Tuesday, May 26, 2009

Narrowing the Debate on Public Health Care

With Barack Obama's efforts to reform the American health care system getting set to kick into high gear, vested interests on both sides of the health care debate are making moves to try to ensure that nothing resembles a full and open debate on the topic ever takes place.

In the united states, Rick Ross and Conservatives for Patients Rights have been distributing videos warning about the alleged horrors of Canadian universal health care, in which patients outline horror stories about lack of accessibility to Canadian health care.

The Real News Network has responded with a video interviewing random passers-by on Toronto's hospital row, attempting to guage Canadian's level of satisfaction with public health care.

Both provide a calculatingly incomplete image of Canada's universal health care system, each one tailored to the needs of one particular set of advocates -- those advocating in favour of publicly-funded universal health care in the United States, and thsoe advocating against it.

No one should confuse the stories peddled by Rick Scott to be absolutely representative of Canadian health care. By the same token, however, neither should anyone make the same error in regards to the stories being peddled by Geraldine Cahill insisting that Canadian health care is A-OK and everyone is entirely satisfied with it.

Not only are there existing problems with Canadian health care, but many Canadians have found it to be far less than satisfactory.

Perhaps the most telling statistic in Canada is that of the amount of after-tax income Canadians are spending on health care. One should immediately recall that universal health care in Canada is paid for out of tax revenues and, as such, the expenditure of after-tax income on health care actually amounts to a sort of double spending on said health care.

Moreover, recent studies have suggested that Canadian public health care, as it currently exists, is unsustainable. Increasing funding demands on Canada's public health care system have been increasing on an ongoing basis, as the system continually requires funding hikes of an ever-increasing percentage.

The Canadian Institute for Health Information has admitted that Canadian health care spending is growing faster than Canada's economy -- a very basic blueprint for an unsustainable system.

Another key statistic is that of wait times for medical care. In 2007 wait times for elective surgery had reached an all-time high, despite government action to reduce wait times for surgery.

So not only is the Canadian government increasingly spending more and more money to keep Canada's public health care system afloat, Canadians are also seeing diminishing returns on their tax dollar investment.

Certainly, Geraldine Cahill isn't going to get this story from conversing with passers-by on Toronto's Hospital Row, and considering the Real News' particular ideological bent a real question remains about whether or not she'd broadcast it if she did.

Just like Rick Scott clearly has a vested interest in overlooking some very key facts about the American health care system.

Many of these facts are universally well known. 15% of American citizens do not have any health insurance or health care coverage. Moreover, the American government actually spends more money per capita on health care, and provides Americans with less coverage.

If the Canadian health care system is a basic blueprint for an unsustainable system, the American system, in which the federal government pays 35% of health care costs, state and local governemnts pay 11%, private health insurance -- often provided by employers -- pays 36% and the remaining 15% is paid out-of-pocket, is a very complex blueprint for an unsustainable system.

Yet in relying on alternately nightmarish and sparkling anecdotal evidence, both Rick Scott and Geraldine Cahill are acting in a manner that fundamentally narrows the scope of debate on public health care. It obscures the reality of a health care system that, over all, is of tremendous benefit to the people it services but still has key structural problems it has to overcome.

For example, one doesn't expect Cahill to say anything about the disproportioante amount of money Canada's public health system spends on the administration of that system. Entrenched management and bureaucracy has burdened Canadian health care with a high overhead.

Any efforts made by government to try to cull off excess bureaucracy within the system is immediately siezed upon by reactionary proponents of the status quo as "an attack on health care". Health care in Canada, it seems, is constantly under attack. And so must be defended on a permanent basis.

Those most willing to harness the rehtorical strength of these reactionaries -- "Jack Layton and the NDP" -- have even set off to the United States in order to help Barack Obama steer the public discourse in favour of public health care.

"We would go down there to not only defend Canada's health-care system -- but encourage them to adopt similar features," explained NDP national director Brad Lavigne. "[Medicare] is one of the greatest connections we have to each other."

While many Canadians would rush to disagree with Lavigne's implicit argument that universal health care is a central tenet of the Canadian identity, many would agree with him that the United States would be wise indeed to implement a system of publicly-funded health care. However, many of thsoe Canadians should also be honest enough to admit that recommending a complete emulation of Canada's health care system would actually be doing our neighbours a disservice.

But for those who want to reform Canada's public health care system advising Barack Obama on the construction of an American system is a golden opportunity.

Advising Obama on methods by which he could keep administrative and bureancratic glut under control -- thus allowing more funds to be devoted to front-end service -- would allow Canadians to help build a more efficient and effective system after which Canadians could model reforms to our own system.

Unfortunately, the only Canadian groups currently engaging in the American debate are the very parties that rely on the afotrementioned reactionaries for their political strength. Consider them to be something like a socialist equivalent of Rick Scott, opposing reform at all costs.

Those interesting in preserving Canada's public health care system before it becomes too bloated and unaffordable to preserve clearly have a vested interest in the current debate in the United States.

As Canada's system gets sucked deeper and deeper into the microscope of the American debate, the time for Canadian health care reformers to seize the role of Canada's voice in this debate away from the reacitonaries is now.

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