Health Care Debate Seen from the North
(at left: sign for a local CLSC: "centre local de services communautaires" or local community service center where neighborhood health and social services are located.) Since they hear so much about the horrors of the Canadian single-payer system, Americans might be interested to see what the health care debate looks like to Canadians. This recent piece in the Toronto Star by Linda McQuaig gives the flavor of what I've been hearing ever since moving up here - a kind of astonished incredulity, and even pity, that such a rich country can't manage to provide a minimal level of care of all of its citizens. It also expresses the fear of what might happen here, in Canada, if the system is allowed to fragment or fail. Here's an excerpt:
"...While the U.S. media gave prime time to gun-toting health reform opponents, they all but ignored a Harvard study, reported last week in the American Journal of Public Health, that found nearly 45,000 people die in the U.S. each year largely because they lack health insurance.
As resistance to U.S. health reform rages on - with its inane, vicious, even racist overtones - the fiasco should remind Canadians of the dangers of allowing our public health-care system to deteriorate.
What makes health reform so elusive in the U.S. is the way its opponents - led by wealthy corporate interests - are able to play Americans off against each other.
Americans are hunkered down in their own little bunkers, watching out just for themselves and their families. Anyone proposing reforms that might result in higher taxes is met with a rifle poked out the top of the bunker.
It's this dynamic - citizens pitted against each other - that has kept Americans at each other's throats over health care for years.
It's easy to understand, for instance, why middle class American taxpayers resent paying for medicaid, a public program that provides some coverage for the poor, when these same taxpayers can't afford coverage for themselves and their families.
The only real solution is public health care for all. A Canadian-style plan could save Americans $400 billion a year, Harvard's Dr. David Himmelstein wrote recently in the New England Journal of Medicine.
But Americans are so uninformed about the rest of the world that few even seem aware any Canadian can spend weeks in hospital getting state-of-the-art medical treatment and then walk out the front door without owing a penny. Such is the menace of public health care...
...the snarling fury of America's current crop of right-wing extremists almost makes one nostalgic for last year's gentler, childlike lunacy of Sarah Palin."
While the Canadian writer of this article has it approximately correct, I object to her characterization of Americans as "watching out just for themselves and their families", ready to "point a rifle" at anyone proposing higher taxes. There's an element of truth there for sure, but it's an oversimplification. Many are certainly hunkered down, buffeted by competing forces that are certainly a product of capitalism. The bunker mentality doesn't develop from lack of care for others as much as from fear - but to the rest of the world, it looks like meanness, competition, and selfishness coming from the grassroots. Let's talk about the greed of surgeons who make insane salaries, or their counterparts in the top levels of hospital administration, or drug companies, or insurance companies who stand to lose a lot with a single-payer system -- that's greed and meanness. When you go out into the hinterlands and talk to ordinary poor and middle-class people trying to pay for rising health care costs in a terrible economy, you quickly understand that what they feel like are victims of a huge system over which they have absolutely no control -- and that health care is only one of the aspects of American life that makes them feel that way. People in dire straits, without a great deal of education, and full of anxiety, are easily manipulated by fear tactics.
I wish Americans could understand that universal coverage actually works, and I wish that the Scandinavians, French, and Canadians could really understand the pressure that so many un-insured or under-insured Americans are under. When I talk to people here they really don't get it; that level of suffering in the midst of perceived plenty is as incredible to Canadians as compassionate and fair universal coverage is to many Americans. We all succumb to stereotyping, and while I won't defend America's insularity, greediness, or me-first-ness, those are not the overriding characteristics of the Americans most at risk in this debate.