Canadians Watch the American Health Care Struggle

Canadians watch with incredulity and a degree of smugness as Americans take extreme positions on the issue

Page 433

of health care. Yet, it took a real struggle before universal health care became an accepted service in Canada. For those whose memories do not go back to the era before its 1961 introduction, it can be taken for granted, or even roundly denounced for its imperfections. It was not until 1984 that comprehensive health care for Canadians was finally enshrined in the Canada Health Act, but even so, not all accept the result.

The need for reform of the inadequate piecemeal health services of the first half of the 20^th century came as part of the appalling conditions of the Great Depression and the dust bowl drought that afflicted the Canadian prairies. The rural poor were especially vulnerable. Some Christian clergy, especially those of Methodist and Baptist persuasions who were serving the poor, became activated in the cause of social justice. Among these were Salem Bland, and later, Tommy Douglas. Douglas, a Saskatchewan Baptist preacher, was so incensed by the lack of medical care for his congregation that he took up their cause politically. Douglas’s political rise is legendary. Despite fierce opposition by doctors, insurance companies, and conservatives, he became premier of the province, helping to establish universal, publicly funded health insurance mandated in 1947.

The success of Saskatchewan’s plan, which neither caused the predicted financial ruin to the province nor undermined the independence of its doctors, led Douglas to the wider field of Canadian politics. As leader of the Canadian Commonwealth Federation, forerunner of the New Democratic Party, he pressed for extension of universal health care to the whole of Canada. We Canadians may gripe about excessive wait times for certain types of surgery, or to see specialists, but there is almost no complaint about the quality of care. We both can testify from recent illnesses that the care can be superb.

Page 434

However, it seems that no government is able to assess the demographic predictions so that numbers of doctors, nurses, and medical technologists balance with public need. Yet to be covered are dental and pharmaceutical costs outside of hospital, and there is a lot more that could be done towards improving mental health services. In fact, the national health plan is under constant constructive scrutiny, as shown by the 2002 Romanow Royal Commission with its 47 recommendations for improvements. But these are minor problems in a system providing great security to every person carrying a social security card—the right of every citizen. No Canadian need allow illness or injury to go unattended or be ruined by medical debt.

What puzzles us most about the present debate in the U.S. is that infant mortality, the best known measure of the level of health care in a country, is far higher there than in any other developed nation in spite of spending more per capita, only to have poorer outcomes. This fact alone should prompt fundamental re-thinking about how health care is funded and administered. But no: reactionary forces are able to mobilize significant opposition to President Obama’s moderate proposals for health reform. Unfortunately, dissident Canadian voices are helping them.

The appearance on American television of a Canadian woman, Shona Holmes, purporting to be a victim of excessive wait times in the Canadian system, has produced a widespread public reaction defending our system. Newspapers have been full of accusations against Holmes for misrepresenting the severity of her illness, for misusing the system, for her alignment with right-wing politics, and raising the possibility that she is taking money for T.V. interviews. While Holmes’s allegations have been discredited, they nonetheless pose an ongoing risk to Canadian health care. Private insurers advocating a two-tier health system in Canada are an ever-present pressure group taking comfort from

Page 435

Holmes’s position. Under NAFTA regulations, if private health services are permitted in Canada, the field is wide open to American corporations, which are ready and willing to exploit the field for profit.

The Canadian health care system may have its imperfections, but the vast majority of Canadians feel that it is a major defining point in who we are as a nation. In fact, in 2008, when a poll was conducted identifying the greatest Canadian, Tommy Douglas was endorsed across party lines. If we find ourselves ill while on the American side of the border, we scamper home to the excellent medical care we can count on. Personal experience makes this a heart-felt statement, though of course there is always expensive private health insurance for those who can afford to travel and pay for the privilege.

Overall, Canadian “socialized” medicine is humanely efficient, cost-effective and it greatly reduces the anxiety that goes with injury and illness. The very words “socialism” and “socialized” applied to publicly funded health care strike fear in the hearts of many Americans. In Canada, the words are seldom used. Call it what you will, the imperfect system that we enjoy aims ultimately towards a concept of positive health and acknowledges a shared responsibility when illness or accident strikes.

Page 436