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Canadian health care — it's their right

In contrast to the US, where health care is a commodity, Canada has, so far, treated it like a human right.

Canada's prime minister, Stephen Harper, takes questions from reporters about health care in Winnipeg in 2005, when he was leader of the Conservative Party of Canada. Behind him is paraplegic Member of Parliament Steven Fletcher. Pressure to widen the private sector’s role in delivering medical services is increasing in Canada. (J.P. Moczulski/Reuters)

TORONTO, Canada – It’s a bit of a sport in Canada to watch Americans at war with themselves.

There’s nothing malicious about it: We’re a generally bored and inward-looking bunch, so when our neighbors unleash another full-blown clash over ideology, we’re grateful for the distraction and the front row seat.

Pure entertainment value is part of the attraction — like the congressman who, during a town hall meeting on health care reform, said he refrained from pissing on a protester’s leg for fear of wasting his urine, or Rush Limbaugh huffing and puffing about socialist hordes at the gates.

Laughs aside, the American tendency to treat policy debates as life and death struggles over “the American way of life” reminds many Canadians, rightly or wrongly, of how lucky they are to be living north of the border. It’s hard not to feel civically more evolved when, in some U.S. states, people can legally show up at presidential speeches sporting handguns or assault rifles.

U.S. culture wars, in other words, often reinforce Canada’s national identity.

The latest to have that effect is U.S. President Barack Obama’s attempt to extend health care coverage to the 47 million, mostly working Americans, who can’t afford private medical insurance.

The move has unleashed a ferocious defense of private insurance companies by Americans scandalized at the notion of the government providing its own health insurance as a competing alternative. For Canadians, the debate highlights a key difference between the two countries: In the U.S., health care is a commodity to be bought and sold for profit; in Canada, it’s considered a human right.

Canada’s publicly funded health insurance, known as Medicare, covers all residents. In other words, except for the taxes Canadians pay, the health care they receive is free. They’re also free to choose their family doctor and to get second opinions.

Under the 1984 Canada Health Act, the federal government transfers health funds to provinces — which have constitutional jurisdiction over health care — that meet certain conditions. The conditions include the need for provincial health insurance plans to be administered on a non-profit basis, to cover services provided by hospitals and doctors, to set the rate charged for those services and to maintain coverage when the resident of one province uses the medical services of another.

The federal government enforces the law by withholding funds if the conditions aren’t met. Still, the law leaves plenty of room for private enterprise, despite charges of “socialist” medicine by American opponents.

Canada’s “single-payer” public insurance system covers medically necessary interventions — including visits to the doctor, laboratory tests, surgeries and hospital stays. That accounts for 70 percent of all health expenditures. The rest — including dental work, eye care, cosmetic surgeries, prescription drugs and home care — is covered by private insurance or out-of-pocket expenditures for most Canadians.