Canadian Prime Minister Stephen Harper recently sat down with ABC’s Jake Tapper, and the discussion inevitably turned to health care. From that short discussion, the Prime Minister revealed two important things for us to keep in mind – one intentional, and one probably not so much.
Most important was the accident. When asked if Canadian waiting lines were too long, the non-answer revealed much:
In Canada, health care is principally the responsibility of our provincial government. The federal government provides some transfers. We do some of the drug regulation, a number of other activities.
But it is principally a system run by our provincial government. So first of all, I don’t feel qualified to intervene in the debate.
Not qualified? Canada is the quintessential Single Payer system. “Single.” As in, “One, singular, centralized.” As in “THE” national Canadian government. If the head of that government isn’t qualified to form an opinion as to the service that government provides, who is? And Canada isn’t even the same kind of federal republic that we are, so he doesn’t even have the excuse of the 10th Amendment in particular or federalism in general.
Just to put a bow on it:
Yes, but the responsibility for the health care waits, in our country, are the responsibilities of provincial governments.
I have taken the view, as the federal prime minister very different than some of my predecessors as I don’t lecture the provinces publicly on how they should be running their health care systems.
So in spite of that, he disclaimed responsibility and passed the buck. It’s not his fault, you see. It’s the Provincial government who are screwing up. And if he won’t even take responsibility, how can he begin to address the problems inherent in his system of health care?
Does anyone seriously think the same thing wouldn’t happen here? If there’s anything you can count on politicians to be, it’s craven. When problems inevitably arise, as they always do even in good government programs, who will step up and accept responsibility?
I suspect that even if that were to happen, the solution would involve even more government involvement, and a blame-fest aimed at capitalists, conservatives, and the free market in general.
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The second is more direct, and more obvious:
At the same time, all of this costs money. If you are prepared to spend an unlimited amount of money, you can do an almost unlimited number of things in people’s health care. But you don’t have an unlimited amount of money no matter what your system is. And these are challenges that every system has to address.
This statement posits only the stupendously obvious. But in spite of that, it’s the portion of the debate that is most lost on the pro-Obamacare people.
Ultimately, for too many people, it’s not about “reform.” It’s all about a portion of the population wanting someone else to pay for their health care. And that’s exactly what Obama is promising, almost as if all that government money was his in the first place.
But it’s not. Government money is wealth generated from people who haven’t asked the government to pay for or run their lives. (Or it’s money borrowed from China, which must be paid back by those producers with interest.) And just like Cash for Clunkers, when you give away tons of other people’s money, people will line up to take it at rates no bureaucrat or politician can forecast or imagine.
I suspect that those people who insist that the “government” pay for their health care wouldn’t have the courage to knock on their thriftier neighbor’s door and ask them to cover their health care costs – much less put a gun in their face and demand they open their wallets or go to jail. (And I’m not talking about the truly indigent, for whom I believe in having a safety net. I’m talking about the Middle Class Obama is trying to sell this to. If you have cable TV and a cell phone and a computer and an i-pod and a DSL line, you shouldn’t need to beg your neighbors to pay your mortgage, grocery bill, or health insurance premium.)
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So let’s not forget these two Canadian lessons. One, the government will never accept responsibility when things go south. And two, you can’t buy what you can’t afford. If everyone understood these things, support for Obamacare would truly find itself permanently consigned to the dustbin of history where it belongs.
I like your article. But, there are a couple of points that need addressing. First of all, the statement by Stephen Harper re: actual healthcare implementation is accurate. The regulation is national, but the carriage, the payment structure, and exactly where the money from that payment structure goes is decided on a province by province basis by that province’s individual governments. Obama is, by the sounds of it, trying to make the whole thing national–regulation, implementation, management, everything. Not the same at all.
In addition, we don’t pay for each other’s healthcare in Canada. If you can aford to pay your provincial taxes, of which I believe no province is exempt from collecting, you can aford to cover your own healthcare–in fact, some provinces (Ontario for one) include the cost of covering healthcare into the provincial taxes you pay. Now, again, there are arangements in place for those who don’t actually pay taxes–the unemployed, the underage, etc–but the majority of the middle class is still covered. Again, not the same system as what Obama’s proposing. So, when Harper says it’s not his place to tell the individual provinces how to run their aspects of the healthcare system, he’s correct. All his government does is mandate that the provinces must cover any treatment that is considered to be medically necessary. Beyond those regulations, the federal government is hands off.
Your entire article is based on either an inability to read simple english or deliberate willful ignorance.
First of all, as James just pointed out, you don’t understand the first thing about how the Canadian health insurance system works. And you have no excuse since it was explained to you in material you quoted. It IS in fact run by the provincial governments, and every province has it’s OWN system. The Feds just apply a regulatory framework to ensure each of them meet basic minimum requirements.
Harper explained this IN THE QUOTE YOU POSTED and yet you then immediatley proceeded to decide it was Harper who didn’t understand his own nation’s health insurance structure as well as you obviously do.
The other peice of ignorant tripe is one you have in common with far to many people in the US discussing this issue. You would rather pay $100 taxes and $150 out of pocket for something, than $101 taxes and $60 out of pocket for the same thing… to save the$1 in tax.
Because THAT’S WHAT YOU’RE DOING NOW and so fiercely defending.
As of 2005, last available OECD stats:
Canadians pay 6.95% of their GDP *IN TAXES* to health care. And less than 3% of their GDP out of pocket for health care on top of that.
The US spends 6.85% of it’s GDP in taxes on health care. No, you’re not reading that wrong, you pay almost exactly the same amount of taxes to your health care system as Canadians do . But because you REFUSE to let the government run a cost effective universal coverage program you get squat for that money. So Americans end up paying almost 9% of their GDP out of pocket on top of that for health care.
But as long as you pay even a single dollar less in taxes that’s better… because it’s less taxes! And taxes are the EVIL!
Idiocy.
Grant, where do you get the notion that Americans get “squat for [their] money”?
I see my doctor the same day I request an appointment, often within the hour of requesting the appointment. Yet my Canadian co-workers tell stories of waiting months for an appointment.
Your statement that the US spends 6.85% of its GDP in “taxes on health care” is flat out wrong. That is the Medicare tax– the amount of taxes paid to operate the existing government health care program (primarily for people over age 65).
I don’t dispute that Americans spend more on health care. What I dispute is that the government is going to provide similar (or better) quality for less money.
In order to make universal health care work, the US government will take that additional 9% of GDP (that we currently pay to a provider of our choosing). Then the government will dictate the service. I can switch to a different health care provider if I do not like my current provider. With a government system I have no choice.
SirWhoopass: First of all, I’m curious why you found it necessary to change the word “that” to the word “their” in my statement, thus altering it’s meaning so you could then argue with it? The way it was originally written rather clearly showed I was talking about tax money., not just any health care spending at all.
And unless you are on Medicare or getting care from the VA…. you are getting squat as far as health care is concerned for your tax money
And I’m incredibly puzzled by how you can say I’m “flat out wrong” about 6.85% of US GDP in tax dollars being spent on health care then in the NEXT SENTENCE say it’s being spent on Medicare.
Medicare. Is. Health. Care.
I find it implausible you didn’t know that since you referred to it as such.
And dispute that the government will provide similar or better quality coverage for less cost all you like. Pay absolutely no attention to the fact that that is EXACTLY what happens in the most of rest of the industrialized world in nations with higher levels of public sector involvement in their health care sectors. Reality isn’t nearly as important as your opinions, right?
Oh… and as for wait times. It’s real easy to claim you have short average wait times when you throw millions of people out of line completely then don’t count them as “waiting” because they’re NEVER getting treatment since they can’t afford it.
It’s pure bull, but it’s easy. And lots of people will fall for it.
@SirWhoopass: Two words. Medically necessary. If you need to see a doctor same day, and I’m not just talking your ear hurts or you have this annoying cough that just won’t go away, you get in to see your doctor same day. No ifs, ands, buts or why nots. The only people who happen to be on waiting lists are those with non-life threatening issues, or things that wouldn’t otherwise be high priority. Which is precisely the way it should be. Just because you have the money to do so doesn’t mean you should get to jump ahead of someone who doesn’t have the money and needs the service more than you do. Yes, it’s nice you get to see your doctor the same day you book your appointment. Wonderful. I’m happy for you. Meanwhile you’re taking up space that would be far better served going to someone who couldn’t aford to book the appointment for same day.
I don’t see how changing the wording in any way alters your meaning, or my rebuttal. Americans pay into Medicare and it provides health care for people over age 65. Clearly something is being provided for the money.
The “flat out wrong” comment was because I misunderstood your intention in the original post. When you wrote Canadians pay “in taxes TO health care” and Americans pay “in taxes ON health care” I assumed you made the distinction to imply that Americans were paying some kind of sales tax on their health care (and, thus, your assertion that they get nothing for the money).
James: I was “taking up space” better used for someone else?
I had annoying (but not debilitating) symptoms. The doctor did a lab test that day, and discovered a bacterial infection that, if left unchecked for a few weeks, would have caused organ failure and death.
If the doctor had not seen me how would he have known the difference between my stomach ache and the guy who just ate too much pizza?
You assume everyone would just get right in to see the doctor immediately. Any decent hospital will have a general idea of what’s going on with you before the doctor even knows your name. If it’s just because you ate too much pizza, you’re told to not be an idiot and go home. Often times, at least in Canada, if it’s for something minor the doctor doesn’t have to do a whole lot more than maybe sign a refill for a prescription.
My point is that I did get in that same day to the doctor. Not a hospital or emergency room for treating life threatening injuries (who, in the US, will treat anyone regardless of ability to pay). Just the family doctor at a clinic.
I have the basic minimum health insurance offered by my employer. And this allows me to chose a doctor an clinic which offers same-day service for a modest ($10) visitation fee.
This is the health care that is so vilified.
Stating that “millions” of people are being thrown out of line and are just not getting health care in the United States is just absurd and hyperbolic. There has never been complaints about people dying on the streets from a broken leg or pneumonia because they don’t have health insurance. The problem with our current system is that those people DO go to the E.R., get treatment, don’t pay for it, and then everyone else’s expenses go up to compensate for it.
[…] I’m not entirely sure the reporter understood it after the second or third time Stephen Harper said it. He almost seemed a tiny bit disappointed that Harper wouldn’t jump into that debate–wonder which of the wingnut club paid him to try that out. Johnson apparently was quite disappointed with it. So, he decided to create one […]
I’m glad too, that James and Grant seem to really like their health care in Canada. That means they won’t be coming here for treatment and burdening our already over-burdened system. That’s at least two Canadians we can count on (I’m presuming you are both Canadians). Say what you will about the great care being given in other industrialized nations, I would still prefer to be treated in a US hospital over an Italian hospital, French hospital or British hospital.
Gentlemen,
James, thank you for your enlightening comments. You have an excellent point that with the proposed centralized regulation that will be part of any Dem proposal, it will actually be WORSE and less accountable than the Canadian Single Payer system even Obama (now) claims is too extreme for America.
But with respect, you’re missing the point. I understand that Prime Minister Harper doesn’t sit in his office and pass the hours by personally managing the CT scan waiting lists. But the system is still controlled from the top. And the guy at the top with ultimate responsibility is passing the buck.
And not only is he unwilling to hold himself accountable, he’s unwilling to hold anyone else accountable, either. He can’t even form an opinion? These aren’t problems he’s thought about or considered? He’s not going to exercise any leadership on the issue? Are you kidding me?
While I don’t doubt his technical description of the distribution mechanisms is accurate, his statement that he isn’t responsible in any way is not. If Alberta decided they wanted to opt out of the national system and privatize it completely, they could not (at least not realistically, given the financial strings the CHA requires). If Ottowa wanted to tighten the regs on the Provinces, they could do it in a minute. The central government is NOT blameless, and Harper can no more wash his hands of his system’s problems than a company CEO can escape blame when his employees pour cancer-causing pollutants into a river on his orders.
Grant,
Calm down, buddy. If I’ve got something wrong, correct me. That’s fine. But your shrill tone makes me think thou doth protest just a bit too much.
Your system only saves money because care is rationed, and because your governmental stats don’t consider the folks coming down here for care and treatment they can’t get to in Canada. If the system is so good, why is that traffic pretty much all one way? Why do Canadians have to sue their government for the right to privately contract for additional insurance to supplement their inadequate government supplied system? Why bother if the public system is adequate? If there was no need or desire for the private sector, why would the government have to outlaw buying private insurance in the first place? Wouldn’t those industries just whither away? Why does your government routinely have to send people to my country to see specialists? Doesn’t that embarass you?
There are mountains of stats out there which indicate you aren’t getting the bang for your buck that we are. (For example, when you factor out the NON-medical reasons for death, like crime and accidents, we outlive you.) But stats be damned – just look at the way people are voting with their feet and their pocketbooks. You’re losing doctors, you’re losing hospitals, your provincial health programs are broke ($1.1 Billion in the red in Alberta alone), your innovation lags ours, and the situation is only deteriorating. Even Harper couldn’t deny the waiting times are unacceptable, which is why he hedged the answer and washed his hands of any responsibility.
We have improvements to make in our system, but there isn’t any problem that we have that wouldn’t be made worse by socializing our system to a greater extent than it already is.
Canadians happy with their system need to understand that the US is the release valve that prevents their system from collapsing completely, and should pray we don’t emmulate our neighbors to the north.
Another thing: Handing over my entire ablity to make my own health care decisions, hire my own doctor, and chose my own insurance plan isn’t worth it, even if it was “more efficient.” Liberty has it’s own value, and I hold that value dear.
You’re still not getting it, Orrin.
Canada’s healthcare system doesn’t restrict you to a particular doctor/hospital/what have you.
As said earlier, you’re prioritized based on necessity. If your life is being threatened by some degree of illness, you will get an immediate or near immediate appointment. If you just have a non-fatal cyst, you wait in line. As it should be.
We have a shortage of doctors not because of any problems with our healthcare system–in fact, the shortage of doctors could probably be partially to blame for our problems with the healthcare system–but rather, many of them choose to practice in the US. Why? More money. Private insurance will pay them more than they’ll get up here. That’s really all there is to it.
I never said our system was perfect by any means. But it’s also not the gigantic disaster many republicans will make it out to be.
We still spend less and achieve better outcomes, waiting lists or no waiting lists.
Patients do come from the US to Canada for treatments–most noteably certain types of cancer.
If for whatever reason they either can’t or won’t seak treatment in the US, rather than come to Canada, they’ll go to India instead. Same thing, different country. And, because it’s often cheaper than the insurance claim in the US.
So, while I won’t sit here and say you’re flat wrong on every count, but it just goes to show you do have some learning to do. Also it should be noted that, while we might not have been able to 4 years ago, we have the option of private insurance now. In addition, for as long as I remember, employers still provide you with health insurance, much as they do in the US. The only difference is if you can’t aford your own insurance, or your employer isn’t going to cover you, you aren’t left without options as you currently are in the US.
Also, Stephen Harper *is* holding someone else accountable. The provinces, who’s responsibility it is to manage wait times. Your assumption that it isn’t the way it’s supposed to go only serves to prove you need to do further research on the subject.
“As said earlier, you’re prioritized based on necessity.”
Who decides necessity? As my friend Sir Whopass’ experience showed, sometimes you don’t know what’s necessary until you’ve been admitted. He had a stomach ache which could have been anything. What if the Grand Prioritizer would have told him to take some Alka-seltzer and wait his turn and not given him the test until a spot opened up the next month? Had he waited even a few more days, that appendix might not have come out in time. On the other hand, say the test ruled that out, and showed it really was just a mild case of food poisoning or the flu, we would have some government know-nothing explain how that money was wasted on an “unnecessary” procedure, and how he was “taking up space” for someone who “really needed it.”
Do you really think that if we paid our doctors what you do that you’d have more doctors? I rather think we’d have less – for a net loss between us. (I bet the hospital industry in the Bahamas would thrive, though.) People who go through med school work HARD, and incur great expense doing it. Without a profit motive, what’s to incentivize them from going to med school at all?
But on the original point of the post, James, we’re talking past each other a little. I’m not saying that the Canadian system is a living hell. I’m saying it’s a) worse than ours in general, b) would be even worse if y’all didn’t have us capitalist pigs to the south, and c) would be an utter disaster in the United States for reasons you yourself mentioned. We also have a fundamental disagreement in terms of our value hierarchy in our nations – Canadians generally are willing to give up what are in my mind essential liberties for security, safety, and inoffensiveness, and Americans are not.
What I found most instructive – and dangerous – in Harper’s comments was the demonstration that politicians can ALWAYS be counted upon to pass the buck. It’s not so much a post about the relative merits of our healthcare systems, it’s a post about political accountability. The bigger and more distant the centers of owner are, the less responsive those centers of power are to the People. Harper’s dismissive comment demonstrates this in spades. And I’m supposed to prefer this over my insurance agent who lives in my town and whose direct phone line I have programed into my cell phone?
Harper was asked about a serious problem, and said he wasn’t qualified to involve himself in so much as a discussion of the solution. That’s not my idea of leadership. What Harper said is the OPPOSITE of what you contend – that he is “holding people accountable.” He’s not holding anyone accountable, he’s passing the blame to someone else. He’s saying, “don’t look at me. I have no responsibility here whatsoever. Go blame that guy over there.” Maybe he secretly is taking the provincial governments to task, but it seems an odd thing to do the right thing and then not take credit for it.
Finally, I KNOW that you can buy private insurance now, and that this is a new development (at least legally). But keep in mind that you ONLY have that option because your system was collapsing under the weight of a government system that wasn’t getting the job done. Private insurance saved your healthcare system (at least for the time being). Ironically, people here are blaming private insurance for our problems. Your example teaches us that the source of the problem is exactly the opposite.
(In spite of all this, I still love your country. Really. It’s beautiful, and the people are gloriously friendly. I can’t wait to drive the AlCan again…)
Most of this misses the major divide. Canadians have their system because frankly, they’re more comfortable than Americans with an extensive nanny-state. The rest of it is just window dressing.
And, of course the more free-market system will provide more freedom, innovation, personal liberty, choice and efficiency, just as the more socialist system will produce more “fairness,” homogeneity and longer lines.
Here is further evidence that Canada relies on medical care in the United States for its system to “work.”
You conservatives seem to be burdened with a distinct lack of reasoning.