Five myths Americans have about the Canadian Health Care system

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.

99 years ago: Insulin first used (here in Canada)

On 11 January 1922, insulin was first used to treat diabetes.  In Canada.

Insulin had been discovered by three doctors at the University of Toronto:  Sir Frederick G Banting, Charles H Best and J.J.R. Macleod.

At that time, children in comatose states (from diabetic ketoacidosis) were kept in large wards of 50 or more patients.  Their deaths were considered inevitable and their families gathered at their bedsides during their final hours.

With nothing to lose from administering their purified insulin extract, Banting, Best, and James Collip (the Canadian biochemist who had purified the extract) went from bed to bed, injecting the entire ward. 

Before the three doctors had reached the last dying child, the first few were awakening from their comas, and the ward resounded with joyful cries from their family members.

The discoverers of insulin were reluctant, at first, to patent their process for purified insulin, but when they learned that an American company (Eli Lilly) intended to hijack and monopolize the production of insulin, they obtained a patent in the name of the University of Toronto with one condition spelled out:

The patent will not be used for any other purpose than to prevent the taking out of a patent by other persons. 

When the details of the method of preparation are published, anyone will be free to prepare the extract, but no one can secure a profitable monopoly.

And that's a story more compellingly dramatic than any war story I've heard.

I recently watched "The Post" (Tom Hanks, Meryl Streep, 2017)

Recently, I watched the movie The Post on Netflix (2017 with Tom Hanks, Meryl Streep).  The movie is the true story of journalists from The Washington Post attempting to publish The Pentagon Papers in 1971 and the remarkably courageous decision made by Katherine Graham, who had inherited the newspaper after husband’s suicide.  (Reminder: this is a true story).

Watching the movie, I could not help contrasting the public reaction that followed the publication of The Pentagon Papers (which were provided by a whistleblower Daniel Ellsberg) and the reaction to Edward Snowden's revelations about secret illegal US spying programs. In both cases, the American public was informed (by a government contractor) of things their government was doing in secret, and in violation of the US Constitution.  For those who don't know or don’t remember, The Pentagon Papers was a 7,000 page top-secret RAND Corporation study of the Vietnam war commissioned by Secretary of Defense Robert McNamara in 1967.  It contained facts about the Vietnam war which the American people were never supposed to know.  After the initial publication of The Pentagon Papers by the New York Times in the Sunday edition of June 13, 1971, the reaction of the public was immediate; it led to street protests; it led to Congressional hearings; people were outraged, and so was the American press.

I turned 13 in 1971.  I wasn't a bit interested in the Pentagon Papers; and to be quite honest, I never understood why it was such a big deal.  I'd seen the thick paperback in bookstores, which became a bestseller, but couldn't imagine anyone actually buying and reading it.  I didn’t understand that the case was a big deal, not just because of what was inside The Pentagon Papers, but because when the New York Times attempted to publish them they were enjoined from doing so by a federal court.  America's government, in other words, tried to keep the American people from learning the truth about what it was doing. People bought and read The Pentagon Papers because they were outraged by the fact their government would go to almost any length to prevent them from knowing the truth.  People were protecting their right to know by using that right.

Imagine today's pathetically weak US news organizations acting in this manner:  When the New York Times was ordered (on Jun 15, 1971) to cease the publication of The Papers, their biggest rival, the Washington Post, without hesitation started printing it (on the 18th of June).  And when the Post was also threatened with a court injunction, the Boston Globe began printing it, then the Chicago Sun-Times started printing it; all 11 Knight Newspapers started printing it, along with the LA Times.  In all, The Pentagon Papers was distributed to 17 national news organizations, most of whom planned to print it. On June 29th, only two weeks after its initial printing Senator Mike Gravel (D-Alaska), during a filibuster against the selective service draft, entered 4,100 pages of The Pentagon Papers into the Congressional Record.

On June 26, 1971, again only two weeks after the initial publication of The Pentagon Papers, the Supreme Court of the United States agreed to hear the government's case for prohibiting that publication; the Court returned a decision only 4 days later, on June 30, 1971. In a 6-3 decision, the Supreme Court of the United States of America upheld the 1st Amendment right of the New York Times and the Washington Post to publish the information. It was a huge blow to the government of Richard Nixon, and it was a clear victory for the American people and the American free press.  It was huge.  It marked a major change in the relationship between the government and the media. The US media declared itself independent of the government, an independence they have since largely ceded. As the authors of a college textbook on free speech in America wrote, "the journalists of America pondered with grave concern the fact that for fifteen days the 'free press' of the nation had been prevented from publishing an important document."

It surprised me to learn how immediately the American people, and the American press, and the American Congress, and even the US Supreme Court, reacted to The Pentagon Papers, and what a contrast that reaction was to the lackadaisical response to what Edward Snowden revealed; which is no less significant, no less shocking, and touching far more of us directly.  Edward Snowden had to defect from the US to release the information he provided us; he had to do it through foreign journalists and publications. A badly-weakened American press wouldn't touch it.  Americans should be shamed by that; and, indeed, it indicates just how morally apathetic Americans have become. How little they value their freedom.

I gave up my job, my career, my clearance, and I staked my freedom on a gamble: if the American people knew the truth about how they had been lied to, about the myths that had led them to endorse this butchery for 25 years, that they would choose against it. And the risk that you take when you do that is that you'll learn something, ultimately, about your fellow citizens that you won't like to hear, and that is that they hear it, they learn from it, they understand it, and they proceed to ignore it.

– Daniel Ellsberg, Radio Interview, 1972

The greatest fear that I have regarding the outcome for America of these disclosures is that nothing will change. People will see in the media all of these disclosures. They'll know the lengths that the government is going to grant themselves powers unilaterally to create greater control over American society and global society. But they won't be willing to take the risks necessary to stand up and fight to change things to force their representatives to actually take a stand in their interests.

– Edward Snowden, Hong Kong interview, June 6, 2013

   http://www.theguardian.com/world/video/2013/jun/09/nsa-whistleblower-edward-snowden-interview-video

The Press was protected so that it could bare the secrets of the government and inform the people. Only a free and unrestrained press can effectively expose deception in government. And paramount among the responsibilities of a free press is the duty to prevent any part of the government from deceiving the people.

 

– Justice Hugo L. Black (1886-1971) US Supreme Court Justice

   Source: New York Times v. United States (Pentagon Papers) 1971   

Both Daniel Ellsberg and Edward Snowden are true American heroes.   Both men put their lives and careers squarely on the line for their values and their honor.  Both men expressed their greatest fear:  that their fellow Americans would not possess the backbone to do the same. 

Times, apparently, have changed.  And, apparently, so have Americans. 

Edward Snowden deserves a fair trial.  That’s the right of every American citizen.

Two years ago: the first "School Strike for the Climate" (2018)

Greta Thunberg believed, strongly, that it was time for world leaders to stop acting like everything is normal when normal is leading us straight to catastrophe.

 

That is why, at age fifteen, she decided to stop doing the one thing all kids are supposed to do when everything is "normal":  go to school to prepare for their futures as adults.

 

So, in August 2018, at the start of the school year, Thunberg didn't go to class.

 

Instead, she went to Sweden's parliament and camped outside with a handmade sign that read simply, SCHOOL STRIKE FOR THE CLIMATE.  She planned to demonstrate in front of the Swedish parliament from the first day of the fall term until the country's parliamentary elections three weeks later.

 

Every morning, she would ride her bike to the parliament, arriving when her classes would have started. After posting on social media, she would turn off her phone, as would have been required in the classroom. During the day, she sat on the ground outside the building, studying her textbooks, although she made it clear in interviews, that she found preparing for the future to be pointless.

 

As she explained:

 

"Why should we be studying for a future that soon may be no more when no one is doing anything whatsoever to save that future? And what is the point of learning facts in the school system when the most important facts given by the finest science of that same school system clearly means nothing to our politicians and our society?"

 

At the hour when school would normally end, she packed up her things and cycled home. She did it alone.  She returned every Friday, spending the entire day there. One day, a young boy asked if he could sit with her.  Others joined them.

 

In a matter of days, she became a globally recognized figure, known for her precise articulation of the scientific causes of climate change and the unequivocal condemnation she rained upon her elders for failing to address it. After the Swedish elections, she decided to continue her campaign by striking only on Fridays, sparking what has become a global student movement called Fridays for Future.

 

Of course, Greta's story is now well known to all of us.

___

Charles Aulds

20 August 2020

They weren't "heroes"; they were fools

I've read quite a bit about the 1st "World War" and what I have read has appalled me.  It's nothing like what I was taught in the American History classes I had in primary, high school, and university. Nothing at all like what I was taught.

I never heard of the battles of Verdun, Ypres, the Somme, and the two battles that are so well-known to every Canadian, Vimy Ridge and Passchendaele.

Why?  Because the United States wasn't a "no-show" in all of those battles.  I can only assume that Americans rewrote the history of that war for my personal benefit; though I cannot quite comprehend why it was advantageous to me to embrace lies and to wrap myself in any national flag.

What was the cause of the First World War ?  Do you think you know for sure?

If you are absolutely certain you know; please read NO FURTHER than this sentence.  Because the causes are still uncertain/controversial/debatable.  There are many causes ... the debate is about which were most critical in precipitating the mechanized slaughter that took place between 1914 and 1917.

I thought I knew ... it was the Assassination of Archduke Franz Ferdinand of Austria.  Although I had no idea at all who he was, or why he was killed, I knew that was the spark that started the war.  I just didn't know quite why (and I really didn't care, to be honest). It was just one of those complicated European things.  Except he was killed in a city called Sarajevo in a place called Yugoslavia (in a region called "Bosnia" ... maybe you've heard of it??).  It was part of the Austro-Hungarian Empire/Monarchy and the Archduke was the "heir-apparent" to the throne.  He was killed by a Serbian nationalist.  Blah-blah-blah.

When this Emperor-to-be was killed, the European countries all took sides and started killing each other (again).  Same old imperialist bullshit.

And when it was all over?  An estimated 10 million combatant deaths and 13 million civilian deaths as a direct result of the war, and the resulting genocides, and starvation, and the related 1918 influenza pandemic caused another 17 million deaths worldwide.  What the f*ck?

For three years the battle lines remained virtually stationary in France. Each side would push forward, then fall back, then push forward again, then, well ... lather, rinse, repeat.

Ten million were buried on the battlefields; 30 million more were to die of hunger and disease related to the war. And no one since that day has been able to show that the war brought any gain for humanity that would be worth one human life.

But, certainly, for so many people to die, there must have been a VERY good cause, right?  Right?

Maybe not ... and that's my point. There was no "good cause" ... like I was taught.  It was the US and Canada getting involved in another European war in which they had no business.

The advanced capitalist countries of Europe were fighting over territorial boundaries, colonies, spheres of influence; they were competing for Alsace-Lorraine (created as part of the German Empire in 1871), the Balkans (Bulgaria, Bosnia, Croatia, Serbia), and vast colonies in Africa (Morocco, Algeria, Tunisia, the Ivory Coast, Sudan, Niger, the Congo).  They were fighting for empires in their age-old tradition.

What does that have to do with me?  With you?  Exactly:  nothing.

We were taught a body of falsehoods about that war.

Canada?  Entered the war because it was part of the British Commonwealth.  No reason at all for Canadians to be there.  Ever. But Canada's total casualties stood at the end of the war at 67,000 killed and 173,000 wounded, out of an expeditionary force of 620,000 men.  My god, they weren't even fighting for their own homeland, or their families.  They sacrificed themselves, and their families, for someone else's grand cause.  Fools, all.

Were the French Canadians of Québec right to protest the conscription of their young men to fight another British war for empire?  Hell yes, they were right.  And the world would be a better place if more people had the courage to make the same choice.

"forced masturbation"? Really?

The United States Army and Central Intelligence Agency personnel committed a series of human rights violations against detainees in the Abu Ghraib prison in Iraq, including physical and sexual abuse, torture, rape, sodomy, and murder. The abuses came to public attention with the publication of photographs of the abuse by CBS News in April 2004. The incidents received widespread condemnation both within the United States and abroad, although the torturers received support from conservative media in the United States.

https://en.wikipedia.org/wiki/Abu_Ghraib_torture_and_prisoner_abuse#Convictions_of_soldiers

The Taguba Report (the result of the investigation by a US Army Major General, Antonio Taguba) was released in April 2004. The report concluded that 60% of the detainees at Abu Ghraib "were no longer deemed a threat and clearly met the requirements for release."  (Ref. Page 25)

In other words, the treatment of those detainees, by US Army soldiers and by CIA personnel, was committed against people who were guilty of NOTHING. Against innocent civilians.

On Page 16 of the Taguba Report, Major General Taguba states, "I find that the intentional abuse of detainees by military police personnel included the following acts:Punching, slapping, and kicking detainees; jumping on their naked feet; Videotaping and photographing naked male and female detainees; Forcibly arranging detainees in various sexually explicit positions for photographing; forcing detainees to remove their clothing and keeping them naked for several days at a time; forcing naked male detainees to wear women’s underwear; forcing groups of male detainees to masturbate themselves while being photographed and videotaped."

Friend, that is some sick shit.

Abu Ghraib (and Guantanamo) were never about the treatment of terrorists by Americans ... they were about how Americans were treating people against whom no evidence of terrorist activities can be demonstrated.

It makes all the difference.

The logic that was used was: "since we can't prove them not guilty of any crime, they must be, therefore, assumed guilty."

That's obviously contrary to long-standing American values; codified as the supreme law of our land, but espoused in our Declaration of Independence as the God-given rights of all men.

To accept the claim that only terrorists were treated inhumanely by Americans is tantamount to a submissive acceptance of a fascist state (one in which power overrules justice, law, and common decency). I reject that claim. I rejected it 16 years ago, and I reject it now.

How about you?

Who is Suleiman Abdullah Salim ?

Suleiman Abdullah Salim was the primary named plaintiff in the first civil lawsuit filed against the US Central Intelligence Agency (5 years ago) by victims of "extrajudicial detention" (no charges, no trial, no judge, no jury) in secret "black sites" (torture centres).

Mr. Salim was a Tanzanian fisherman who was sold by pirates in March 2003 to the Americans in Somalia.  He was taken to a secret prison in Afghanistan that was run by the CIA.  He was held there for fourteen months.  During that time, he was tortured regularly; torture which included anal penetration, mock execution, being doused with icy cold water, and waterboarding.  In July 2014, the CIA turned him over to the US military, who placed him in Bagram prison outside Kabul.
In August 2008, Suleiman Salim was released with a paper which stated that there were no charges against him and that he had been “determined to pose no threat to the United States Armed Forces or its interests in Afghanistan.”

In other words, he was a completely innocent man.  Held unlawfully for five years and tortured, by Americans.

In October 2015, the lawsuit was filed by the ACLU on behalf of Suleiman Abdullah Salim, and two other CIA torture victims, Mohamed Ahmed Ben Soud, who was a Libyan exile from Muammar Gaddafi’s regime; and the estate of Gul Rahman, an Afghan refugee who froze to death while being "interrogated" (tortured).

The lawsuit named as defendants two CIA contract "psychologists", James Elmer Mitchell and John “Bruce” Jessen, who were independent contractors of the CIA.  For their "services'', these two men billed the CIA between $75 million and $81 million.

From the day he was sold to the Americans, Suleiman Salim was a dead man walking; the fact that he's alive today is remarkable.  There are Americans (at least two of them) wishing, now, that they'd "disappeared" him when they had the chance.

Americans didn't violate Suleiman Salim's "civil rights".  He had no such rights or any expectation of humane behaviour.  What was violated in Afghanistan was not anyone's "civil right"; what was violated were core American principles of behaviour.  Before Americans violated anyone's rights; before a single person was tortured or held without trial; Americans violated their own principles; they betrayed their own honour.  And there's a price to pay for that demonstration of weakness.

Americans need to accept the fact that the worst violations of American principles have not been of any prisoners' legal or human rights (indeed, the US has declared that "detainees" essentially have no such rights) ... the worst abuses have been of American principles of justice, morality, and of the standards that define "civilized behaviour."

Americans betrayed themselves.

No people who are guilty of that deserve our respect.  Ever.  It's an irredeemable violation of honour.

Let history record it so.


Update:  Salim v Mitchell was scheduled to go to trial before a jury in Spokane Washington on 5 September 2017.  The lawsuit was settled out-of-court (for an undisclosed amount).  Despite that, the lawsuit brought out into the open hundreds of pages of previously classified documents about the planning and operation of the CIA’s "extraordinary rendition" program, and produced an evidentiary record of over 4,000 pages.

Suleiman Abdullah Salim