U.S. commentators should learn about Canadian health care before dissing it

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U.S. Senator Bernie Sanders speaking at the 2019 California Democratic Party State Convention. Image: Gage Skidmore/Flickr

During this year's Academy Awards, actor Josh Gad made a telling joke about one of the central issues of the U.S. election campaign -- a campaign that is well underway, nine months before the actual vote in November.

Gad's role was to introduce a song from the animated film Frozen 2

The film's lead character is named Elsa, and Gad riffed a bit about all the different versions of Elsa there are in multiple nationalities, from the Japanese to the Maltese to the Mexican. 

When he got to the Canadian Elsa, Gad joked that she was "basically the same as the American Elsa -- but with health care."

The actor got a big laugh from the assembled stars, moguls and hangers-on. In Hollywood, folks seem to agree that here in Canada we have figured out how to guarantee quality health-care-for-all in a way that still evades the U.S. 

Note that Gad didn't say the Canadian Elsa had "single-payer health insurance, but with long wait times for elective procedures." He just said she had health care, full stop -- something out of reach for tens of millions in the world's biggest and richest economy. 

Single-payer health care scares powerful interests in the U.S.

Whenever presidential candidate Bernie Sanders points out that 30,000 Americans a year die for lack of health care, none of his adversaries -- and none of the many skeptical media personalities who interview him -- question that figure. Nor do they dispute the fact the Vermont senator frequently cites that, on a per capita basis, the U.S. spends about twice what most comparable countries do on health care. 

Few who doubt, or outright oppose, Sanders' signature policy proposal for a health-care system based on the Canadian model argue that the status quo in the U.S. is not dysfunctional. 

The most common objection to Sanders on health care is not based on the notion that there is a better way to provide access to health care for all. It is based on the time-honoured principle of political inertia. 

In the U.S., commentators are wont to say, the power elite -- that is, the Congress, the powerful financial interests and their apologists and camp followers in the media – will never accept the massive "government takeover" of a key sector of the economy Sanders proposes. The whole concept of single-payer, comprehensive health insurance, available to all, and paid for out of public funds is too radical for the U.S., the naysayers argue. For good measure, they add that there are even unionized workers who oppose universal health care. Those workers are apparently loath to trade the job-related health plans they won through hard fought negotiations with their employers for an unknown, public plan. 

From here in the frozen north, it all seems like a debate in the twilight zone. 

If you're Canadian and under 55, you were not even born by the time most provinces had adopted the single-payer, public health insurance system we often call medicare. If you're under 70 you were not yet in your teens by the time most of Canada had instituted our current system, and are not likely to have any memory of the good old days of free enterprise medicine.

We did not get our current system in Canada without a struggle. The Prairie province of Saskatchewan was the first to institute it, and when it did, the doctors went on strike. 

Today, however, most doctors in Canada support the current system, or at least they take it for granted. After all, Canada's version of medicare-for-all means physicians never have to chase patients to pay their bills. They can focus on medicine, not administration. 

As the U.S. campaign heats up, Canadians can expect lots of (almost always false) attacks on our system from south of the border. The last time that happened, when Barack Obama was running, Canada's Conservative government sat on its hands and did not object. 

The Harper Conservatives' support for our current system was passive-aggressive, based on political pragmatism, not principle. They knew talk of even partially dismantling our system, which is what they secretly wanted, would be wildly unpopular everywhere in the country. 

Today, we can hope that our current minority Liberal government will show some courage and fight back when loud U.S. voices tell lies about this country. 

One of those lies is that huge numbers of Canadians travel to the U.S for treatment. The number of Canadians who have ever sought treatment in the U.S. is, in fact, less than one per cent. It is such a rare occurrence that it is statistically insignificant. 

Another lie -- or, at least, misperception -- is that Canada's system is entirely socialized, 100 per cent government run. In fact, Canada's health-care system, like those of most other industrialized countries, is, in majority, publicly funded, but also has a large private sector. 

In Canada, the public part of the system accounts for 70 per cent of all health spending. The remaining 30 per cent -- including much of the spending on drugs, dentistry, audiology, eyecare, prosthetics, physiotherapy and podiatry -- is private. 

Like many Canadians, this writer has private insurance to help cover essential services not covered by the public plan. Many workers in Canada have similar employer-sponsored group plans. 

Notwithstanding the blather one hears from anti-single-payer propagandists in the U.S., private health insurance and privately provided health services are not banned in Canada. 

There is a thriving private health insurance industry here, as there is in most countries with comparable health systems, such as France, Germany, Japan and Sweden. There are also private labs, private dentistry practices and private radiology providers. Many doctors operate their practices as private businesses, although, for the most part, they send their bills to publicly owned health insurance agencies.

Bankers, 'hacks' and liberal free enterprisers attack Sanders

The political establishment in the U.S. is panicking at the prospect of Bernie Sanders as the Democratic standard bearer, and a good part of their attacks on him focus on his notionally unrealistic health plan.

The free market liberals' favourite ideologue, New York Times columnist Thomas Friedman, rang the alarm bells the day after Sanders won the New Hampshire primary, calling for billionaire and former Republican mayor of New York Michael Bloomberg to step in and save the day. 

Friedman did not mince words on Sanders:

"On which planet in the Milky Way galaxy is an avowed 'socialist' -- who wants to take away the private health care coverage of some 150 million Americans and replace it with a gigantic, untested Medicare-for-All program, which he'd also extend to illegal immigrants -- going to defeat the Trump machine this year?"

Lloyd Blankfein, the former CEO of Goldman Sachs, the Wall Street investment banking firm that happily accepted billions of taxpayer dollars to save it from bankruptcy in 2009, tweeted:

"If Dems go on to nominate Sanders, the Russians will have to reconsider who to work for to best screw up the US. Sanders is just as polarizing as Trump AND he'll ruin our economy and doesn't care about our military." 

Former Bill Clinton senior advisor James Carville said he feared the "end of days" if Sanders became the Democratic candidate. 

One is tempted to say: With enemies like that, Sanders does not need friends. 

Here we have a columnist who supported George W. Bush's disastrous invasion of Iraq, a billionaire banker and, to use Sanders' phrase, a "political hack" warning Americans about a dangerous "socialist" who would provide an easy target for the narcissist in the White House. 

In truth, what Sanders proposes are the kind of welfare state measures that conservatives, liberals and social democrats alike have long accepted as the norm not only in Canada, but in most advanced industrial economies. 

Since when are raising the minimum wage, making post-secondary education affordable, equalizing the tax burden, doing something serious about climate change, and assuring that basic health care is accessible to all radical ideas?

There are, of course, some ways in which Bernie Sanders is a problematic candidate. 

He is 78 years old and has suffered a heart attack. But Michael Bloomberg is the same age and Joe Biden is even older.  

From time to time, Sanders does demonstrate a truculent manner. He shouts, they say. So does Trump. The difference between the two is that Sanders harnesses his anger in support of evidence-based policies. For Trump, it is all about an infantile need to attract attention to himself, the facts be damned. 

On the debate stage, Sanders' fearless, take-no-prisoners style might work well against Trump's incoherent bluster. It would likely have been a lot more effective last time, in 2016, than Hillary Clinton's calculated, over-rehearsed and inauthentic approach. 

In the final analysis, Americans who want a new president will make up their own minds. 

They do not need advice from Canada, or anywhere else. And even if they did need it, most Americans are not interested in what foreigners think about them. 

But when they do weigh their options, citizens of the U.S. should, at least, be forewarned when politicians and commentators tell bald-faced lies about Canada, especially about our health-care system. 

Karl Nerenberg has been a journalist and filmmaker for more than 25 years. He is rabble's politics reporter.

Image: Gage Skidmore/Flickr

 
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