Sacred Cows and Emperors Clothes

When I first began writing down ideas on this particular topic, our friends in the USA were in the midst of a very partisan battle over (so called) “Obamacare.” During the debate, like millions of other people, I also engaged in numerous discussions on this and other similar topics. Some of the more left-wing proponents of Obama’s plan like to point to Canada and even Cuba as a basis for changing the current US system to a more socialist system. Now, the Supreme Court of the United States has handed down its ruling on the constitutionality of the legislation.

Before going any further, I just want to make it clear that I cannot speak for circumstances in Cuba (nor would I want to!) but I can offer some comments on the Canadian situation – though I am by no means an “expert.”

In one exchange of emails regarding the Canadian System of health care vs the system in the USA, I received the following comments:
“...they just released some stats down here last week and thought you might like to hear a few.... There were over 700,000 personal bankruptcy caused by medical expenses here in the US last year.... what is really surprising though is 75% of those claims had medical insurance. This was compared to less than a half of a percent of those in Canada who said they filed for Bankruptcy due to medical expenses.”

Well, I can’t vouch for the accuracy of those numbers as I’m not familiar with the report noted or the source for those figures; but regardless of how close the numbers may be they do not tell the whole tale. One would need to know (for instance) how many of those bankruptcies were exclusively the result of medical expenses vs. how many might simply have been the final debt incurred after years of poor spending choices and other mounting personal debts?

The figure noted for personal bankruptcies in the USA (caused by medical expenses) is reported at 700,000 with the vast majority claiming to have medical insurance. These same statistics were quoted to me several weeks later in discussion with another person. I happen to agree that this is a lot of people and if you happen to be one of the 700,000 it would be quite unacceptable. The thing is, I don’t think it has to be an either/or situation when it comes to the health care debate – I don’t think it has to be either a “USA style” system or a “Canadian style” system.

Statistics are deceiving and can be used by either side in any debate. For instance 700,000 is less than .002% of the US population. Further, I’d hate to hold up a system such as we have here in Canada if it could not stand up to the scrutiny of much closer examination and if it cannot meet most of the health care needs of those it is meant to serve. Something that is supposed to be free has very little value if it cannot be accessed or if access is so poor that one would rather pay for superior service.

Here in Ontario there are over 1,000,000 people who do not have a family doctor AND HAVE NO HOPE OF GETTING ONE. The population of Ontario Canada (2008) was 12,891,787 and even using figures that are four years old, this means that over 7% of Ontario’s citizens do not have (and cannot get) a family doctor. The doctor shortage is so severe (and growing) that people have given up even looking for a doctor.

Free hospitalization is of little value if it means you must spend days (sometimes weeks) on a stretcher in the emergency department because there are no beds. If you are in pain and awaiting a “free operation,” do you really want to wait a couple years for the procedure when the same procedure can be had in a couple weeks in the USA? The currency many Canadians are forced to pay in is not dollars and cents but time – and some of the sickest don’t have too much of that.

The health care system is becoming less and less about what’s in the best interest of the sick and suffering, in my opinion. Health care should really be about the patient and those trained professionals (from the various health care disciplines) best able to provide the services and care that are needed by that individual. The primary relationship is supposed to be doctor-patient, nurse-patient, therapist-client etc. with some necessary regulation to govern appropriate behaviour, expectations and professionalism in order to insure the individual gets the best treatment and care they seek. However, it is that primary relationship that is under attack (so to speak) and is vulnerable to all sorts of “middle men” because getting into the middle of that relationship can become the source of both power and profit. Worming their way into the space between health care provider and client we find insurance companies and their incestuous symbionts, the litigation lawyers. Since politicians have the power to legislate, we can usually find them in the middle as well making it cozy for themselves (and all others who have crawled into that space with them).

Now to be clear, I’m not arguing against insurance or legal representation, simply the degree and type of their involvement. Lawyers and insurance companies tend to feed each other (each creating a greater need for the other – at tremendous expense). Insurance also isolates the consumer from the expense and therefore limits the market’s ability to control costs. This being the case, other mechanisms need to be developed to help the market become competitive and hold costs to reasonable levels. Various kinds of insurance to practice could be brought way down if some form of control were brought to bear on the litigation process. If various “class action” lawsuits and other nuisance suits could not be brought forward until after legal ground to do so had been established, this would help bring down overall costs. (The legal ground would need to be something like a finding against the health care provider by either their professional governing body or through criminal proceedings.)

Instead, health care has become the currency, of those holding political office, to buy voters. For instance, why is it even necessary for former Prime Minister, Paul Martin (when he was in office and running for reelection) to say he would pass a law banning private delivery of essential health care services? Ask yourself why someone is willing to pay big bucks out of their own pocket for these services if they are already available at no cost through our (Canadian) government scheme. Why does a government have to make it an illegal activity for someone to move out of a two year line up in order to purchase the service in a much timelier manner? Health care has become Canada’s sacred cow and those on the Left (especially) are riding it as far as it will take them – consumer be dammed.