Canadian health care: Socialized insurance, not socialized medicine

Aug 11 2009

"Amid the debate about reforming heath care in the United States, it's tough to turn on your television these days without hearing a political ad condemning the Canadian health care system," NPR reports. While those ads are "provocative," NPR asks whether they accurately portray Canadian health care.

"Canada has a universal health care system that's paid for through income taxes and sales tax. All Canadians are covered, and they can see any doctor they want anywhere in the country with no copays or deductibles." Some services, such as dental care and outpatient prescription drugs, are paid out-of-pocket or through private insurance. "U.S. critics of Canadian health care like to call it socialized medicine, but it's more like socialized insurance — meaning the risk is pooled together. And while the individual provinces and territories set their overall health budgets and administer the health plans, the delivery of medical care is private. Doctors run their own businesses and then bill the government."

One criticism is that the Canadian system rations care. "When federal spending on Canadian health care declined during a recession in the 1990s, lines for non-urgent procedures — and some urgent ones — grew. A few years later, Canada's Supreme Court found that some patients had in fact died as a result of waiting for medical services. Stories of the deaths and of residents traveling to the U.S. for medical care dominated Canadian news coverage." But the Canadian government then "poured billions of dollars into reducing wait times in the five medical areas deemed most troublesome, including cancer care, cardiac care and joint replacement surgery. And wait times for these services has dropped."

"Keith Neuman of Environics, a long-standing Canadian polling group, says 'It's not something that everybody is completely satisfied with or complacent about. There are concerns about waiting and that sort of thing. But... the vast majority think the system's pretty good.' At the same time, he says, about half of Canadians say they would like the option to buy a private health insurance plan. Currently, that's not allowed" (Varney, 8/10).

ABC News reports that at a press conference with Canadian Prime Minister Stephen Harper and Mexican President Felipe Calderon, "President Obama defended Canada's health care system as one that works for them, not the U.S. and pushed back against critics who attempt to use Canada's health care system as a boogeyman to scare those away from his calls for reform" (Miller, 8/10).