Fortunately, this report from NPR's Sarah Varney is a respite from the norm. Rather than reprinting the claim that Canadian health care system indiscriminately rations care, Varney actually examines the Canadian health care system and concludes that it's getting a "bum rap." Just like Medicare beneficiaries who protest against "government health care," protesters who use Canadian care as an example of "government interference" or rationing, will be surprised to learn that the Canadian health care system relies on both government and private insurers to provide Canadians with comprehensive coverage:
Canada has a universal health care system that's paid for through income taxes and sales tax. All Canadians are covered, and they can see any doctor they want anywhere in the country with no copays or deductibles….And while the individual provinces and territories set their overall health budgets and administer the health plans, the delivery of medical care is private. Doctors run their own businesses and then bill the government.
As it turns out, the system works fairly well:
- Physicians in Canada earn a good living and aren't faced with the same administrative hassles that American doctors gripe about.
- The Commonwealth Fund looked at deaths that could have been prevented with access to quality medical care in the leading 19 industrialized countries. In the latest survey, the United States ranked last and Canada came in sixth.
- When federal spending on Canadian health care declined during a recession in the 1990s, lines for non-urgent procedures — and some urgent ones — grew. In response, Canada's government poured billions of dollars into reducing wait times in the five medical areas deemed most troublesome, including cancer care, cardiac care and joint replacement surgery. And wait times for these services has dropped: Most provinces now report those times on publicly available Web sites.
- Few Canadians go south for medical care. Canadian researchers say it's a bit like getting struck by lighting — it's extremely rare, but when it happens, everyone talks about it.
- Public opinion polls continue to show strong support for publicly financed, universal health care in Canada.
Varney contradicts the oft-repeated claim that Canadians can't purchase health insurance coverage by writing that many Canadians purchase private coverage for "optometry, dentistry and outpatient prescription drugs" — services the public plan does not cover. Yet at the end of the piece, she quotes a pollster who notes that the Canadian health care system "'is not something that everybody is completely satisfied with or complacent about.' About half of Canadians say they would like the option to buy a private health insurance plan. Currently, that's not allowed."
Canadians can purchase supplemental private coverage for services that are not covered by the public plan, but cannot purchase private insurance for basic services. As CBC News points out, private health insurance is "a crucial part of the system," and Canadians spent about $43.2 billion on private coverage in 2005. Private insurance covers "anything beyond what the public system will pay for. For instance, should you have to spend some time in the hospital, the public system will cover the cost of your bed in a ward, which usually has three other patients. If you want a private room, the extra charge will come out of your pocket, unless you have extended health coverage either through your employer or through a policy you have bought yourself."
Basic services are covered by the government precisely because the large risk pools allow the government to negotiate cheaper rates with providers and control health care costs. The government fears, with good reason, that if Canadians can leave the purchasing pools, the government's market power would diminish.
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