Posted At ViveleCanada.ca
BY : Robert Billyard
Paul Krugman, New York Times columnist, and Princeton University economist is truly a modern day pioneer. He has undertaken the quixotic challenge of convincing Americans, and the American power structure that the United States of America must undertake a universal health care program. In doing so he also becomes a necessary, though coincidental, defender our own system.
In making his case Krugman delivers powerful intellectual and economic arguments for the adoption of a universal health care system and often cites our medicare system as a model for his country. Unfortunately though, our system is degenerating into the same disarray as the US system- a semi-privatized system that is inefficient, duplicitous and unfair to millions.
A large part of the problem in Canada is that the federal government, administrator of the Canada Health Act, is dithering in its commitment and enforcement of the act. It would be interesting to run a poll asking Canadians if they trust the government to maintain and defend the CHA and Medicare- yet another vote of non-confidence?
The reason NDP leader, Jack Layton, withdrew his support for the government was that he and the prime minister could not agree on protections necessary for Medicare.
One of the great differences between our two countries is that in the US health care is considered a privilege whereas here it is considered a right. In Canada, administering Medicare is considered a fundamental function of government. The function of government has though undergone a sea change and it comes in the form of neoliberal/ neoconservative ideology; one that denigrates the role of government and advocates dismantling the social contract. This pernicious ideology is pervasive in both countries though much more deeply rooted in the US.
The mantra of privatization is being hailed as the solution to cost effective medical services- but the numbers tell a different story. In the US where health care is largely privatized, far from comprehensive and where millions have no coverage at all the cost per person is $5, 267, in Canada $2,931, in the UK $2160, and in Germany 2,817.
We are quick to criticize our system though compared to the US we are a paragon of efficiency, and we compare favourably to the UK and Germany without taking into consideration the demographics of those two countries.
As Krugman points out we may have longer waiting periods, but endemic to the US system is that doctors are less accessible, a third of American are deterred from seeking treatment by cost, and medical errors are rife.
In the US 40% of prescriptions go unfilled because the patient cannot afford the cost.
One of the daunting issues that bedevils the US system is that when faced with claims corporate insurers will often impose minimal treatment rather than appropriate treatment to guard their profit margins. In a universal public system appropriate treatment is a first priority.
Krugman also cites how employment based medical insurance costs have been a factor in the demise of General Motors. For every car it produces it is paying $1500 in health care. Where it pays huge premiums on behalf of its American workers, its Canadian workers are covered much more efficiently by Medicare.
One of the formidable hurdles Krugman must overcome is:
To get effective reform, however, we'll need to shed some preconceptions - in particular, the ideologically driven belief that government is always the problem and market competition is always the solution.
So too, is this true in Canada.
In a recent letter to the Toronto Star an 80 year old senior from Victoria was “terrified” that we might lose our Medicare system. She, like Krugman, writes with considerable cachet as she can vividedly recall the dark days before Medicare came into being.
Her comment raises some very pertinent questions: Do we take our medicare system for granted? Do we have to see it lapse into chaos before we realize its importance? Are we willing to sit idly by and let self-serving ideologues dismantle it? When we have a vivid example of the alternative(a case study) so close at hand-just across the 49th parallel- how can we fail to identify effective strategies?
