Fifteen years ago, I moved my family to Canada from the United States, at the rather advanced age of 48. I came to this country with a number of misconceptions about Canada's single-payer system of universal health care, most of all, the false notion that hospitals are government institutions, and that medical providers are government employees. It doesn't work that way in Canada.
Americans, particularly young Americans, are looking for a medical care system like the one Canada has. Obamacare is not that system. Obamacare was just a first step in the right direction.
During the heated debate over the Affordable Care Act or "Obamacare", I spent several hours reading about it trying to understand why it was met with such fierce resistance. My wife asked me for a quick synopsis of the plan and the controversy; I explained it to her as I understood it.
"What you just described," she said, "is not a 'health care' plan at all ... you just described a national 'insurance' plan. You said nothing about health care."
I was floored, "Whoa ... in 5 minutes, she understood what had taken me hours to comprehend."
Because she reduced it to its core elements; she wasn't distracted by the hype on one side, and the fear-mongering on the other.
Americans don't need an insurance plan like Obamacare. America needs an extension of its own world-class (Medicare) health care plan for seniors, which is similar to Canada’s system, funded by taxes, where doctors and hospitals have a single customer for billing: the government. Medical services are mostly by the private sector, but there is a single customer for billing purposes: the government.
It is very encouraging that so many post-Boomer Americans are no longer afraid of the word "socialism." Because, in that, lies the best hope Americans have for a better future.
Here are the most five most common misconceptions I've found that Americans have about Canada’s system of universal single-payer health care:
Myth: Medicare is a Canadian-wide federal government program. Canada's Medicare system is not a federal program, and is not administered by the federal government; it is provincial, and service varies, coverage varies, taxes vary, between provinces. In some provinces, people pay insurance premiums for Medicare; in New Brunswick it is free, but here we don't have prescription drug coverage under the age of 65 (I have employer-provided supplemental insurance coverage for medications). The only thing the federal government has to do with Medicare is to set "guidelines" for the provinces to ensure that every Canadian resident has equal access to all "medically necessary" health care services. Medical providers are required to abide by the Canada Health Act of 1984, which basically guarantees every Canadian resident equal access to all "medically necessary" health care services, without co-payments of any kind. Incidentally, access to medical care is a right of all human beings under the 1948 UN Universal Declaration of Human Rights, which was written, incidentally, by a Canadian, John Peters Humphrey.
Myth: Wait times for medically-necessary procedures are long in Canada. I know there are horror stories, I've heard them too, but I'm not aware of anyone, personally, who has gone without badly-needed medical treatment ... elective surgery can have long waits. If you have a need to see a medical specialist, at least in New Brunswick, you go immediately in most cases. That's my personal experience, in this province. As for waiting lines for health care ... how many Americans wait for the remainder of their natural lives for necessary medical procedures? Far too many. Quite literally, they die waiting.
Myth: Government bureaucrats, not doctors, make medical decisions in Canada. It is important that everyone understands that, in Canada, the only people who are allowed to make decisions about who gets care are physicians. In the United States, by contract, HMOs and other private medical insurers do indeed make decisions about who gets what care (it's probably more appropriate to say "who gets denied the care they need). In Canada, medical decisions are left entirely up to doctors, and there are no requirements for pre-authorization whatsoever. If your family doctor says you need an MRI, you get an MRI. In the U.S., if an insurance administrator or HMO rep says you are not getting an MRI, then you're not getting one regardless of what your doctor thinks — unless, of course, you pay for it out of your own pocket. I bet you there are far more Americans paying for necessary medical procedures out of their own pockets than there are Canadians who find it necessary to do that.
Myth: The government "manages" patient care in Canada. Another misconception among Americans is the government of Canada "manages" patient care. That's a gross misunderstanding, but a common one. The health care system in Canada is not run by the government; it is funded by the government; there is a huge difference. Medical treatment is solely the responsibility of doctors, not the Medicare system and its administrators. This is complete unlike Health Management Organizations (HMOs) in the US, where, essentially, a corporation DOES make medical decisions. In Canada, a doctor's relationship to his patient is a professional medical one only; and doctors bill the government for services rendered under Medicare. The doctor isn't forced to deal with insurance claims or payment collections. It's much better that way.
Myth: Doctors in Canada work for the federal government and draw civil servants' salaries. Nearly all health care in Canada is provided by private providers and administered by private or non-profit organizations. None of the four hospitals my family has used in Canada is directly administered by the government.
