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Wednesday, September 19, 2012

America’s cruel healthcare system, and the GOP’s determination to preserve it


Michael Buholzer/Reuters
Michael Buholzer/Reuters


As the National Post reported Thursday, a conservative American advocacy group is seeking to cast doubt on Obamacare by linking it to the failures of Canada’s single-payer health system. The star of the group’s $6.3-million ad campaign is Waterdown, Ont. resident Shona Holmes, who received neurological treatment in the United States for conditions that, she flatly claims, might have rendered her blind or dead had she waited for treatment here in Canada.
The real facts of her case turn out to be more complicated. As the media has reported, some Canadian specialists who have studied her case say Ms. Holmes’ condition actually was a benign cyst, which did not qualify, in her context, as a medical emergency. These experts also say that in cases where a patient is believed to have serious neurological problems, the Canadian health system responds “immediately.”
I have no special insight into the medical details of Ms. Holmes’ case. But as an everyday consumer of the Canadian health system, her story rings odd. Our system is hardly perfect (see below), but it springs to life with shocking speed as soon as any patient is in genuinely urgent distress. The hospital in my neighbourhood once made me wait 12 hours for treatment for my mildly infected arm. But when I brought my 6-month-old daughter in with breathing problems, the very same health system suddenly presented itself like a scene out of ER.
Isolated tragedies notwithstanding, lifespans in Canada are actually longer, and our rates of childhood mortality lower, than those in the United States. By turning Ms. Holmes into a propaganda figurine, conservative U.S. lobbyists are giving Americans a skewed, overly negative image of Canada’s universal health system.
Where the Canadian health system is sluggish and riddled with delays is in the area of elective surgery, including orthopedic procedures; as well as radiological imaging, which sometimes involves multi-month waiting lists. When a condition does not present as life-threatening at the primary-care level, just getting an appointment with a Canadian specialist can take months. That part of Ms. Holmes’ narrative rings true.
One of my family members who lives in the Toronto area, for instance, suffers from acute osteoarthritis; and recently found herself in need of a knee replacement. Her local Canadian doctor told her she could get one — for free, of course — but that it would take more than a year. Unwilling to spend 12 months on crutches and pain killers, she called up a hospital near her retirement community in Naples, Florida. They said she could get the replacement done within two weeks — but at a cost of $60,000.
And therein lies the real difference between the two systems. While both do a good job when a patient’s life is on the line, the American one also gives the wealthy and well-insured gold-plated service in the elective domain, not to mention an all-you-can-scan buffet of high-tech diagnostics. I had a taste of this when I lived in the United States as a university student, enjoying an all-inclusive health plan that made me feel like I was back in Canada, minus the waiting lists.
This, at root, is why there is so much opposition to Obamacare: Most middle-class, middle-aged Americans typically already have solid health care plans — as do elderly Americans, who have been covered by “Canadian-style” medicare for generations. They see Obamacare as a form of socialist meddling whose benefits will be felt primarily by people who are on average poorer (and blacker) than themselves. And there is some truth to that.
Yet the needs of those poor patients are real, and it is a scandal that this extraordinarily rich country contains almost 50-million people who lack any form of health insurance. According to one advocacy group, 26,000 Americans die every year due to a lack of health insurance.
Perhaps instead of focusing on dubious Canadian medical tales such as that of Ms. Holmes, Americans should focus on curing this ongoing moral disgrace — a project that Mitt Romney took on in Massachusetts, to his great credit, and now has abandoned for the sake of indulging his party’s free-market dogma, to his great shame.
Every year, I drive through Massachusetts — and New Hampshire, and New York, and Vermont — en route from my home in Toronto to our family’s traditional summer vacation spot in Ogunquit, Maine. And every year, I make a habit of taking secondary country roads, to enjoy the region’s beautiful small-town landscapes.
But on the bulletin boards at gas stations and general stores, you often can see the names of the forgotten victims of America’s health system traced out in ballpoint pen: notices seeking donations so this or that poor local family can buy cancer care for their child, or diabetes treatment for an uncle. You will sometimes see collection jars on the counter at diners, or yard sales, with homemade labels soliciting donations for a stroke victim, or a crippled senior. These ballpoint-pen people are America’s answer to Shona Holmes.
It is a stain on the United States that they are so legion. And a stain on the Republican Party that they have resisted efforts to bring them the universal health coverage that is available in every other developed country on earth — including, thankfully, Canada.

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