of the top 20 countries having relatively homogeneous populations under 10 million.
The United States is not such a country and American concerns about the rationing of care are not unwarranted. Many Canadians like to point out that the United States did not fare well on the aforementioned WHO rankings, coming in 37th. But Canada didn‘t even make the playoffs, coming in 30th. Let’s remember that and fight the all-too-Canadian urge to lecture our neighbours.
