Happy Fourth of July!!!
We don’t write that often about larger political issues as they relate to Medicine. In honor of American Independence Day, we thought we’d say something positive about America. I want to thank Dr. Rob Oliver for bringing my attention to an article from the Investor’s Business Daily about the awful state of Canada’s health care system. Canada’s socialized health care is often compared to its counterpart in the US, usually by someone who would like to see the same sort of system here. Take the movie Sicko, for example, which held up Canada’s system as the shining beacon for us all to look towards for inspiration.
The article quoted one of the father’s of the Canadian system talking about its ruinous state and advocating for some privatization. The article mistakenly referred to Claude Castonguay as the architect of Canada’s socialized medicare when, in fact, this distinction belongs to Tommy Douglas who, while Premier of Saskatchewan in the early 1960’s, instituted a number of government interventions into the corporate and medical world. These changes have influenced the self-perception of Canadians until this day, and many do still see Canada as a kinder, gentler nation for it. To give you an idea of how much Canadians have thought of these events, they recently voted Tommy Douglas as “The Greatest Canadian” of all time in a nationally-televised contest.
Having lived and worked in both systems, I’ve had a unique opportunity to see both in action. The US system’s treatment of the underinsured is without a doubt less than ideal, with most having poor access to preventive care and using the ER as a walk-in clinic. I was amazed though, when I was training in New York, that even patients with Medicaid could walk-in same-day and see a specialist without a referral. That kind of thing doesn’t EVER happen in Canada. Wait lists to see a specialist can range from weeks to months. If you don’t have a family doctor to refer you, you might be out of luck because they’re hard to find these days. And access to highly specialized testing, treatments and surgery is far slower than it is here.
In Canada, the system is far more equal for all…not completely, mind you. A whole underground network has evolved where favors and influence can move someone up the list, known as ‘jumping the queue’. The costs are contained (somewhat) by rationing services. My most memorable run-in with the Canadian system was when a surgery I had scheduled was cancelled by the hospital because I ran later than expected with my previous case which, in turn, had been bumped by a slash wound neck trauma that I had been dealing with the night before.
It devastated me to have to come out to the patient waiting room at 3 in the afternoon to break it to this poor woman that I was sorry she had been left starving all day, and that she would have to wait weeks longer for a necessary surgery that had taken 4 months to schedule in the first place, even though I was more than willing to proceed. My hands were tied. She swallowed the bitter pill quietly. What choice did she have? And that was the breaking point for me. I’m not sure any American would put up with that, or even knows that this goes on.
That type of event symbolizes for me the differences between Canada and the US. Canada is like the friend who says “Sorry you’re hurt, hope you feel better”….kind, but passive. The US is more likely to say “What are we gonna do about it?”….headstrong, but taking action. If you ask Americans, theirs is the greatest country in the world. Canadians?? Same thing. Neither one has a perfect answer to Medicare in the modern age.
If you ask me, I don’t trust pencil pushers on either side of the fence, government or private. Private medicine has its problems, but don’t count on politicians to ride in and save the day with universal healthcare! Anything that’s completely free loses its value, gets taken for granted, and ultimately gets thrown away like a wet rag, as I saw in Canada. I found it interesting that the number of patients we saw in New York for the sniffles and other frivolous visits went down by 60% when a small $2 co-pay was instituted. So, if every doctor and patient takes personal responsibility for how we use the system, we could save a lot of money and a lot of wasted air-time, and still take care of those who need it.
Rant over. Just one opinion of a cross-border doctor. Easy for me to say, I do elective surgery most of the time…No comments