Health Care Blind Spots on Both Sides
One thing Americans and Canadians can agree on is we don't want each other's health care systems. In truth, most Americans don't know how Canada's system works and Canadians don't know much about the U.S. system.
What Americans know has come mainly from the negative talking points of politicians and others who have argued for years against national health insurance. Two decades ago, the New York Times reported Canadian women had to wait for Pap smears, a point vigorously refuted by the Canadian ambassador who shot back in a letter to the Times editor: "You, and Americans generally, are free to decide whatever health care system to choose, avoid or adapt, but the choice is not assisted by opinions unrelated to fact."
Yes, there are waiting lists for some services -- but, no, Canadians are not coming across the border in droves to get American care.
There's misinformation among Canadians, too. Wherever I went, Canadians told me they thought, mostly based on what they said they heard on CNN and Fox, that Obamacare meant America was getting universal health coverage like their country has.
When I explained the law was just another patch on a patchwork quilt of coverage, and the Congressional Budget Office estimated last year there would still be some 30 million people without insurance, the reaction was "the news media didn't tell us that."
Separating fact from opinion was something I tried to do as I travelled across Canada while visiting recently. In some ways, the Canadian system is very different from U.S. health care. In other ways, it's very much the same and faces similar challenges.
Although the Affordable Care Act in the U.S. calls for more people to have health insurance by offering subsidies and mandating all Americans have it or face penalties, the concept of universality is still a far distant goal. The Canada Health Act, on the other hand, calls for universality -- all residents must be covered by the public insurance plan run by their province on uniform terms and conditions. They have coverage wherever they are treated in their home province, and there's none of this stuff about limiting the doctors and hospitals patients can use as a condition of getting full benefits. In Canada, there are no financial barriers to care at the point of service as there are in the U.S.
Canadians don't pay co-insurance of 30 per cent or 50 per cent if they have an outpatient procedure or go to an urgent care clinic, charges that are increasingly common in the U.S. They don't worry about paying a gigantic bill if they happen to use an out-of-network doctor or hospital. Their publicly funded system bases patients' access to medical services on need, not on ability to pay. …