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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.

A mish-mash of provincial laws makes it difficult for the private medical sector to expand. Some prevent doctors from billing more for services than the rate set by the government, others ban private insurance companies from covering the medically necessary services protected by the Canada Health Act.

But while hospitals are publicly funded, most are privately owned and run by a board of directors or religious institution. The difference with the U.S. is that they’re run on a not-for-profit basis. Stories of insurance companies cutting off customers in the middle of treatment, ostensibly for undisclosed previous conditions, are unheard of in Canada.

As for outcomes, here are some comparative statistics:

  •  The World Health Organization, in an assessment of the health care systems of 192 countries in 2000, ranked Canada 30th and the U.S. 37th.
  • In 2007, Canada spent 10 percent of its GDP on health care; the U.S. spent 16 percent, according to the Organization for Economic Cooperation and Development (OECD). Per capita, Canada spent $3,895 compared to $7,290 for the U.S. (Makes you wonder who the big spending socialists really are.)
  • Thirty-one percent of U.S. health expenditures go towards administrative costs. In Canada, it’s 16.7 percent, according to a study in the New England Journal of Medicine. In 2005, the OECD used a different calculation and arrived at 7.3 percent in the U.S. and 2.6 percent in Canada.
  • In 2007, 7 percent of Canadian adults with above average incomes and 18 percent with below average incomes, went without medical care due to costs, according to the OECD. In the U.S., medical costs prevented 25 percent of adults with above average incomes and 52 percent with below average incomes from getting care.
  • In 2006, life expectancy was 80.7 years in Canada and 78.1 years in the U.S. Canadians are as likely as Americans to survive heart attacks, breast cancer and childhood leukemia.
  • Infant mortality rates in 2006 were five deaths per 1,000 live births in Canada and 6.7 deaths in the U.S.
  • Obesity rates among adults are 15 percent in Canada and 34.3 percent in the U.S.
  • Sixty-five percent of Canadians view their health care system positively while only 31 percent of Americans view their own system that way, according to a cross-border poll in July by the Angus Reid firm.
  • Canada ranked 4th this year as the best place to live in the United Nation’s quality of life index for 182 rated countries. The U.S. ranked 13th.

Canada and the U.S., proportionately, have the same number of acute care hospital beds. The U.S., however, has more doctors per capita, more MRI units and more CT scanners.

The more serious concern in Canada is the length of time it takes to get medically necessary surgery. Since 2000, public anger forced governments to increase funding and make reducing wait times a priority. In Ontario, average wait times for general surgery is 99 days, for breast cancer surgery 33 days, for angioplasty 18 days and for a knee replacement 181 days. Still, pressure to widen the private sector’s role in delivering medical services is increasing. As a result, supporters of Medicare are keeping a close watch on Prime Minister Stephen Harper.

Critics say Harper has done little to defend Medicare in the face of gross misrepresentation of it south of the border. Some even question his commitment to it. In 2001, while head of the National Citizens Coalition, a staunchly conservative lobby group, Harper advised the western province of Alberta, which wanted more private medical care, to break away from the national program and set up an autonomous system.

Polls indicate Harper is on the verge of a majority government if his shaky minority one were to fall soon. If, as some fear, he opens the door to more private health care, American-style culture wars might be coming here.