American doctors on Canadian healthcare and the future for America

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This guest post is written by Kate Harveston, a writer and political activist from Pennsylvania. She blogs about culture and politics, and the various ways that those elements act upon each other. For more of her work, you can follow her on Twitter or subscribe to her blog, Only Slightly Biased.

As lawmakers put on an extended match of political football with the American healthcare system, many have pointed to Canada as a shining example of how things should be done.

Canada uses a socialized healthcare system based around a single-payer, an idea that has recently gained momentum with left-leaning Americans. However, that doesn’t make Canada’s system perfect.

It takes someone with an intricate knowledge of healthcare, in general, to break down the real similarities and differences in the two current systems. So, what are American doctors who’ve been to Canada saying?

A fundamental difference

One critical difference in the way that we approach the subject of healthcare shapes the entire discussion around US vs. social medicine in any country. That is, in countries with socialized healthcare, healthcare is considered a right.

Think about that for a moment. It means that as Americans we’re consciously allowing our fellowcitizens to get sick and even die without treatment if they can’t afford it. Gun ownership is a right, and health care is not — it’s that simple.

Countries that make healthcare a right — like Canada — do so at a small cost to the people who live there. It is doable, and American doctors who have worked in Canada are coming forward now to share what they have observed and how the two nations could learn from one another.

A simpler approach

In the states, we believe in the free market. That has introduced a whole cavalcade of moving parts into our healthcare system that simply don’t exist in most socialized systems.

Take big pharma. With the multitudes of drugs available on the market and pressure on physicians to promote them, patients in America are at a higher risk of pharmaceutical fraud than they realize. For example, big-name company Johnson & Johnson has seen a multitude of scandals and lawsuits related to their products over the years.

They have so much money and power that they continue to get away with this and operate even after so many blows that one would think would crush a company. It’s hard to know exactly what they’ve gotten away with. One case resulted in as high as an $800 million settlement for J & J’s off-market marketing of one of its drugs, emphasizing the importance of seeking legal help if you think you’ve fallen victim to big pharma’s game.

However, the responsibility should not be on the average consumer. The responsibility of a government is supposed to be to do what’s in the best interest of the people. The US government’s current ties to big pharma are not helping accomplish this. In a socialized system where doctors receive the same pay regardless of how they promote medications, the risk of fraud and corruption is greatly reduced.

One size fits all

There are, however, drawbacks to the socialized model as well. Two American physicians who have practiced in Canada both cite the lack of access to advanced medical technologies such as MRIs, which can leave patients waiting for weeks to diagnose a problem.

To quote Dr. Peter Cram, “In Canada, everyone gets Kmart care, there’s no Neiman Marcus care.”

Wealthy Americans who are used to a higher standard of care see that as a problem. They don’t want to wait in lobbies with poor people and expect higher quality appointments and better food. You can’t have those perks in Canada. It’s a sacrifice to make, but while conservative Americans point to a tax hike being required to fund such a program, the result is much lower overall medical costs.

Doctor-approved

The reason is that the American system commoditizes medical procedures. Doctors charge much higher fees and work much longer hours in the United States. It’s true that they make more money in some cases — but not all.

Dr. Suneel Dhand, an American doctor with experience working in Canada, asked a fellow doctor with similar experience to share some thoughts about the conditions he worked in during his time up north.

He reported that the first thing he noticed was how happy the doctors in Canada are, citing that they were “far from burnout,” a condition that often affects US doctors hustling to stay prosperous with falling healthcare compensation from insurers.

“Everyone valued everyone’s input,” the article goes on. “I found no backstabbing or backbiting. And the group did well incorporating other locum tenens, residents, and students.” Is it worth it to you to have a doctor who’s feeling good and communicates with their co-workers operating when you go under the knife?

Even with all the places that socialized care shines, it isn’t perfect and neither Dhand nor Cram glosses over that. There are certain things you just can’t have in Canada that top-tier US healthcare provides.

Canada’s healthcare system only covers doctor visits and medical costs. Other costs covered by US insurers, like optical and dental care and prescription medication, require a secondary policy that most Canadians choose to buy — but it’s not mandatory.

The cost to provinces is extremely high. It can constitute up to 40% of their budget. Can you imagine states absorbing so many medical costs? Not likely.

America at a crossroads

Still, we have an inefficient system in the states, and it’s having an impact in multiple ways. Medical fees are inflated, making it difficult for those with insurance to pay for care, and the less fortunate can’t afford care at all. How bad do you want to see things change? I guess that depends on how likely you are to wind up broke tomorrow.

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