A Northern Perspective

As a Canadian spectator watching the U.S. health care reform ruckus from a distance, I am intrigued and disheartened by the heated (and often uncivilized) clash over the issue. Town hall brawls and scathing verbal assaults seem to be the favorite means of communication between opposing sides. Makes me wonder how progress can ever be achieved. Of course, it’s easy to watch smugly from the Canadian peanut gallery and criticize, ignoring the fact that we’ve had our own share of unsavory health care debates up here.

But what is clear, even from this viewpoint, is that something has to change. Almost 43 million Americans without health insurance is unconscionable. We may not have the perfect system in Canada, and reform is desperately needed here too, but one thing we can attest to is that each and every man, woman, and child in our population of 33 million has public health insurance. It’s not the fantasy world of Michael Moore, where people can walk into a hospital in any part of the country and always receive immediate care, or where your general practitioner jumps when you call, but the basic care is there. You will be seen, you will not pay from your pocket.

Several years ago, my husband was transferred to Cleveland, Ohio. His package included a health care plan commiserate with what we were accustomed to in Toronto. In the two years that we lived there, I spent more time in doctor’s offices and hospitals than I had in the previous decade. Why? Because every minor medical concern seemed to warrant a battery of tests.

When a pediatrician detected a mild heart murmur in our two-year-old son during a check-up, he recommended a major cardio investigation. Off we scurried to the Cleveland Clinic where one of the best pediatric cardiologists in the country oversaw our son’s case. After many tests, amounting to several thousand dollars, the specialist escorted us to his elegant office and thoroughly reviewed every detail of the results. The murmur—benign. The prognosis—fine. The course of action—nothing.

Would a doctor in Toronto have advocated such an intensive examination under the same circumstances? Absolutely not. Upon our return to Canada a year later, our own doctor didn’t even mention the heart murmur during our son’s check-up. When I queried her about it she said yes, he had a slight murmur, but it was inconsequential. Not the kind that required further scrutiny.

Whether this was a case of malpractice paranoia, work creation, or genuine concern for our son’s well-being, I can’t know for sure, but our American experience represents an inefficient system that provides over-care for some and under-care for others.

In Canada there can be long waits in emergency rooms and shocking time lags for life-saving operations. Appointments for MRIs may take months and equipment may be out-dated (especially in rural communities), but everyone in this country has the same access to the same kind of care. And most of the time, it’s good.

The American system has its benefits. Indeed, if you belong to the fortunate 25% of the population who has superior insurance, you will be well taken care of. You will jump the line, you will not wait for an operation or an MRI, and you will have the best doctors and the best facilities at your disposal. But what about everybody else? I would gladly have given up the superior care we received in order to give someone else the critical health services they lacked. Five star treatment is nice, but if three star treatment has the same outcome, is it not incumbent upon us as humane citizens to make the trade-off?

Barack Obama spins a great argument in his New York Times article, “Why we Need Health Care Reform,” where he outlines his four-point health reform plan. As is typical, his message is clear, concise, and informative. He counsels dissenting constituents to listen carefully, to gather all the facts and to argue reasonably. He cautions about the risk of doing nothing: “If we maintain the status quo, we will continue to see 14,000 Americans lose their health insurance every day. Premiums will continue to skyrocket. Our deficit will continue to grow. And insurance companies will continue to profit by discriminating against sick people.” President Obama is a wise man. His measured words inspire action...and hope.

From my northern perspective, I see a great opportunity for Americans. With collective goodwill and a shift from thinking “me” to thinking “we,” a new social fabric can emerge– where everybody wins.